Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Estrogens include

A

estradiol
estrone
ethinyl estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SERMs include

A

Clomiphene
ospemifene
raloxifene
tamoxifen
toremifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anti- progestin

A

mifepristone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Progesterone agonist/ antagonist

A

ulipristal acetate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Physiology of menstrual cycle

A

hypothalamus - gonadotropin releasing hormone is secreted
Anterior pituitary - GnRH stimulates FSH and LH by the anterior pituitary
FSH and LH downregulates the release of GnRH from the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Days of menstrual cycle

A

days 1-5 - menstruation
days 6-14 - follicular phase (estrogen driven)
day 14 - ovulation (LH driven)
days 15-28 - luteal phase (progesterone driven)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MOA of estrogens

A

agonist to the estrogen receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Use of estrogens

A

oral contraceptive
menopausal hormone therapy
gynecologic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Estrogens are most often administered with a _______ in combination oral contraceptives (COC)

A

progestin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

COC MOA

A

suppresses LH and FSH by interfering with hypothalamic gonadotropin-releasing hormone and pituitary gonadotropin secretion
Ovulation is suppressed by inhibition of the mid-cycle LH surge
Suppression of ovarian folliculogenesis via suppression of pituitary follicle stimulating hormone secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why we give estrogen and progesterone

A

estrogen - potentiates progesterone so lower doses can be used, allows for endometrial growth so less breakthrough bleeding

progesterone - protects against estrogen-induced endometrial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Progestin related mechanisms:

A

endometrium becomes less suitable for implantation
cervical mucus thickens and becomes less permeable to penetration by sperm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Level of activity: High

A

Norgestrel
Levonorgestrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Level of activity: Moderate

A

Norethindrone
Norethindrone acetate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Level of Activity: Low

A

Ethynodiol
Norgestimate
Desogestrel
Drospirenone
Dienogest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Benefits of COCs (Noncontraceptive)

A

Abnormal or dysfunctional uterine bleeding
Dysmenorrhea
PMS and PMDD
Endometriosis
Adenomyosis
Functional ovarian cysts
PCOS
Hormone replacement in women with primary hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Potential adverse effects of COC

A

HTN
Thromboembolism: DVT, PE, stroke
Changes in lipids (decreased HDL)
Bleeding irregularities
Nausea
Mood changes
Breast changes
Wt gain
HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Estrogen Deficiency can cause

A

vasomotor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Estrogen Excess can cause

A

chloasma (melasma)
Menorrhagia and clotting
increased breast size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Progestin Deficiency

A

breakthrough bleeding
delayed withdrawal bleeding
dysmenorrhea
heavy flow/ clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Progestin Excess can cause

A

Candidiasis
appetite increase
depression
fatigue
libido decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Androgen Excess can cause

A

acne
Hirsutism
libido increase
oily skin and scalp
edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Contraindications to estrogen-containing contraception

A

Thromboembolic disorders
smokers > 35 yo
impaired liver function
abnormal vaginal bleeding
pregnancy
cardiac disease
migraine

Consider progestin only contraceptive options

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Drug interactions

A

Anticonvulsants - phenytoin, carbamazepine, barbiturates, topiramate
Antibiotics - rifampin
Drugs used to treat HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Emergency Contraception MOA

A

works by delaying or blocking ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Emergency contraceptives must be used within

A

72 hours of unprotected intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Emergency Contraception is ineffective once

A

implantation has occurred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Options for emergency contraception include

A

levonorgestrel (Plan B)
Ulipristal (high dose progestin)
COC (higher dose hormones)
Copper IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Levonorgestrel MOA

A

prevents ovulation or fertilization, alters endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Levonorgestrel is contraindicated in

A

known or suspected pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Levonorgestrel adverse reactions

A

generally well tolerated, may cause GI upset, re-administer if vomiting within 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Ulipristal is a

A

selective progesterone receptor modulator (progesterone agonist/ antagonist)

33
Q

Ulipristal MOA

A

binds to progesterone receptor and inhibits or delays ovulation, alters endometrium

34
Q

Ulipristal contraindicated in

A

known or suspected pregnancy

35
Q

Ulipristal adverse reactions

A

generally well tolerated, may cause HA, nausea, dysmenorrhea, dizziness, fatigue

36
Q

Mifepristone is a

A

synthetic steroid compound, antiprogesterone

37
Q

Mifepristone use

A

medical abortion

38
Q

Mifepristone MOA

A

Competitively binds progesterone receptor (blocks progesterone receptor)
Antagonizing endometrial and myometrial effects leads to contraction inducing activity - disrupts implanted embryo

39
Q

Mifepristone used for pregnancies less than

A

49 days (7 weeks)

40
Q

Mifepristone is followed by

A

Misoprostol for expulsion of the products of conception

41
Q

HRT goals of therapy

A

decrease symptoms which may include vasomotor symptoms (hot flashes), mood lability, vaginal atrophy, sleep disturbance

42
Q

HRT is given as

A

estrogen only - women that have had a hysterectomy
estrogen-progestin - women with a uterus

43
Q

HRT is only given for approximately

A

< 5 years - considered safe
and not beyond the age of 60

44
Q

HRT is associated with an increased risk of

A

coronary heart disease
stroke
DVT/Pulmonary embolism
invasive breast cancer

45
Q

HRT appears to be protective against:

