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Endocrine > Female repro pharm > Flashcards

Female repro pharm Flashcards

1
Q

general adverse effects of progestins

A

Headache

breakthrough bleeding

androgenic actions, acne hirsuitism

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2
Q

decreases estrogen driven endometrial proliferation and leads to development of secondary endometrium

A

progesterone

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2
Q

contraindications estrogens

A

pregnancy

estrogen dependent cancers

undiagnosed uterine bleeding

thromboembolic disorders

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2
Q

spironolactone analogue

indications and side effects

A

Drospirenone

indications: pregnancy prevention, PMDD, moderate acne vulgaris

side effects - antimineralcorticoid activity

K should be monitored for hyperkalemia

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2
Q

therapuetic uses for progestins

A

Hormonal contraceptives

Post menopause hormone replacement (only with estrogen)

diagnosis of secondary amenorrhea

endometrial hyperplasia

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3
Q

progesterone analog, (injected+oral)

A

medroxprogesterone

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4
Q

natural estrogens

A

17b estradiol

estrone

estriol

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6
Q

progesterone binds what in plasma

A

corticosteroid binding globulin

albumin

some progestins bind SHBG

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7
Q

anti estrogen that inhibits action of strong estrogens via inhibition of feedback (pituitary hypothalamus) thus increasing pulsitile gonadotropin release amplitude

A

Clomiphene

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7
Q

mechanism and indication Raloxifene

side effects

A

SERM estrogen agonist in bone

Use: reudce rate of bone loss (osteopororsis prophylaxis) risk reduction for invasive breast cancer

side effects: (estrogenic) reduces total cholesterol, hot flashes, increases thrombosis, leg cramps (does NOT cause endometrial thickening as Tamoxifene)

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8
Q

therapeutic approaches for postmenopausal replacement

A

estrogen/progetin combo (intact uterus)

estrogen only (post hysterectomy)

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9
Q

Clomiphene mechanism

A

inhibits action of strong estrogens via inhibition of feedback at pituitary and hypothalamus

causes increase in GnRH pulse amplitude

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11
Q

phsyiological effects of estrogen on endometrium

A

enhance cervical mucus and increases water content

promotes endometrial proliferation

increases tubule contractility favoring rhythmic contractions of myometrium

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12
Q

indication, mechanism, side effects ulipristal

A

Emergency contraception

selective progesterone receptor mdoulator > inhibits LH release > inhibits LH induced folliculr rupture in ovary when taken 5 days after intercourse (inhibits ovulation)

side effects - headache, abd pain

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13
Q

synthetic estrogens

A

ehtinyl estradiol

mestranol

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14
Q

decreases the frequency of GnRH pulses, critical for suppressing gonadotropin release

A

progesterone

16
Q

estrogen skeletal effects

A

skeletal maturation

epiphyseal plate closure

postive effects on bone mass

17
Q

adverse effects estrogens

A

Gall bladder disease (due to increase cholesterol content in bile)

oral estrogens increase risk of thromboembolic disease

nausea and vomiting on initial use

breast swelling

migrane headaches

18
Q

SERMS

A

Tamoxifen

Raloxifene

18
Q

Alternatives to estrogen for the treatment of osteoporosis

A

raloxifene

alendronate (bisphosphonate)

20
Q

progesterone derivative, etyinyl substituent at C17 slows hepatic metabolism to reduce firsts pass

progesterone derivative, racemic mixture, 13 ethyl subtituent results in potent progestin with less androgenic activity

A

norethindrone

Norgestrel

22
Q

therapeutic uses of estrogens

A

combination oral contraceptives

post-menopause hormone replacement therapy

failure of pituitary function and and ovarian development

23
Q

half life progesterone

A

minutes

24
Q

relative strength of natural estrogens

A

estradiol > estrone > estriol

25
Q

Tamoxifen mechanism and idication

side effects

A

SERM: mixed estrogenic and anti estrogenic effects (esp breast)

use: treatment and preventionof breast cancer (ER positive)

side effects (estrogenic) hot flashes, endometrial poliferation (risk of endometrial cancer)

increased thromboembolic disease

antiresoptive effect on bone

26
Q

emergency contraceptive regimens

A

Levonorgeestrel + ethinyl estradiol (2 doses)

Levonorgesrel alone (2 doses)

Ulipristal

27
Q

Aromatase inhibitors, specific mechanism, indication and side effects

A

Letrozole+Anastrozole: non steroidal reversible inhibitors of aromatase (reduce T>estradiol, Androstenedion>Estrone)

Exemestane: suicide inhibitor

use: treat breast cancer, ovulation induction (off-label)

side effects: hot flashes

28
Q

inidcation, mechanism Mfepristone (Ru-486)

side effects

A

abortifacient

competitive progesterone receptor modulator (mainly antagonist)

competitively binds receptor, causing decidual breakdown leading to placental detachment.

snetizies myometrium to contractile actions of prostaglandins for expulsion

vaginal bleeding

Endocrine (45 decks)

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