S2E4: Gonadal hormones

Question 1

Venlafaxine (effexor), fluoxetine (prozac), paroxetine (paxil), sertraline (zoloft)

Answer 1

SSRI tx for vasomotor sx

Question 2

progesterone route of administration

Answer 2

IM only

Question 3

medroxyprogesterone (provera)

Answer 3

progesterone

Question 4

megestrol aceate (megace)

Answer 4

progesterone

Question 5

norethynodrel

Answer 5

progesterone

Question 6

levonorgestrel (norplant)

Answer 6

progesterone

Question 7

norethindrone

Answer 7

progesterone

Question 8

ethynodiol

Answer 8

progesterone

Question 9

norgestrel (ovrette)

Answer 9

progesterone

Question 10

tamoxifen (nolvadex)

Answer 10

Estrogen antagonist (premenopausal pt w estrogen-receptor + breast CA tx)

Question 11

toremifene (fareston)

Answer 11

Estrogen antagonist (post menopausal pt estrogen-receptor + breast CA tx)

Question 12

raloxifene (evista)

Answer 12

Estrogen antagonist (osteoporosis prevention)

Question 13

clomiphene (clomid)

Answer 13

Inhibits estrodiol negative feedback, increasing FSH/LH –> increased estrogen. Use in PCOS.

Question 14

Mifepristone (RU486 or mifeprex)

Answer 14

Progestin antagonist, luteolytic.

Question 15

danazol (danocrine)

Answer 15

inhibits FSH/LH, decreases ovarian fnx. Endometriosis tx.

Question 16

Testosterone, DHT

Answer 16

natural androgens/anabolic steroids

Question 17

testosterone propionate

Answer 17

injectable synthetic steroid

Question 18

testosterone cypionate

Answer 18

injectable synthetic steroid

Question 19

methyltestosterone

Answer 19

PO synthetic steroid

Question 20

fluoxymesterone

Answer 20

PO synthetic steroid

Question 21

-fen(e)

Answer 21

estrogen antagonist

Question 22

finasteride (proscar)

Answer 22

5-alpha reductase inhibitor (antiandrogen). BPH, prostate CA.

Question 23

dutasteride (avodart)

Answer 23

5-alpha reductase inhibitor (antiandrogen). BPH, prostate CA.

Question 24

flutamide (eulexin)

Answer 24

5-alpha reductase inhibitor (antiandrogen). Prostate CA

Question 25

OCP DI

Answer 25

anti-convulsants (phenytoin, phenobarbital, carbamazepine, oxcarbazepine, lamotrigine, primidone, topiramate) abx (rifampin) St. John's wort

Question 26

implanon

Answer 26

progestin coated, sub q. Effective 3 yrs.

Question 27

medroxyprogesterone IM (depo provera)

Answer 27

q90d. Progestin only. | * *black box: reduced BMD in Lspine >5 yrs. reversible in 4 yrs.

Question 28

norgestrel (minipill)

Answer 28

oral progesterone.

Question 29

norethindrone (minipill)

Answer 29

oral progesterone.

Question 30

ethinyl estradiol + norethindrone/levonorgestrel/norgestrel/ | norethinedrone/ ethynodiol/norgestimate/ desogestrel/drospirenone

Answer 30

combination estrogen + progestin

Question 31

monophasic combo dose

Answer 31

constant dose of estrogen/progestin q21d, then 7 days placebo (withdrawal bleeding). 28 day pack.

Question 32

biphasic

Answer 32

amount of estrogen/progestin changes 1/3rd of the way through cycle

Question 33

triphasic

Answer 33

amount of estrogen/progestin changes qweek (7/7/7)

Question 34

quadriphasic

Answer 34

four varying amounts throughout monthly pack

Question 35

same day start

Answer 35

take 1st active pill on first day of menses

Question 36

sunday start

Answer 36

take 1st active pill first sunday after menses begins. | BUM for 1 week-1 mo

Question 37

quick start

Answer 37

take 1st active pill when rx filled (regardless of menses). | BUM for 1 week-1 mo

Question 38

miss 1 pill

Answer 38

no BUM

Question 39

miss 2 pills, week 1 or 2

Answer 39

take both pills when you remember (2 pills for 2 days). BUM x7d.

Question 40

miss 2 pills, week 3

Answer 40

start new pack + BUM x7d. | If Sunday start, continue old pack until Sun, then start new pack. BUM x7d.

Question 41

91 day oral combo

Answer 41

estrogen and progesterone combo for 12 weeks, then 1 week of placebo or estrogen.

Question 42

combined transdermal patch

Answer 42

topical estrogen/progestin each week for 3 weeks, then remove for 1 week. **black box: increased estrogen exposure

Question 43

missed transdermal patch

Answer 43

24 hrs: patch is new "day 1", BUM x7d.

Question 44

vaginal ring (nuvaring)

Answer 44

3 weeks estrogen/progestin, removed for 1 week.

Question 45

Missed nuvaring

Answer 45

3 hrs: reinsert, BUM x7d.

Question 46

levongesterel IUD (Mirena)

Answer 46

lasts 5 yrs. As IUD: prevents implantation Progestin: thickens cervical mucus, thins endometrium, inhibits sperm motility

Question 47

copper IUD (Copper-T)

Answer 47

lasts 10 yrs. Cu inhibits sperm motility. Can be emergency contraception.

Question 48

High-dose estrogen/progestin

Answer 48

emergency contraception.

Question 49

Emergency contraception dosing of Ovral

Answer 49

2 pills immediately, 2 pills 12 hrs later

Question 50

Emergency contraception dosing of low-ogestrel

Answer 50

4 pills immediately, 4 pills 12 hrs later

Question 51

Emergency contraception dosing of tri- rx (trivor, tri-levelen, triphasil)

Answer 51

4 pills immediately, 4 pills 12 hrs later

Question 52

Emergency contraception dosing of alesse, levelite, lessina

Answer 52

5 pills immediately, 5 pills 12 hrs later

Question 53

ovral

Answer 53

High-dose estrogen/progestin

Question 54

ovrette

Answer 54

progestin only emergency contraception (20 pills immediately, 20 pills 12 hrs later.

Question 55

Plan B (levonorgestrel 0.75 mg)

Answer 55

emergency contraception. Take 2 pills 12 hrs apart

Question 56

Plan B one step (levonorgestrel 1.5 mg)

Answer 56

emergency contraception

Question 57

emergency contraception time frame

Answer 57

High dose estrogen/progestin, or progesterone only: within 120 hrs. Copper IUD: within 5 days

Question 58

Copper IUD

Answer 58

Most effective (>99%), but DONT put in pregnant uterus.