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UROGENITAL > [PHARMA] CONTRACEPTION & FERTILITY > Flashcards

[PHARMA] CONTRACEPTION & FERTILITY Flashcards

1
Q

ethinyl estradiol
diethyl stilbosterol side effects(4)

A

1-nausea, breast tenderness, weight gain
2-endometrial hyperplasia
↑endo & breast cancer risk
3-HTN & thromboembolism
4-male= feminization, impotence, decreased libido, gynecomastia

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2
Q

adv effects of ethinyl estradiol & diethyl stilbosterol in MALES (4)

A

1-impotence
2-decreased libido
3-feminization
4-gynecomastia

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3
Q

Synthetic estrogens

A

ethinyl estradiol
diethyl stilbosterol

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4
Q

synthetic estrogens uses (2)

A

1-OC
2-HRT in
(a) 1ry hypogonadism
(b) postmenopause

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5
Q

effects of synthetic estrogens during the postmenopausal period (3)

A

1- ↓osteoporosis
2-↓menopausal symptoms
3- Cardioprotective: ↓LDL ↑HDL

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6
Q

synthetic progestins(3)

A

1-norethindrone
2-norgestrel
3-medroxyprogesterone

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7
Q

synthetic progestins uses (3)

A

1-hormonal contraception
2-dysmenorrhea
3-endometriosis

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8
Q

synthetic progestins adv effects (5)

A

1-irregular bleeding followed by amenorrhea
2-edema, HTN, weight gain
3-depression
4-↓HDL
5-acne, hirustism

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9
Q

ovulation inducing agents (5)

A

1-clomiphene
2-bromocriptine
3-gonadorelin
4-hCG
5-human menopausal gonadotropins

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10
Q

ergot alkaloids (2)

A

1-methylergometrine
2-methylergonovine

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11
Q

methylergometrine & methylergonovine advantages (3)

A

1-potent
2-prolonged sustained uterine contractions
3-less toxic

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12
Q

methylergometrine & methylergonovine CI

A

delivery inducers= fetal distress & mortality

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13
Q

DOC in postpartum Hg

A

ergot alkaloids

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14
Q

ergot alkaloids mechanism of action

A

mixed partial agonists at α adrenoreceptors & 5HT receptors

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15
Q

ergot alkaloids route

A

-oral
-parenteral IM
-intramyometrial

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16
Q

why are ergots not given IV

A

cause severe VC

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17
Q

ergot alkaloids uses (3)

A

1-postpartum Hg
2-after C-section & instrumental surgery= prevent uterine atony
3-subinvolution of uterus

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18
Q

ergots CI (3)

A

1-pregnancy
2-HTN patients
3-coronary artery disease

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19
Q

ergots adv effects (6)

A

1-vasospasm
2-palpitations
3-↑ BP
4-seizures
5-abdominal pain, nausea, vomiting
6-↓milk production w/ prolonged usage

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20
Q

oral contraceptives mechanism of action

A

1-(-) FSH & LH= (-) ovulation
2- change cervical mucous= thick & viscid
3-↓ endometrial glycogen= inhibits implanatation

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21
Q

combined OCs

A

most effective estrog+progest

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22
Q

minipills

A

progestin only
less reliable but no risk of thromoboembolism

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23
Q

parenteral progestin preparations

A

1-implants norgesterel—> 5 years
2-depot injection: medroxyprogesterone–> every 3 months

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24
Q

OCs indication

A

contraception
irregular cycle

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25
Q

minor risks of OCs (3)

A

1-nausea, vomiting, headache
2-breast tenderness
3-edema

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26
Q

intermediate risks of OCs (3)

A

1-bleeding (low dose)
2-amenorrhea (high dose)
3-acne, hirstusim, skin pigmentation

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27
Q

major risks of OCS (4)

A

1-CVS= thromboembolism, pulmonary embolism, MI, stroke, HTN
2-carcinogenic= ↑ breast & endo cancer
3-depression
4-cholecystitis, jaundice, gall stones