A

Osteoporosis
colon cancer

46
Q

Contraindications for HRT

A

Hx of breast cancer
Hx of coronary heart disease
Previous hx of DVT/PE
Hx of CVA or TIA
Active liver disease
Unexplained vaginal bleeding
Risk of endometrial cancer

47
Q

HRT side effects

A

breast soreness
mood symptoms
bloating (progestin)
vaginal bleeding

48
Q

HRT types that are effective in relieving menopausal symptoms

A

all types and routes of estrogen are effective

49
Q

SERMs (selective estrogen receptor modulators) affect different parts of the body:
Tamoxifen
raloxifene
ospemifene
toremifene
Clomiphene

A

Tamoxifen - breast cancer tx, antagonist in breast, agonist at bone and endometrium

raloxifene - osteoporosis tx, antagonist in breast and endometrium, agonist at bone

ospemifene - antagonist in breast, agonist in vaginal tissue and endometrium

toremifene - antagonist in breast, agonist in bone and endometrium

Clomiphene - ovulation induction, antagonist at hypothalamus, weak agonist in other tissues

50
Q

SERMs Adverse reactions

A

flushing, hot flashes
mood changes, depression
GI upset
vaginal bleeding
bone marrow suppression

51
Q

Contraindications of SERMs

A

Warfarin therapy
Hx of DVT/PE
Hx of CVA/TIA
Endometrial cancer

52
Q

Leuprolide MOA

A

inhibitor of gonadotropin secretion - results in transient increase in LH/FSH which leads to transient increase in testosterone and estrogen BUT continuous GnRH agonist use results in decrease in LH/FSH and suppression of testosterone/ estrogen production

53
Q

Adverse effects of Leuprolide

A

HA
Depression
GI
decreased libido

54
Q

Leuprolide indications

A

prostate cancer
endometriosis
uterine fibroids
used for some IVF protocols

55
Q

Flutamide is a

A

synthetic, nonsteroidal anti-androgen
antagonist at androgen receptor - competes with natural hormone for binding to the androgen receptor - blocks effect of androgens on target organs

56
Q

Flutamide adverse reactions

A

GI distress
Gynecomastia
impotence
hot flash
liver failure

57
Q

Contraindications Flutamide

A

Severe hepatic impairment

58
Q

Phosphodiesterase Type V inhibitors include

A

sildenafil
tadalafil
vardenafil

59
Q

Alpha-1 Blockers nonselective includes

A

Doxazosin
Prazosin
Terazosin

60
Q

Alpha-1 Blockers selective include

A

alfuzosin
tamsulosin

61
Q

Tadalafil lasts longer than both Vardenafil and Sildenafil

A

up to 36 hours in some cases (only take once a day or every other day)

62
Q

Phosphodiesterase Type V inhibitors should be taken on

A

an empty stomach

63
Q

Phosphodiesterase Type V inhibitors: Contraindicated in patients taking

A

nitrates - can cause severe hypotension

do not administer nitrate if they have taken PDE5 inhibitors in the past 24-48hrs

Avoid taking in combination with drugs use to treat BPH

64
Q

Side effects of Phosphodiesterase Type V inhibitors

A

Hypotension
Flushing
HA
heartburn
visual effects (blue vision)
priapism

65
Q

5-alpha reductase inhibitors include

A

finasteride
dutasteride

66
Q

anticholinergic agents include

A

tolterodine
oxybutynin
darifenacin

67
Q

Alpha-1 receptor cause inhibition of

A

contraction of smooth muscle of:
ureter
vas deferens
urethral sphincter

68
Q

most common side effect of alpha-1 adrenergic antagonists

A

orthostatic hypotension

69
Q

how to take alpha-1 adrenergic antagonists

A

initiate at bedtime, low doses and titrate up over weeks

70
Q

Other side effects of alpha-1 adrenergic antagonists

A

interaction with phosphodiesterase-5 inhibitors

ejaculatory dysfunction

reflex tachycardia, HA, dizziness, vertigo, nausea, nasal congestion/rhinitis

intraoperative floppy iris syndrome during cataract surgery (tamsulosin)

71
Q

5-alpha reductase inhibitor MOA

A

inhibits type 2 5-alpha reductase -> interfering with the conversion of testosterone to 5-alpha-dihydrotestosterone (DHT stimulates prostate growth)

72
Q

5-alpha reductase inhibitor adverse reactions

A

erectile dysfunction
decreased libido
abnormal ejactulation

73
Q

Drugs used to treat androgen deficiency

A

methyltestosterone
fluoxymesterone
testosterone

74
Q

Indications for androgen deficiency

A

primary or secondary hypogonadism
delayed puberty
menopausal symptoms
occasionally used for metastatic breast cancer

75
Q

Contraindications of methyltestosterone/ fluoxymesterone

A

prostate cancer
women who are or may become pregnant
caution if cardiovascular risk

76
Q

Adverse effects of methyltestosterone/ fluoxymesterone

A

Males: Priapism, impotence, gynecomastia, BPH
Females: masculinization, acne, facial hair

may increase risk of MI or stroke

77
Q

Anabolic Androgenic steroids include

A

synthetic - stanozolol, oxandrolone, nandrolone (many more)

78
Q

indications of Anabolic Androgenic steroids include

A

AIDS wasting
low testosterone state
transgender

also used at high doses by athletes for:
-increasing lean muscle mass and improve performance
-faster recovery
-appearance

Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions