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week 53 > Leffler > Flashcards

Leffler Flashcards

1
Q

Primary causes of Female Infertility

A
  • Ovulation disorders- 35%
    • affects Ovaries
    • hormone imbalances
    • eating disorders
  • Tubal Obstruction- 35%
    • affects Fallopian Tubues
    • PID
    • chlamydia
    • appendicitis
    • emdometritis
    • Peritonitis
  • Endometriosis-20%
    • affects Uterus
    • Age
    • Genetics
    • Toxins
  • Idiopathic-10%
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2
Q

Gonadotropins

A

Hormones secrted by gonadotrope cells in pituitary

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3
Q

Drugs for ovulation disorders

A
  1. FSH
  2. LH
  3. Menotropins (AKA Human Menopausal Gonadotropin; HMG)
  4. Human Chorionic Gonadotropin (HCG)
  5. Clomiphene
  6. Gonadotropin Releasing Hormone (GnRH) Agonists & Antagonists
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4
Q

What is FSH?

A
  • Hormone made and released by gonadotropes in pituitary
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5
Q

What does FSH do?

A
  • Stimulates germ cells in:
    • females-ovarian follicles
    • males-sertoli cells
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6
Q

FSH unique features

A
  • secreted in pulses
  • works synergistically w/LH to regulate reproduction
  • increased in peri/postmenopausal women
  • FSH release regulated by GnRH
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7
Q

FSH: Drug preparations

A
  • Urofollitropin
    • purified from urine of PM women with LH
  • Follitropin alpha & beta
    • recombinant FSh without LH
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8
Q

What is LH?

A
  • hormone
  • made and released by gonadotropes in the pituitary gland
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9
Q

What does LH do?

A
  • LH surge triggers ovulation
  • secreted in pulses
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10
Q

LH Unique Features

A
  • works synergistically w/FSH to regulate reproduction
  • increased in peri/postmenopausal women
  • LH release regulated by GnRH
  • LH levels are measure in “ovulation prediction kits” to help couples conceive
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11
Q

LH: Drug preparations

A
  • Lutropin
    • recombinant LH
    • administed IM
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12
Q

What is Menotropin?

A
  • Human Menopausal Gonadotropin; HMG
  • Gonadotropin mixture of FSH and LH
  • Hormonally active medication to treat infertility
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13
Q

What does Menotropin do?

A
  • stimulates the ovaries to mature ovarian follicles
    • increase fertility
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14
Q

Menotropin Unique Features

A
  • extracted from the urine of postmenopausal women
  • can be given to men to stimulate sperm production
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15
Q

Menotropin Drug Preparations

A
  • Pergonal
  • Repronex
  • Administered IM daily
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16
Q

What is hCG

A
  • hormone
  • made by part of the fertilized egg (syncytiotrophoblast) after conception
  • analog of LH
17
Q

what does hCG do?

A
  • LH-like activity
    • some FSH-like activity
  • sitmulates ovulation
  • helps uterus to thicken
  • maintain growing fetus during pregnancy
18
Q

hCG unique features

A
  • Synthesized by the placenta–>POST contraception hormone
  • major side effects:
    • multiple births
19
Q

hCG drug preparations

A
  • Pregnyl
    • administered IM or SQ
20
Q

What is Clomiphene?

A
  • Antagonist
  • binds to estrogen (E2) receptors in the hypothalamus
21
Q

What does Clomiphene do?

A
  • Increases LH & FSH release by inhibiting estrogen receptors at the hypothalamus
22
Q

Clomiphene unique features

A
  • major side effects:
    • multiple births
    • hot flashes
    • visual disturbances
23
Q

Clomiphene drug preparations

A
  • Clomid
    • adminstered: PO
24
Q

What are GnRH Agonists?

A
  • Synthetic 10 amino acid peptide
25
Q

What does GnRH agonists do?

A
  • regulates LH & FSH release
26
Q

GnRH agonists unique features

A
  • Admin:
    • Pulse
      • Increase LH & FSH
    • Continuous
      • Decrease LH & FSH
27
Q

GnRH Agonist Drug Prepartions:

A
  • Drugs:
    • Leuprolide
    • Gonadorelin
    • Histerelin
    • Triptorelin
    • Nafarelin
    • Goserelin
  • Administered: IM, SQ
  • They are synthetic GnRH agonists, so they. act like natural GnRH
28
Q

What are GnRH Antagonists?

A
  • Synthetic 10 amino acid peptide structurally similar to GnRH
29
Q

What does GnRH antagonists do?

A
  • Decrease LH & FSH release by blocking GnRH receptors
30
Q

GnRH Antagonists:

A
  • Major side effects:
    • headache
    • injection site reactions
    • hot flashes
    • weight gain
    • fatigue
    • increased hepatic transaminases
31
Q

GnRH Antagonist Drug Preparations:

A
  • Drugs: -relix
    • Cetrorelix
    • Ganirelix
    • Degarelix
  • Administered SQ
32
Q

Drugs for Endometriosis

A
  1. GnRH Agonists
  2. GnRH Antagonists
  3. Danazol
33
Q

What is Danazol

A
  • synethetic steroid w/weak androgen activity
34
Q

What does Danazol do?

A
  • Suppresses ovarian function by inhibiting LH & FSH surge
35
Q

Danazol unique features

A
  • therapy initiated during menstruation
  • must be continued for 3-6 months without interuption
  • major side effects:
    • elevated liver enzymes
    • jaundic
    • masculinizaiton
36
Q

Danazol Drug preparations

A
  • Danocrine
  • Administered: PO

week 53 (9 decks)

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