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Pharmacology > Sex Hormones > Flashcards

Sex Hormones Flashcards

1
Q

Norethindrone, Medroxyprogesterone acetate, and Etonogesterel are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

B. Progesterone only agonists

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2
Q

Levonorgestrel and Ulipristal are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

A. Emergency contraceptives

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3
Q

True or False: Medroxyprogesterone has been shown to cause weight gain

A

True

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4
Q

Copper ParaGuard and Levonotgestrel Mirena, Skyla, etc are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

C. IU Devices

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5
Q

Most effective contraceptive class? Least?

A

Most = Intrauterine
Least = Emergency

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6
Q

Combination Oral Contraceptives contain synthetic __ and ___

A

estrogen (ethinyl estradiol) and progestin

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7
Q

COC’s are usually given for __ days, followed by __ days with no pills

A

21; 7 days

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8
Q

Monophasic vs. Multiphasic COC therapy?

A

Monophasic: fixed estrogen + progestin dose
Multiphasic: mimic normal hormonal events of menstrual cycle
- first half = low prog:E2 (endo proliferation)
- second hald = high prog:E2 (secretory endo)
- allows for overall decreased hormone exposure

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9
Q

In biphasic COC, __ dose remains constant while ___ dose changes twice during the cycle

A

estrogen = constant
progesin = changes twice (increases)

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10
Q

___: dose of one or both steroidal agents are changes three times during cycle
A. Monophasic
B. Triphasic
C. Biphasic

A

B. Triphasic

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11
Q

____ is four-phasic drug that uses estradiol VALERATE

A

Natazia

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12
Q

When are two good ‘start dates’ for COC?

A

1) First Sunday after menses - more rapid

2) First day of menses (use backup contraception for 7 days)

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13
Q

True or False: The predominant and most potent estrogen made by ovary is E2 (17-beta-estradiol)

A

True

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14
Q

____ is the primary synthetic estrogen used in COC’s. How does it prevent first pass metabolism?

A

Ethinyl estradiol
- Ethinyl group at C17 prevents first pass metabolism

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15
Q

Where does sulfate and glucuronide conjugation occur for enterohepatic recirculation?

A

Liver

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16
Q

Where does biliary secretion of conjugates occur in enterohepatic recirculation?

A

Intestine

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17
Q

___ enzymes cleave conjugates, allowing for reabsorption of estrogen in enterohepatic recirculation

A

Bacterial

  • Oral Antibiotics could affect this
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18
Q

True or False: Synthetic progestins vary in the androgenic activity, estrogenic activity, and anti-estrogenic activity

A

True

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19
Q

True or False: Gonane progestines (e.g norgestimate and desogestrel) are reported to be less androgenic (less acne causing) than estranes

A

True

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20
Q

___ is a derivative of spironolactine and is anti-androgen. It is indicated for treatment of moderate acne vulgaris.

A

Drospirenone

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21
Q

Estrogen and Progesterone inhibit the release of ___ and ___. Therefore, no ___

A

LH and FSH; ovulation

22
Q

True or False: One will ovulate while taking COC’s

A

False

23
Q

True or False: Women taking COC’s have an LH spike

A

False

24
Q

Most common AE associated with COC’s?

A

Nausea*

25
Q

What are the three dermatological AE’s associated with COC’s?

A

1) chloasma (brown pigmentation of skin)
2) acne (due to increased sebum)
3) hirsuitism

26
Q

True or False: HTN is an AE of COC’s

A

True
- can start 1-3 s/p therapy
- increased risk with duration and age
- estrogens increase RAAS

27
Q

What is a life-threatening AE associated with COC’s?

A

Thromboembolitic disorders
- cause: estrogen (increased clotting factors, decreased anti-thrombin 3)

28
Q

Newer progestins, such as ___, ___, and ___may be associated w increased risk of blood clot formation

A

desogestrel; gestodene; drospirenone

29
Q

What are two metabolic effects of COC’s?

A

1) Decreased glucose tolerance
2) Increased LDL’s and TG

30
Q

True or False: Breakthrough bleeding is associated with use of COC’s

A

True
- most common in first three months
- estrogen deficiency is associated with BTB in early part of cycle while prog def is associated with BTB in later part of cycle

31
Q

COC’s may increase risk of ____ cancer in general population of women and increased risk of cervical cancer in women who are ___+

A

breast; HPV+

32
Q

True or False: Infertility can occur after COC use, last longer in 30-34 year old women

A

True

33
Q

Whey should COC’s be avoided until at least 3-4 weeks postpartum?

A

Estrogen in COC’s can decrease quality of quantity of milk

34
Q

What are three beneficial side effect of COC’s?

A
  • Reduced risk of endometrial cancer
    (progestin prevents endo prolif)
  • Reduced risk of ovarian cancer
    (decreased stimulation of ovaries by FSH and LH)
  • Reduced acne
    (estrogen decreases seb. gland activity and increase SHBG (decrease free testosterone))
35
Q

____ kill normal microbial flora that produces enzymes that cleave sulfate and glucoronide conjugates of ethinyl estradiol - no enterohepatic circulation

A

Abx

36
Q

Which antibiotics induce CYP3A4, thereby increasing metabolism of COC, leading to greater failure rate?

A

Rifbutin
Rifampin

37
Q

True or False: Anti-convulsants can decrease effectiveness of COC’s

A

True

38
Q

Patient with smoking history, h/o thromboembolism should take which type of BC?

A

Progestin only preparations

39
Q

True or False: Estrogen only preparations can be used when women are lactating and want contraception

A

False - Progestin only preparations used!

40
Q

True or False: Progestin only preparations consistently inhibit ovulation

A

False - they do not consistently inhibit ovulation

41
Q

Which progesterone only preparation is given via IM and can cause osteoporosis because it decreases estrogen

A

Medroxyprogesterone

42
Q

True or False: Nexplanon (etonogestrel) is a progestin only preparation

A

True

43
Q

Levonorgestrel is seen in ____ contraception

A

emergency

44
Q

How does emergency contraception affect ovulation?

A

Delays or inhibits ovulation

45
Q

Which emergency contraceptive is a progesterone antagonist and partial agonist?
A. Levonorgestrel
B. Medroxyprogesteron
C. Ulipristal acetate

A

C. Ulipristal acetate

46
Q

True or False: Ethinyl estradiol + Levonorgestrel is more effective and has less side effects than Levonorgestrel alone

A

True

47
Q

How do intrauterine devices produce a spermicide?

A

Cause low grade inflammation -> increases prostaglandins

48
Q

Which IUD prevents fertilization, implantation, and interferes w sperm transport and viability?
A. Paraguard
B. Mirena

A

A. Paraguard

49
Q

Which IUD causes thick, cervical mucus, decreases sperm transport activity, and prevents ovulation by making endometrium inhospitable?
A. Paraguard
B. Mirena

A

B. Mirena

50
Q

AE associated with IUD?

A

Insertion may introduce bacteria into pelvis, leading to PID

Pharmacology (53 decks)

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