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2nd U1 Pharm > Reproduction > Flashcards

Reproduction Flashcards

1
Q

Name the 4 Estradiol esters…

A

Estradiol
Estrone sulfate
Equilin sulfate
Quinestrol

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2
Q

How does Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol enter through the body?

A

Absorbed through:
Skin
Mucus membranes
GI tract

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3
Q

How is Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol distributed throughout the body after absorption?

A

Sex hormone binding globulin

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4
Q

Estradiol esters–Estradiol, estrone sulfate, equilin sulfate and Quinestrol are all used for the treatment of what disorders?

A

Contraception
Primary hypogonadism
Psotmenopausal hormone therapy
Osteoporosis

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5
Q

What are the side effects of the estradiol esters–estradiol, Estrone sulfate, Equilin sulfate and Quinestrol?

A 
Weight gain
HTN
Less commonly:
-breast cancer 
Nausea
Breast tension/pain
Vaginal bleeding
headache
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6
Q

Patients who are put on an estradiol ester therapy are at an increased risk of developing what disorders?

A

Heart attack
Stoke
DVT
Cervical and endometrial cancer

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7
Q

Estradiol esters—Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol are strongly contraindicated in?

A

Breast or endometrial cancers
Endometriosis
Undiagnosed vaginal bleeds

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8
Q

Estradiol esters—Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol are relatively contraindicated in?

A 
pregnancy
Thromboembolic Dz
HTN
hepatic dz
FHx of breast or uterine cancer
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9
Q

Name the 2 Alkyl estrogens…

A

Ethinyl estradiol

Mestranol

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10
Q

How are the alkyl estrogens, Ethinyl estradiol and Mestranol, absorbed into the body?

A

Skin
Mucus membranes
GI tract

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11
Q

How are the alkyl estrogens, Ethinyl estradiol and Mestranol, distributed throughout the body?

A

Sex hormone binding globulin

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12
Q

What are the primary uses of Ethinyl estradiol an Alkyl estrogen?

A

contraception
Primary hypogonadism
Postmenopausal hormone therapy
Osteoporosis

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13
Q

What are the primary uses of Mestranol an Alkyl estrogen?

A

Contraception
Primary hypogonadism
Postmenopausal hormone therapy

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14
Q

What are the side effects of Ethinyl estradiol and Mestranol?

A

Weight gain
HTN
Less commonly:
-breast cancer

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15
Q

Patients on ethinyl estradiol or mestranol therapy are at an increased risk of developing what disorders?

A

Heart attack
Stroke
DVT
cervical and endometrial cancer

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16
Q

What is Diethylstilbestrol?

A

A non-steroidal synthetic estrogen

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17
Q

What reproductive drug therapy has an increased risk of developing clear cell adenocarcinoma of the vagina and cervix?

A

Diethylstilbestrol

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18
Q

What is the reproductive drug therapy that is a non-steroidal anti-estrogen and selective estrogen receptor modifier—used for the treatment of ER + breast cancer?

A

Tamoxifen citrate

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19
Q

What is the mechanism of action of tamoxifen citrate?

A

Blocks estrogen from binding ER and causing growth in ER+ breast cancer

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20
Q

What are the side effects of Tamoxifen citrate?

A

Proestrogenic effect on uterine epithelium–increased risk of endometrial cancer

Partial estrogen agonist in bone and endometrium

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21
Q

What class of drug is Clomiphene citrate?

A

Non-steroidal anti-estrogen

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22
Q

What is the mechanism of action for Clomiphene citrate and what does it stimulate?

A

Blocks estrogen binding to hypothalamic receptors–increased secretion of gonadotropins and LH—> ovulation

23
Q

What is Clomiphene citrate used for?

A

Stimulate ovulation in patients who want to get pregnant

24
Q

What are the side effects of Clomiphene citrate?

A 
Hot flashes
Multiple pregnancy
Stomach pain
Headache
Vomit
25
Q

What is a Cis-isomer (zuclomiphene)?

A

Weak estrogen agonist

26
Q

What is trans-isomer (enclomiphene)?

A

potent estrogen antagonist

27
Q

Name the 2 Natural progesterone drugs…

A

Micronized progesterone

Transvaginal progesterone

28
Q

What are the natural progesterone drugs, micronized and transvaginal progesterone, used for?

