Genito-urinary Flashcards

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1
Q

What drugs reduce the effect of oral contraceptives?

A
  • enzyme inducing drugs
  • anti-epileptics: carbamazepine or phenytoin
  • antibiotics: rifampicin and rifabutin
  • natural produces: St. John’s wort
  • they all increase the production of hepatic CYP450
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2
Q

Why prescribe HRT?

A
  • to treat symptoms of hot flushes/sweats, dyspareunia and osteoporosis
  • NOT for heart disease
  • examples: estradiol, Premarin, medroxygprogesterone acetate, norethisterone, levonorgestrel
  • given oral, transdermal, implant, trans vaginal, nasal
  • risk: venous thromboembolism, CVS disease, stroke
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3
Q

Mifepristone (RU486)

A
  • progesterone receptor antagonist
  • acts as anti-progesterone
  • used for pregnancy termination
  • prevents myometrium contractions
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4
Q

Clomiphene

A
  • SERMS
  • used for anovulation
  • competes wth oestrogen for ER binding
  • leads to ovulation production through increased production of anterior pituitary hormones
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5
Q

Tamoxifen

A
  • pro-drug
  • little affinity for estrogen receptor
  • metabolised in liver to active derivatives
  • varies for each woman because isoenzyme
  • active metablites competes with oestrogen binding to ER
  • SERM
  • in endometrium it is an ER agonist
  • in breast it is an ER antagonist
  • binding of the ER following tamoxifen treatment causes cells to arrest the cell cycle
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6
Q

Ulipristal aceatate

A
  • SPRM
  • used for emergency contraception by delaying ovulation
  • prevents LH surge
  • also effective for the treatment of uterine fibroids
  • has different effects dependent on the tissue
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