Repro Pharmacology Flashcards
Theoretical efficacy vs. actual efficacy with contraceptive use:
Theoretical efficacy is the effectiveness of contraception if used perfectly
Actual efficacy is the typical use of contraception that involves human error and other factors
A “combined oral contraceptive” means that it contains _ + _
A “combined oral contraceptive” means that it contains synthetic estrogen + synthetic progesterone
Of the following, synthetic estrogen helps to prevent (maturation/ ovulation/ fertilization/ implantation)
Of the following, synthetic estrogen helps to prevent maturation and ovulation
* Via negative feedback on GnRH release and LH/FSH release
Of the following, synthetic progesterone helps to prevent (maturation/ ovulation/ fertilization/ implantation)
Of the following, synthetic progesterone helps to prevent ovulation, fertilization, implantation
Extended cycle combined OCP means _
Extended cycle combined OCP means 3 cycles skipping 2 menses
Estrogen containing OCPs are contraindicated for patients with…
Estrogen containing OCPs are contraindicated for patients with…
* Thromboembolic disorders
* History of CAD
* History of stroke
* History of breast or liver cancer
* HTN
* Smoker > 35 years
* Age > 45
* Gallbladder disease
Estrogens promote the expression of clotting proteins like _ and inhibit the expression of anti-clotting proteins like _
Estrogens promote the expression of clotting proteins like fibrinogen, VII, X and inhibit the expression of anti-clotting proteins like anti-thrombin
Estrogens and progestins can promote the growth of _ and _ cancers
Estrogens and progestins can promote the growth of breast and liver cancers
Emergency contraception like Plan B uses _ to delay ovulation
Emergency contraception like Plan B uses progestin to delay ovulation
Emergency contraception like Plan B is most effective if taken during _ phase of menstrual cycle
Emergency contraception like Plan B is most effective if taken during pre-ovulatory phase because it works to prevent implantation
Leuprolide and _ are both GnRH analogs
Leuprolide and Goserelin are both GnRH analogs
Goserelin and Leuprolide can have two different function depending on how they are administered; explain
If given in pulsatile manner: function as GnRH agonists
If given continuously: function as GnRH antagonists because of downregulation of pituitary receptors
Leuprolide drug target is found in the _
Leuprolide drug target is found in the anterior pituitary (GnRH receptors)
Name some clinical uses of leuprolide:
Name some clinical uses of leuprolide: leuprolide is used in lieu of GnRH
* Uterine fibroids
* Endometriosis
* Precocious puberty
* Prostate cancer
* Infertility
Degarelix has _ mechanism of action
Degarelix is a GnRH antagonist
* Used for prostate cancer
Adverse effects of degarelix include:
Adverse effects of degarelix include:
hot flashes, liver toxicity
MOA of ethinyl estradiol
Ethinyl estradiol binds estrogen receptors
* Used for hormone replacement therapy, in OCPs, etc
Clomiphene MOA
Clomiphene is a selective estrogen receptor modulator; it acts as an antagonist at estrogen receptors in the hypothalamus –> prevents normal feedback inhibition –> increases release of LH, FSH –> stimulates ovulation
Clomiphene is used to treat _
Clomiphene is used to treat anovulation (ie PCOS) –> stimulates ovulation
Clomiphene acts on target receptors in the _
Clomiphene acts on target receptors in the hypothalamus
* Antagonist of estrogen receptors in hypothalamus
_ is a selective estrogen receptor modulator that acts as an estrogen antagonist at the breast but agonist at the uterus
Tamoxifen is a selective estrogen receptor modulator that acts as an estrogen antagonist at the breast but agonist at the uterus
* Used to treat ER/PR positive breast cancer
Anastrozole, letrozole, and exemestane are all _ type drugs
Anastrozole, letrozole, and exemestane are all aromatase inhibitors
Anastrozole clinical use is treatment of _
Anastrozole clinical use is treatment of ER+ breast cancer
* Prevents the peripheral conversion of androgens –> estrogen
_ drugs thicken cervical mucus
Progestins thicken cervical mucus
Norethindrone is a _ type drug
Norethindrone is a progestin
Ulipristal is a _ type drug
Ulipristal is a antiprogestin
Megestrol is a _ type drug
Megestrol is a progestin
Mifepristone is a _ type drug
Mifepristone is a antiprogestin
Ulipristal is used for _
Ulipristal is used for emergency contraception
Mifepristone (with misoprostol) can be used for _
Mifepristone (with misoprostol) can be used for termination of pregnancy
How do combined OCPs work?
Combined OCPs –> inhibit LH/FSH –> prevent estrogen surge –> no LH surge –> no ovulation
_ cause thickening of cervical mucus, limiting access of sperm to the uterus
Progestins cause thickening of cervical mucus, limiting access of sperm to the uterus
* Progestins also make the endometrium less suitable to implantation
How do copper IUDs work?
Copper IUDs produce local inflammatory reaction that is toxic to sperm and ova, preventing fertilization and implantation
_ is the most effective emergency contraception
Copper IUD is the most effective emergency contraception
Adverse effects of copper IUD
Copper IUD adverse effects:
* Heavy, long periods
* Dysmenorrhea
* Risk of PID
Danazol MOA
Danazol is a synthetic androgen that acts as partial agonist at androgen receptors
* Can be used to treat endometriosis
Finasteride MOA
Finasteride is a 5a-reductase inhibitor
* Decreases testosterone –> DHT
* Used for BPH and male pattern baldness
Finasteride side effects:
Finasteride side effects:
* Gynecomastia
* Sexual dysfunction
Flutamide MOA
Flutamide is a non-steroidal competitive inhibitor at androgen receptors
* Used for prostate cancer
