Reproductive System Agents

Question 1

teratogens

Answer 1

substances that cause developmental abnormalities in the fetus

Question 2

therapeutic uses of estrogen/progestin (5)

Answer 2

• contraception
• menopausal therapy
• anti-estrogen used for hormone-responsive breast cancer and infertility
• anti progestin used for medical abortion
• other non-contraceptive uses: menstrual cycle issues, acne

Question 3

physiologic mechanism of oral contraceptives (3)

Answer 3

• suppresses pituitary secretion of FSH and LH (decreased stimulation of follicle develpment and ovulation)
• creates changes in the endometrium to make it less favorable for implantation of fertilized ovum
• changes quantity and viscosity of cervical mucus to make it hostile to sperm

Question 4

monophasic BCPs

Answer 4

• most common

- fixed ratio of estrogen to progestin throughout cycle

Question 5

biphasic BCPs

Answer 5

fixed estrogen, varied progesterone

Question 6

triphasic BCPs

Answer 6

• newest combination pill
• low doses, few side effects
• either estrogen or progesterone varies during 3 phases

Question 7

extended cycle BCPs

Answer 7

24 days of active hormonal therapy + 4 days of placebo (normal is 21 days + 7 days)

Question 8

continuous dosing BCPs

Answer 8

• 28-day packets taken continuously without interruption for withdrawal menses - no placebos
• only 4 periods per year with possible breakthrough bleeding

Question 9

estrogen combination BCPs with drospirenone

Answer 9

estrogen (Ethinyl Estradiol) combined with progestin derived from spironolactone (Aldactone)

Question 10

estrogen-drospirenone combination BCPs contraindications (3)

Answer 10

kidney, liver, or adrenal disease

Question 11

what levels should be checked when taking drospirenone BCPs?

Answer 11

• potassium - may be increased due to diuretic property

- check esp. when taking with other drugs that increase K (NSAIDs, K-sparing diuretics, ACE inhibitors, ARBs, heparin)

Question 12

ACHES

Answer 12

dangerous side effects of BCPs:
A - abdominal pain (severe)
C - chest pain, shortness of breath
H - headache (severe), dizziness, weakness, numbness, speech difficulties 
E - eye disorders 
S - severe leg pain, calf/thigh swelling

Question 13

rare side effects of BCPs

Answer 13

thromboembolism, PE, MI, CVA, retinal thrombosis

Question 14

hormone therapy indications

Answer 14

• estrogen-progestin therapy (EPT) for use with women who have an intact uterus
• estrogen therapy (ET) for use with women who have had a hysterectomy (removal of uterus)
• cross-sex hormone therapies - to achieve congruence with gender identity

Question 15

meds for treatment of osteoporosis (2)

Answer 15

• biophosphonates - slows bone resorption

- selective estrogen receptor modulators (SERMs)

Question 16

hormone therapy for osteoporosis

Answer 16

no longer recommended for treatment of osteoporosis, but should be considered as a preventative measure in postmenopausal women who are at risk

Question 17

osteoporosis prevention (3)

Answer 17

• calcium, vitamin D
• weight-bearing exercises
• fall prevention

Question 18

drugs used for sexual disfunction

Answer 18

phosphodiesterase reuptake inhibitors: Sildenafil (Viagra), Tadalafil (Cialis)

Question 19

sildenafil action

Answer 19

potent and selective reuptake inhibiter of cGMP (helps to relax smooth muscle, which increases vasodilation and blood flow) in corpus cavernosa

Question 20

sildenafil + nitrates interaction

Answer 20

potentiates hypotensive effects

Question 21

sildenafil contraindications (3)

Answer 21

• CHF, cardiomyopathy, CAD
• anatomic deformities
• conditions predisposing to priapism

Question 22

sildenafil common side effects (4)

Answer 22

• headache - most common, due to vasodilation
• flushing
• GI distress - dyspepsia, diarrhea
• nasal congestion

Question 23

sildenafil rare side effects (2)

Answer 23

• blurred vision, photosensitivity, changes in color perception (esp. blue/green)
• urinary tract symptoms (frequency, dysuria, cloudy/bloody urine)