Repro Flashcards
Oestrogen
- actions
- side effects
Actions:
- mild anabolic
- sodium and water retention
- raises HDL, lowers LDL
- decrease bone resorption
- impaired glucose tolerance
- increase blood coaguability
Side effects:
- water retention
- nausea, vomiting
- thromboembolism
- imapaired glucose tolerance
- increase blood coaguability
- breast tenderness
- endometrial + breast hyperplasia and cancer
- ovarian metaplasia and cancer
Progesterone
- actions
- side effects
Actions:
- anabolic
- fluid retention
- increase bone mineral density
- secreteroy endometrium
- mood changes
- maintains pregnancy
Side effects:
- anabolic
- fluid retention
- nausea/vomiting
- acne
- weight gain
- irritability, depression, PMS
- lack of concentration
Testosterone
- actions/side effects
- anabolic
- male secondary sexual characterstics
- acne
- voice changes
- agression
- decrease HDL-C/LDL-C (increase atherosclerotic risk)
Alendronic acid
Indication: osteoporosis, pagets disease, malignancy
Class: bisphosphonates
Actions: control osteoclast activity - reduce bone turnover
Adverse effects:
- oesophagitis (remain upright for 30 mins after)
- hypocalcaemia (check ca and vit D levels before)
Other:
- long half life
- poor gut absoprtion
Must take first thing in the morning. Empty stomach. Stay standing/sitting 30 mins after
Mifepristone
Indication: termination of pregnancy
Class: progesterone (and glucocorticoid) receptor antagonist
Actions: sensitises the myometrium to prostaglandin-induced contracions
Finasteride
Indication: BPH
Class: 5-alpha reductase inhibitor
Actions: prevent conversion of testosterone to dihydrotestosterone
Side effects: sexual dysfunction
Other: 3-6 months untill benefits
Clomiphene
Indication: anovulation
Class: SERM
Action:
- competes with oestrogen for ER binding
- increased production of anterior pituitary hormones
- leads to ovulation induction
Raloxifene
Indication: osteoporosis
Class: SERM
Action: bone specific
Tamoxifen
Indication: breast cancer
Class: SERM
Action:
- active metabolites compete with oestrogen for binding to the ER
- causes cells to arrest in the cell cycle
Adverse effects: in endometrium acts as an ER agonist - increased risk of endometrial hyperplasia/cancer
Other:
- pro drug therefore metabolised in the liver to active derivatives
- genetic differences in enzymes in the liver means tamoxifen is not metbaolised and therefore not active in some people
Ulipristal acetate
Indication: emergency contraception, uterine fibroids
Class: SPRM
Action: delay/inhibit ovulation
