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S4M3 > Pharmacology of Female Reproductive System > Flashcards

Pharmacology of Female Reproductive System Flashcards

1
Q

What is Endometriosis?

A

Characterized by dysmenorrhea, dyspareunia, dysuria, pain during defecation and infertility

Goal of treatment is to decrease pain and induce regression/ control further growth of ectopic endometrial tissue

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2
Q

What drugs can be used for endometriosis?

A
  1. Combined oral contraceptives
  2. Progestin
  3. GnRH agonists
  4. Anastrozole
  5. Danazol
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3
Q

How do combined oral contraceptives help with endometriosis? MOA?

A

reduce pain by decreasing mestrual flow and regressing endometrial growth

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4
Q

What are the adverse effects of combined oral contraceptives?

A

Nausea, bloating, headache

C/I in women with history of thromboembolism

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5
Q

What is the MOA of Progestin?

A

Induce atrophy of endometrial tissue

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6
Q

What are the adverse effects of progestin?

A

Breakthrough bleeding, weight gain, fluid rentention and mood swings

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7
Q

Mechanism of action for Goserelin, leuprolide and nafarelin?

A

inhibit ovarian estrogen production-> estrogen deprivation diminishes endometrial implants

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8
Q

What are the adverse effects of goserelin, leuprolide, and nafarelin?

A

Bone loss -> prevented with Bisphosphonates

and vasomotor symptoms

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9
Q

What is the MOA of Anastrozole?

A

competitive inhibitor of aromatase activity

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10
Q

Adverse Effects of Anastozole?

A

arthralgia, diarrhea and osteoporosis

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11
Q

What is the MOA of Danazol?

A

synthetic derivative of 17 ethinyltestosterone

results in decrease FSH and LH

induces anovulation, amenorrhea and endometrial atrophy

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12
Q

What are the adverse effects of Danazol?

A

acne, hirsutism, occasional irreversible virilization,

menstrual irregularities, decreased breast size,

hepatotoxic and thromboembolism

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13
Q

What is Polycystic Ovarian Syndrome?

A

characterized by menstrual irregularities, amenorrhea or anovulation, hirsutism, acne and infertility

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14
Q

What medications can be used for Polycystic Ovarian Syndrome?

A
  1. Combined oral contraceptives
  2. Spironolactone
  3. Finasteride, flutamide
  4. GnRH agonist
  5. Clomiphene
  6. Metformin
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15
Q

How do combined oral contraceptives help polycystic ovarian syndrome? MOA?

A

decrease serum testosterone levels by decreasing ovarian androgen secretion and stimulating hepatic synthesis of sex hormone binding globulin SHGB

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16
Q

What is the MOA of spironolactone?

A

aldosterone receptor antagonist

weak inhibitor of testosterone synthesis also 5 alpha reductase

17
Q

what is the MOA of finasteride and flutamide

A

anti androgen agents

also inhibts 5 alpha reductase and androgen R inhibitor

18
Q

What is the MOA of GnRH agonists fo PCOS?

A

suppress ovarian androgen and estrogen synthesis

19
Q

What is the MOA of Clomiphene citrate?

A

Ovulation inducer: blocks estrogen receptors in the hypothalamus and anterior pituitary inhibits estradiols negative feedback increase FSH and LH

20
Q

What is the adverse effect of clomiphene citrate?

A

ovarian hyperstimulation increase incidence with multiple births ovarian cysts and hot flashes

21
Q

What is the MOA of metformin?

A

corrects hyperinsulinemia in PCOS and may promote ovulation

22
Q

What is menopause?

A

characterized by symptoms of estrogen deficiency (hot flashes, chills, sweating, headache, palpitations, vaginal and urethral atrophy, osteoporosis, cardiovascular changes)

23
Q

What is the treatment for menopause ? and what is its MOA?

A

Post menopausal Hormonal Replacement Therapy

oral, transdermal and vaginal

lowest dose of estrogen for limited period of time

**can use bisphosphonates for bone loss

Hot flashes are the most common indication of short course of HRT

with intact uterus should take estrogen +progestin

24
Q

what are the adverse effects of post menopausal hormonal replacement therapy

A

estogen only replacement can cause endometrial carcinoma

vasomotor symptoms can be relieved by clonidine

25
Q

What are uterine leiomyomas?

A

fibroids, myomas

symptoms include: irregular excessive bleeding, pressure, pain during intercourse, pelvic pain, recurrent pregnancy loss, infertility, may be asymptomatic

surgery is the definitive treatment

reproductive years and regress after menopause

26
Q

What are the medications for uterine leiomyomas?

A
  1. GnRH agonists
  2. Levonorgestrel
  3. Mifepristone
27
Q

How does GnRH agonists help uterine leiomyomas?

A

significant reduction (35-60%) in uterine size within 3 months

28
Q

What are the adverse effects of GnRH agonists?

A

hot flashes, sleep distrubances, vaginal dryness, myalgias, arthralgias, bone loss, impairment of mood cognition

29
Q

What are the MOA of Levonorgestrel?

A

reduction in uterine volume and bleeding and increase in hematocrit

30
Q

What is the MOA of mifepristone?

A

anti progesterone

31
Q
A

S4M3 (5 decks)

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