A

Contraception

Hormone replacement therapy

29
Q

What are the side effects of the natural progesterone drugs–micronized and transvaginal progesterone?

A

Fatigue

Drowsiness

30
Q

Natural progesterone drugs are contraindicated in?

A 
Thromboembolic disorders
Patients with a Hx of:
-liver dz
-undiagnosed vaginal bleeding
-Pregnancy---atrophy of endometrium reading to birth defects
31
Q

Name the 4 synthetic progesterone drugs?

A

Medroxyprogesterone
Norethindrone
Norgestrel
Megestrol

32
Q

What are the synthetic progesterone drugs used for?

A

Contraception

Hormone replacement

33
Q

What are the side effects of synthetic progesterone therapy with Medroxyprogesterone, Norethindrone, Norgestrel, Megestrol and patients are at an increased risk of developing what with this therapy?

A

Edema
Abdominal bloating
Less commonly:
-strong androgenic effects–hirsutism, acne

Anxiety
Irritability
Depression
Muscular pain

Increased risk of thrombus and PE

34
Q

Synthetic progesterone drugs are contraindicated in?

A 
Thromboembolic disorders
Patients with a Hx of:
-liver dz
-undiagnosed vaginal bleeding
-Pregnancy---atrophy of endometrium reading to birth defects
35
Q

name the 3 combination pills used for contraception…

A

Monophasic ortho-Novum
Biphasic Ortho-Novum
Triphasic Ortho-Novum

36
Q

What is the mechanism of action of the combination pills used for contraception?

A

Constant level of estrogen suppresses FSH, LH surge
Progesterone suppresses LH surge, thickens cervical mucus, leads to endometrial atrophy, counters estrogenic effect on endometrium

37
Q

Patients who are on a combination pill for contraception are at a decreased risk for the development of______.

A

Endometrial cancer

38
Q

Monophasic Ortho-Novum estrogen and progesterone doses are?

A

Consistent–pill taken for 21 days

39
Q

Biphasic Ortho-Novum estrogen and progesterone doses are?

A

Fixed estrogen

Progestin increased for days 11-21

40
Q

Triphasic Ortho-Novum estrogen and progesterone doses are?

A 
Fixed or variable estrogen
Progestin increases in 3 phases
-1-7
-8-14
-15-21
41
Q

What is mini-pill and when is it used?

A

A progestin only pill–less effective that combination pill for contraception

Used when patients have estrogen contraindication

Good for use in lactating women–estrogen reduces milk production

42
Q

What are the side effects of mini-pill?

A

More likely to produce irregular menstrual cycle

43
Q

Mini-pill suppresses?

A

Endometrial cancer

44
Q

What is Levonorgestrel, a synthetic progestogen, used for?

A

Plan-B

Used to prevent implantation

45
Q

What is the time window for taking Levonorgestrel?

A

within 72 hours of coitus

46
Q

Mifepristone is in what class of drug?

A

Anti-progestin; glucocorticoid receptor antagonist

47
Q

What is the mechanism of action for Mifepristone?

A

Competitively binds to progesterone receptor–leading to detachment of fetus

48
Q

What is the use of Mifepristone, an anti-progestin glucocorticoid receptor antagonist?

A

Abortion

Cushing’s syndrome

49
Q

What is the time window for taking Mifepristone?

A

Must be taken early in pregnancy–by day 49

PO administration

50
Q

Name the 3 PDE5 inhibitors?

A

Sildenafil citrate
Vardenafil HCl
Tadalafil

51
Q

What is the mechanism of action for the PDE5 inhibitors, Sildenafil citrate, Vardenafil HCl, Tadalafil?

A

Bind catalytic site of PDE5–inhibiting PDE5 breakdown of cGMP—> decreased Ca++ —> smooth muscle relaxation—> erection

52
Q

What is the used of PDE5 inhibitors?

A

Erectile dysfunction–does not trigger an automatic erection, but improved response to sexual stimulation

53
Q

What are the side effects of PDE5 inhibitors?

A

Headache
Dizziness
Change in vision

Flushing 
Upset stomach
Stuffy or runny nose
UTI
Diarrhea
54
Q

PDE5 inhibitors are contraindicated in patients who…

A

are on nitrates or a-blockers– due to the possibility of unsafe drop in BP..

2nd U1 Pharm (11 decks)

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