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28
Q

drug interactions of OCs

A

enzyme inducers:
rifampcin ↓ efficacy of OC

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29
Q

increased risk of cervical & breast cancer caused by OCs can be ↓ by

A

adding progestins

30
Q

clomiphene mechanism of action

A

partial agonist
(-) central estrogen receptors in hypothalamus
(-) feedback inhibition of FSHRH & LHRH
(+) ovulation & corpus luteum formation

31
Q

clomiphene route

A

oral

32
Q

clomiphene uses (2)

A

1-female infertility (ovulation disorders)
2-IVF w/ gonadotropins

33
Q

IVF drugs (3)

A

1-clomiphene
2-GnRH
3-hCG

34
Q

clomiphene adv effects (3)

A

1-hot flushes
2-multiple pregnancies
3-ovary overstimulation

35
Q

tamoxifen uses

A

TTT of hormone-sensitive breast cancer

36
Q

tamoxifen mechanism of action

A

selective estrogen receptor modulator (SERM) peripherally
ANTAGONIST–> Breast= (-) endogenous estrogen from activating receptors in estrogen sensitive cancer

AGONIST–> bone= increase density (-)osteoporosis in pt w/ breast cancer
uterus=↑ endo cancer risk

37
Q

tamoxifen adv effects (3)

A

1-hot flushes
2-vaginal discharge
3-menstrual irregularity

38
Q

raloxifen mechanism of action

A

SERM partial agonist
similar to estrogen on bone but NOT ON breast/uterus= no cancer risk

39
Q

raloxifen uses

A

TTT of osteoporosis

40
Q

drug causing ovary overstimulation

A

clomiphene

41
Q

drugs reducing milk production

A

ergot alkaloids

42
Q

acts centrally

A

clomiphene

43
Q

acts peripherally

A

tamoxifen

44
Q

treats osteoporosis

A

raloxifen

45
Q

↑ risk of endometrial cancer

A

1-synthetic estrogens
2-tamoxifen

46
Q

↑risk of cervical & breast cancer

A

combined OC

47
Q

decrease risk of breast cancer

A

tamoxifen

48
Q

used to induce abortion in case of intrauterine fetal death

A

mifepristone

49
Q

raloxifene side effects

A

1-hot flushes, sweating
2-leg spasms

50
Q

raloxifene CI

A

venous thromboembolism

51
Q

combined OC CI

A

liver disease

52
Q

contraindicated in coronary artery disease

A

ergots

53
Q

contraindicated in venous thromboembolism

A

raloxifene

54
Q

contraindicated in pregnancy & HTN patients

A

ergots

55
Q

antiprogestin

A

mifepristone

56
Q

mifepristone mechanism of action

A

competitive inhibitor of progesterone & glucocorticoids receptors

57
Q

mifepristone use

A

therapeutic abortion

58
Q

GnRH

A

1-gonadorelin
2-leuprolide
3-nafarelin

59
Q

use of GnRH given in pulses

A

infertility= ↑gonadotropins= (+) ovulation

60
Q

use of GnRH given continuously (3)

A

↓ gonadotropins:
1-cancer prostate
2-endometriosis
3-IVF

61
Q

GnRH adv effects (3)

A

1-hot flushes, headache, depression
2-vaginal dryness, ovarian cyst, ↓libido
3-osteoporosis

62
Q

GnRH anatogonist

A

ganirelix

63
Q

ganirelix uses

A

1-controlled ovarian hyperstimulation ( inhibit LH surge)
2-advanced prostatic cancer

64
Q

gonadotropins FSH, LH uses

A

1-(+) spermatogenesis + testosterone
2-(+) ovulation & ER/PR

65
Q

drugs used in prostatic cancer

A

GnRH
ganirelix

66
Q

hMG (3)

A

menotropins (FSH+LH)
urofollitropin (FSH) follitropin
r-FSH

67
Q

hcG similar to

A

LH

68
Q

hcG uses (3)

A

1-infertility–>IVF
2-undescended testis
3-1ry or 2ry amenorrhea dt ↓gonadotropins

69
Q

gonadotropins adv effects (4)

A

1-hyperstimulation $
2-multiple births
3-spontaneous abortions
4-gynecomastia in males

70
Q

pulsatile GnRH route

A

SC

71
Q

hcG route

A

parenteral

UROGENITAL (22 decks)

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