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Kaplan High yield: Reproductive > Female reproductive pharmacology > Flashcards

Female reproductive pharmacology Flashcards

1
Q

What is the MOA for estrogens and progestins?

A

suppress FSH and LH to inhibit ovulation and alteration of cervical mucus in endometrium

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2
Q

What are commonly used estrogens?

A

ethinyl estradiol;

mestranol

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3
Q

Commonly used progestins?

A

norgestrel;
norethindrone
medroxyprogesterone

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4
Q

How are the estrogens and progestins available?

A

orally as monophasic, biphasic or triphasic combos;

some progestin only preparations

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5
Q

What are common side effects of estrogen and progestins?

A 
headache, nausea;
breast tenderness;
weight gain; 
depression;
thromboembolism
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6
Q

What are absolute contraindications of estrogens and progestins?

A

thrombophlebitis; thromboembolic disorders;
cerebral vascular disease; coronary occlusion;
possible pregnancy;
smoking over 35;
impaired liver function;
possible breast cancer

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7
Q

What are off label uses of estrogens and progestins?

A

female hypogonadism; HRT; acne; dysmenorrhea; uterine bleeding

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8
Q

Why use postcoital contraceptives?

A

prevents pregnancy if used w/in 72 hours of unprotected intercourse

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9
Q

What are postcoital contraceptive types?

A

estrogens alone; progestins alone; combination pills;

mifepristone (RU486)

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10
Q

What are intauterine devices?

A

create hostile environment in endometrium via low grade intrauterine inflammation and increased PG formation => interfere w/ implantation of fertilized ovum

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11
Q

What are examples of intrauterine devices?

A

Copper T 380;

Progesterone T

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12
Q

Define menopause

A

permanent cessation of menstruation secondary to loss of ovarian follicular activity

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13
Q

What is used to treat menopause?

A

HRT

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14
Q

What effects of menopause is HRT used to treat?

A

prevent hot flashes; atrophic changes in UG tract; osteoporosis

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15
Q

If estrogen replacement therapy is used alone, what is the risk? What might be use to mitigate the risk?

A

endometrial growth and cancer;

concomitant progesterone use to prevent

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16
Q

Why is HRT no longer widely used?

A

associated with increased breast cancer and stroke risk

17
Q

What are selective estrogen receptor modulators (SERM)?

A

Tamoxifen;

Raloxifene

18
Q

What is the MOA of tamoxifen?

A

estrogen ANTAGONIST in breast;
estrogen agonist in endometrium;
estrogen agonist in bone

19
Q

When is tamoxifen used?

A

hormone responsive breast CA;

reduces risk of breast CA in high risk women

20
Q

What are side effects of tamoxifen?

A

increases risk for endometrial CA;
hot flashes;
increase risk of venous thrombosis

21
Q

What is the MOA for Raloxifene?

A

partial estrogen agonist in bone;
estrogen ANTAGONIST in breast;
estrogen ANTAGONIST in uterus

22
Q

Why is raloxifene used?

A

prevents osteoporosis in post menopausal women;
reduces risk of breast CA in high risk women;
NO INCREASED ENDOMETRIAL CA RISK

23
Q

What are side effects of raloxifene?

A

causes hot flashes and increases risk of venous thrombosis

24
Q

MOA of Clomiphene

A

fertility agent => nonsteroidal agent selectively blocks estrogen receptos in pituitary, reducing neg feedback mech increasing FSH and LH and stimulation of ovulation

25
Q

Patient comes to your clinic looking to get pregnant. What medication would you give her and what side effects are associated?

A

Clomiphene = multiple birth pregnancy

26
Q

MOA for danazol

A

inhibits ovarian steroid synthesis

27
Q

Clinical use for danazol

A

endometriosis;

fibrocystic breast disease

28
Q

MOA for anastrozole and exemestane

A

aromatase inhibitors => decrease estrogen synthesis

29
Q

clinical use for anastrozole and exemestane

A

breast CA in post-menopausal women

30
Q

MOA of mifepristone (RU486)

A

progesterone and glucocorticoid antagonist

31
Q

clinical use for mifepristone

A

postcoital contraceptive;

abortifacient

32
Q

MOA of dinoprostone

A

PGE2 analog

33
Q

clinica uses for dinoprostone

A

induce labor => causes cervical ripening and uterine contractions;
abortifacient

34
Q

MOA for Ritodrine and Terbutaline

A

Beta 2 agonists

35
Q

clinical uses for Ritodrine and Terbutaline

A

relax uterus => suppress premature labor

Kaplan High yield: Reproductive (18 decks)

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