Lecture 3 Exam 5

Question 1

Estrogen (ethnyl estradiol) effect of FSH

Answer 1

suppresses FSH production, prevents dominant follicle and ovulation

Question 2

Effect of estrogen (ethnyl estradiol) on sex hormone binding globulin

Answer 2

Increases sex hormone binding globulin and increases binding of free androgens

Question 3

How does ethnyl estradiol improve acne

Answer 3

It increase binding of free androgens

Question 4

how does progestin inhibit ovulation

Answer 4

prevents LH surge

Question 5

effect of progestin on cervical mucus

Answer 5

thickens mucus (inhibits sperm penetration)

Question 6

Effect of progestin on motility of fallopian tube

Answer 6

(impair sperm/ova transport)

Question 7

effect of progestin on endometrium

Answer 7

impairs implantation

Question 8

3 components of progestin

Answer 8

progestational
androgenic
antiestrogenic

Question 9

progestational effects of progestin

Answer 9

prevents ovulation
lessens bleeding
desire high activity

Question 10

androgenic effects of progestin

Answer 10

acne
hirsutism
desire low activity

Question 11

antiestrogenic effects of progestin

Answer 11

androgenic side effects
desire lower activity.0

Question 12

highest androgenic activity drug

Answer 12

levonorgestrel

Question 13

highest progestational activity drug

Answer 13

levonorgestrel
desogestrel/etonogestrel

Question 14

What are some signs of not enough progestin

Answer 14

breakthrough bleeding late in the cycle
no withdrawal bleeding
heavy menses

Question 15

signs of too much progestin

Answer 15

acne
hirsutism
decreased sex
depression
increased appetite
increased sex drive
weight gain
less energy

Question 16

Common side effects of progestin

Answer 16

Acne worsening
hair growth in weird places
heavier periods

Question 17

drug name
Efficacy
hormone type
ROA
side effects
return of fertility

Of the Implant (nexplanon)

Answer 17

Nexplanon
>99% efficacy
only progestin
left in non-dominant arm for 3 years if inserted >5 days after start of period, use backup method for 7 days
side effects include- Acne, h/a, mood changes, bleeding
fertility returns within 6 weeks

Question 18

drug name
Efficacy
hormone type
ROA
side effects
return of fertility

of levonorgestrel IUD

Answer 18

99% efficacy
progestin only
left for 3-7 years
use backup method for 7 days after inseertion
side effects- uterine perforation, expulsion, infection

Question 19

Efficacy
hormone type
ROA
side effects
return of fertility

of depot medroxyprogesterone

Answer 19

94%
progestin only
15 weeks
weight gain, acne
delayed return of fertility

Question 20

serious side effects of COC

Answer 20

blood clots(estrogen related)

Question 21

What are some progestin only pills

Answer 21

Norethindrone (minipill)
Drosperinone

Question 22

Timing for norethindrone (mini pill)

Answer 22

within 3 hours everyday

Question 23

how long does it take for the mini pill to be effective

Answer 23

48 hours

Question 24

What to do for the minipill if more than 3 hours late

Answer 24

take ASAP and use backup for 2 days

Question 25

What to do if late for dose for COC

Answer 25

if 1 pill- take asap of 2 pills- take asap and next pill at usual time, use back up contraceptive for 7 days

Question 26

is minipill safe to breast feed?

Answer 26

yes

Question 27

return to fertility for minipill

Answer 27

Immediate

Question 28

number of placebo pills in norethindrone (minipill) vs drosperinone (slynD)

Answer 28

0 for mini 4 for drosperinone

Question 29

how long should backup be used for drosperinone and COC if started more than 5 days after period

Answer 29

7 days

Question 30

Name drugs for the monthly and annual vaginal ring. Difference is administration? hormone content?

Answer 30

annual- annovera monthly- nuvaring, eluring annual- left in place for 3 weeks and removed for 1, wash, reinsert monthly- 3 weeks and removed 1 week. both are progestin+estrogen

Question 31

what to do for the rings if removed for more than 3 hours

Answer 31

reinsert and use backup for 7 days

Question 32

What to do if ring was in for 3 weeks but less that 4 weeks

Answer 32

remove ring, put new ring in 7 days later

Question 33

What to do if ring was in for more than 4 weeks

Answer 33

Put in new ring immediately and use backup for 7 days

Question 34

Name 2 patch drugs hormone type strength How to apply

Answer 34

Xulane, Zafemy progestin & Estrogen 35 mcg estrogen/day (HIGH) Put on a new patch every week for 3 weeks, 1 week no patch

Question 35

What to do if patch was on for more than 9 dayys and off for 24 hrs

Answer 35

apply new patch and use backup for 7 days

Question 36

serious side effects of patch? why?

Answer 36

blood clots, due to more estrogen

Question 37

how many mcg of estrogen does the patch TWIRLA have

Answer 37

30 mcg (less than other patches)

Question 38

Serious side effects of estrogen

Answer 38

ACHES Abdominal pain chest pain headache eye problems swelling