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Obgyn > Pharmacology 3 > Flashcards

Pharmacology 3 Flashcards

1
Q

Estrogen digunakan dalam?

A
  1. Replacement therapy (Menopause)
  2. Oncology
  3. Contraceptives
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2
Q

Estrogen paling banyak diproduksi oleh?

A

Sel theca interna dan Sel granulosa

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3
Q

Estrogen sintetis steroidal

A

Ethinyl estradiol, Mestranol, Tibolone

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4
Q

Estrogen sintetis non-steroidal

A

Diethinylstilbestrol, hexestrol, dienestrol

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5
Q

Ciri estrogen natural

A

Inactive orally, short duration, rapid metabolism

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6
Q

Jumlah sekresi estrogen harian, saat kehamilan, dan post menopause

A

10-100 mcg
30 mg
2-10 mcg

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7
Q

Efek farmakologis estrogen pada tulang

A
  1. maintaining massa tulang

2. ekspresi protein tulang

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8
Q

Mechanism of action estrogen

A
  1. Masuk ke sel target (ER alfa dan ER beta) dengan binding pada reseptor sitosolik spesifik
  2. Dimerisasi
  3. Translokasi ke nukleus
  4. Ekspresi gen
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9
Q

Farmakokinetik estrogen

A
  • Absorbsi : Oral, transdermal
  • Metabolisme cepat
  • Terikat protein plasma
  • Terkonjugasi asam glucoronic dan sulfat
  • Ekskresi di urin
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10
Q

Side effects of estrogen

A
  1. Supresi libido
  2. Gynecomastia, feminisasi pada pria
  3. Fusi epifisis
  4. Carcinoma cervix (Stilbestrol)
  5. Irregular bleeding - Carcinoma endometrial
  6. Growth of Breast cancer
  7. Gallstones, hepatoma
  8. Migraine, epilepsy, endometriosis
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11
Q

Farmakoterapi apa yang digunakan pada menopause

A

Estrogen 0,625 mg/hari

Progestin 2,5 mg/hari

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12
Q

Indikasi estrogen

A
  1. Post hysterectomy
  2. Premature menopause
  3. Cyclical HRT
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13
Q

Ciri dan indikasi tibolone

A

Indikasi : HRT

Dosis : 2,5 mg

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14
Q

Fertility pill

A

Clomiphene citrate (antiestrogen)

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15
Q

MOA Clomiphene citrate

A

Induksi sekresi Gn dengan menghalangi feedback inhibisi estrogen sehingga meningkatkan sekresi FSH/LH

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16
Q

Indikasi antiestrogen

A

Unexplained infertiliy, anovulatory infertility, oligospermia, inseminasi buatan

17
Q

Farmakoterapi pada infertilitas

A

Clomiphene citrate 50 mg/hari dari hari 5 selama 5 hari
selama 2-3 siklus
konsepsi insyaallah siklus ke 4-6

18
Q

Efek samping antiestrogen

A

Polycystic ovary, gastric upset, hot flushes, vertigo, dermatitis alergi

19
Q

MOA dari SERM (Tamoxifen)

A

Stimulasi proliferasi endometrial dan menurunkan Gn dan Prolactin, menurunkan LDL, meningkatkan massa tulang

20
Q

Farmakoterapi Karsinoma payudara dan post menopause

A

Tamoxifen 10-20 mg 2 kali/hari

21
Q

MOA Raloxifene

A

Sama seperti Tamoxifene tapi Agonis parsial pada payudara dan endometrium

22
Q

Farmakoterapi osteoporosis pada menopause

A

Raloxifene

23
Q

Farmakoterapi pada dysfunctional vaginal bleeding

A

Ormeloxifene

24
Q

Obat-obatan Aromatase inhibitor

A

Letrozole, Anastrozole, Exemestene

25
Q

MOA dari Letrozole

A

Reverse inhibition dari aromatisasi, supresi proliferasi estrogen

26
Q

Derivat-derivat progesterone

A

Medroxyprogesterone acetate
Megestrol acetate
Dydrogesterone
Levonorgestrel

27
Q

MOA Progestin

A

Interaksi dengan PR, mimic efek stimulasi progesterone, menurunkan proliferasi endometrial

28
Q

Indikasi Progestin

A
  1. Kontrasepsi oral
  2. Uterine bleeding disorder
  3. Premature labor
  4. HRT
  5. Endometriosis
  6. Premenstrual syndrome
  7. Endometrial carcinoma
  8. Stimulasi appetite pada AIDS dan cancer
29
Q

Efek samping Progestrin

A

Mild nausea, mastalgia, bleeding, edema, headache, weight gain, vaginal infection, amenorrhea, thromboembolism

30
Q

Indikasi Anti progesterone Mifepristone

A
  1. Terminasi kehamilan pada trimester pertama bersama dengan prostaglandin
  2. Induksi persalinan pada IUFD
  3. Endometriosis
31
Q

MOA Mifepristone

A

Mempromosi shedding endometrium, softening cervix, dan kontraksi uterus sehingga terjadi abortus spontan

32
Q

Obat-obatan yang sering digunakan dengan Mifepristone

A

Misoprostol dan Prostaglandin

33
Q

Efek samping Mifepristone/Misoprostol

A
  1. Menstrual cramp
  2. Perdarahan vagina (9-13 hari)
  3. Nausea, vomiting, diare, headache
34
Q

Kontraindikasi Mifepristone/Misoprostol

A
  1. Kehamilan ektopik
  2. Alergi
  3. IUD
  4. Penggunaan Kortikosteroid lama
  5. Penggunaan antikoagulan

Obgyn (25 decks)

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