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pharmacology II > reproductive 1 > Flashcards

reproductive 1 Flashcards

1
Q

What type of hormone are the sex hormones

A

Steroid based fat soluble so they pass through cell membranes easily

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2
Q

Three types of estrogen

A

Estradiol E2 - the most powerful, Estriol E3, Estrone E1

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3
Q

How do the estrogens compare

A

Estradiol E2 is 10 times more potent than Estriol and Estrone

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4
Q

are naturally occurying or synthetic estrogens more bioavailable?

A

Synthetic estrogens are more bioavailable because they are less subject to first pass hepatic metabolism

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5
Q

Why what HRT originally used

A

Postmenopausal: Reduce vasoactive response, tissue atrophy, improvesleep, blunts osteoporosis

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6
Q

concerns with exogenous estrogen replacement (without progestin)

A

increases risk of stroke, clots, ovarian endometrial and breast cancer

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7
Q

why is progestin added to those with uterus

A

because unopposed estrogen can increase risk of endometrial cancer

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8
Q

Differences between estrogen and estrogen with progestin trials

A

both had reduced risk of fracture, and increased risk of stroke, but in addition the progestin plus estrogen had increase risk of MI, DVT and breast cancer

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9
Q

bioidentical hormone options

A

BiEst: E3:E2 or TriEst: E3:E2:E1 both oral or topical

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10
Q

Compare Bi and Triest

A

E3:E2 80:20 / E3:E2:E1 - 80:10:10

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11
Q

what is the conjugated estrogens

A

Premarin ; estrone with equillin so it undergoes less hepatic metabolism

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12
Q

what is premarin used for

A

prevent and treat osteoporosis and post menopausal sx

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13
Q

how does premarin and all the hormones work?

A

MOA is altering gene transcripton

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14
Q

what is importain to know when using premari

A

you must add progesteron if you still have your uterus

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15
Q

category of premarin

A

Cat X, they also are contraindicated with hx of DVT, breast, ovarian or uterine cancer

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16
Q

what is synthetic progestogen

A

progestin, similar effect of progesterone

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17
Q

why are progestins used?

A

Hormonal contraception and prevention of endometrial hyperplasia in HRT

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18
Q

name a synthetic progesterone/progestogen

A

Medroxyprogesterone/Provera

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19
Q

indication for medroxyprogesterone/provera

A

contraceptive, HRT, dysfunctional uterine bleeding, endometriosis

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20
Q

how is medroxyprogestrone administered

A

PO or DEPO iv

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21
Q

side effects of medroxyprogestrone/provera

A

increase LDL/HDL ratio, facial hair, weight gain,

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22
Q

when is medroxyprogesterone contraindicated

A

Hx of female cancers, or DVT hx, and will cause birth defects if taken while pregnant

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23
Q

the pill

A

combo of estrogen and progestin

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24
Q

what does the estrogen of birth control doo

A

supresses ovulation

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25
Q

what does the progestin of birth control do

A

prevents implantation and makes mucus impenetrable to sperm

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26
Q

how effective are BCPs

A

97-98%

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27
Q

most commonly used estrogen fir BCP

A

ethinyl estradiol

28
Q

combination pills

A

contstant estrogen with changeingamount of progestin

29
Q

what are benefits of the OCP

A

reduce risk of colorectal cancer, improves PID, dysmeorrrhea, PMA and acne, PCOS sx and anemia

30
Q

side effects of OCP

A

increase CVD, DVT, HTN, Stroke,

31
Q

what should you not do while on the pill

A

Smoke, or be over 35

32
Q

what is mini pill

A

consistent progestin with no estrogen for 21 days

33
Q

why would someone want mini pill

A

it cant tolerate estrogenic, but its not as effective

34
Q

what can reduce the efficacy of the pill

A

antibiotics, sulfa drugs and st johns wart

35
Q

how much does pill reduce ovarian and endometrial cancer risk

A

about 50% in 5 and 80% in 10 years

36
Q

Drospirenone

A

yaz, it has a way higher risk of thromboembolism

37
Q

how often for Medroxyprogesteron acetate /depo proveria IM

A

four times each year, immediate protection

38
Q

how does depo provera work

A

inhibit folicular development to revent ovulation

39
Q

what does medroxyprogesteron acetate/provera also prevent

A

reduce risk of endometrial cancer by upt to 80%

40
Q

how long to get pregnant after depo

A

9-10 months after last injection

41
Q

risks of depo/medroxyprogesterone acetat

A

increase osteoporosis, has a black box warning, it shouldn’t be used for more than 2 years

42
Q

what are the current implantable contraceptives

A

Implanon - can last 3 years

43
Q

transtermal patches

A

Ortho evara - applied withing first 5 days of cycle , never apply over breasts

44
Q

what happens if patch falls off

A

if you replace it in 48 hours no backup contraception is needed

45
Q

concerns with patch ortho evara

A

higher estrogen than pills, twice the risk of clotting

46
Q

what is in nuva ring

A

combined progestin and estrogen, 3 weeks, per ring, increased risk of blood clots

47
Q

if ring falls out what then

A

if out more than 3 hours back up method for 7 days

48
Q

IUD brand names

A

Copper: ParaGard, Hormone: mirena, liletta and skyla

49
Q

whats in homonal iud

A

levonorgestrel and progestin

50
Q

how does hormonal IUD work

A

Levonorgestrel : deminish ovulation, mucus consistency, make implation less likely, inflammatory response

51
Q

Mirena duration

A

levonorgestrel : 5 years / 20 mcg day

52
Q

liletta

A

levonorgestrel: 5 years / 20mcg day

53
Q

Skyla

A

levonorgestrel: 3 years/14mcg day

54
Q

Progestin only contraceptives

A

Levonorgestrel: Plan B, Next choide: 750 ug 12 hours apart

55
Q

what is Ulipristal acetate/Ella

A

SERM, selective progesterone receptor modulator for emergency contracepton given within 5 days.

56
Q

moa of ulipristal acetate /ella

A

delay or inhibit ovulation and inhibit folicular rupture

57
Q

what are combo mornin after pills?

A

estrogen and progestin, 2 doses, same effect as stacking reglular pills

58
Q

what are the 4 types of emergency contraceptive

A

progestin only, SPRM, combo, abortifacient

59
Q

First 2 months of pregnancy abortifacient

A

Mifepristone: synthetic steroid,

60
Q

moa of Mifepristone:

A

progenstin antagonist partial agonist so off and part on. 85% effective in first trimester

61
Q

side effects of mifepristone

A

crampin, bleeding 9-16 days., emergency if incomplete

62
Q

contraindications of mifepristone

A

in presence of IUD, ectopic pregnancy, hemorrhagic disorders, prednisone

63
Q

SERMs

A

Clomiphene/Clomid

64
Q

MOA of clomiphene/clomid

A

bind estrogen receptor sites in brain interfering with negative feedback on GnRH to resuld in increase secretion of GnRH, increasing LH and FSH stimulationg ovulation.

65
Q

what are these SERMS clomphine/Clomid used for

A

infertility or amenorrhea.

pharmacology II (31 decks)

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