WK4 (Female) Flashcards
Leuprolide is what?
GnRH Agonist
Ganirex is what?
GnRH Antagonist
Cetrorelix is what?
GnRH Antagonist
GnRH agonist Pulsatile vs. Non-pulsatile administration?
Pulsatile causes FSH and LH release
Non-Pulsatile causes HPA shut down with transient FSH/LH increase
Uses of Leuprolide?
Shut down HPA during ovulation for follicle stimulation
Reduce Uterine Fibroid symptoms
Control hormone dept Prostate and Breast Cancer
Use of Ganirex or Cetrorelix?
Prevent endogenous LH during folliculogenesis induction
Prostate and Breast Cancer
Benign Uterine Disease
Menotrophin is what?
Purified human FSH and LH gonadotrophin
Urofolitropin is what?
Purified Human FSH
Follitropin is what?
Recombinant human FSH
Uses for FSH/LH gonadotrophins?
Folliculogenesis
Hypothalamic non-function
Superovulation in normal women
Gonadotropin Side Effects?
Multiple Fetuses
Ovarian Hyperstimulation Syndrome
Ovarian Hyperstimulation syndrome?
Fluid shift to abdominal and thoracic cavity causing hypovolemia, ascites, bloating
Risk factors for OHSS?
Young Low BMI High Dose FSH/LH High serum Estrogen Previous OHSS
Clomiphene Citrate is what?
Estrogen R agonist (SERM)
Clomiphene Citrate use?
Folliculogenesis
Polycystic Ovarian Syndrome
Clomiphene Citrate contraindications?
Liver failure
Clomiphene Citrate toxicity?
Hot Flashes
OHSS
Drugs for folliculogenesis?
Gonadotropins
- Menotropin
- Urofolitropin
- Follitropin
Clomiphene Citrate
Drugs for ovulation induction?
1st. Gonadotropin or Clomphene
2nd. hCG
Tamoxifen is what?
SERM
Agonist and Uterus, bone, Lipoprotein
Antagonist in Breast and vasculature
Raloxifene is what?
SERM
Agonist in bone and lipoprotein
Antagonist in breast and uterus
Toremifiene is what?
SERM
Agonist at uterus
Antagonist at breast
SERM uses?
ER+ Breast Cancer
Which SERM for Pre-menopausal women with ER+ breast Cancer?
Tamoxifen
Which SERM for ER+ cancer prevention?
Raloxifene
SE of SERMs?
Nausea, vomiting Rash Hot flashes Thrombi Endometrial Cancer
Fulvestrant is what?
SERD (Selective Estrogen Receptor Downregulator)
Pure antagonist
Fulvestrant use?
ER+ Breast Cancer
Fulvestrant administration?
IM injection
Fulvestrant SE?
GI
Hot Flashes
Thrombi
Anastrozole is what?
Non-Steroid
Reversible
Aromatase Inhibitor
Exemastane is what?
Steroidal
Non-reversible
Aromatase Inhibitor
Aromatase inhibitors used for what?
ER+ breast cancer
Aromatase inhibitors SE?
Hot Flashes
Unknown long term concequences
Letrozole is what?
Non-steroid
Reversible
Aromatase Inhibitor
Ethinyl Estradiol use?
Oral Contraception
HRT
Estradiol Valerate Use?
Injection
Topical HRT
Vaginal Ring
Absolute Estrogen Contraindications?
PE CAD Eestrogen Tumor Liver Disease Undiagnosed Uterine Bleed Smoker >35yrs old Migranes + Aura
Estrogen Benefits?
Decreased Flow Reduced ovarian, endometrial , colorectal cancers Improved acne Improve osteoporosis Decreased Ectopic pregnancy
Estrogen risks?
Thrombi
Cervical Cancer
Medicine interactions
Breast Cancer (Unproven)
Norethidrone is what?
2nd gen Progestin Estrane
Levonorgestrel is what?
2nd gen Progestin Gonane
Norgestimate is what?
3rd gen Progestin Gonane
Desogrestel is what?
3rd gen Progestin Gonane
Medroxyprogesterone Acetate is what?
Injectable Progestin Progestane
Progestins used in combo oral contraception?
Norethidrone
Levonorgestrel
Norgestimate
Desogestrel
Etonogestrel is what?
Implantable progestin rod
Who uses progestin only oral contraception?
Patients with estrogen contraception
Nursing Moms
Patients with SE to combo contraception
Progestin only oral contraception SE?
Amennorhea
Androgen effects
Breakthrough ovulation
Osteoporosis
Estrogen or Progesterone causes androgen effects?
Progesterone
Androgen effects?
Increased LDL
Decreased HDL
Acne
Hirsutism
Early gen progestin with least androgenic effects?
Norethidrone
Specific SE of late gen progestins
(Norgestimate, Desogestrel)?
Less Androgenic
More Thrombi
Benefits of progestin only oral contraception?
Amennorhea
NO RISK OF THROMBI
Reduced risk of endometrial cancer
Fast return to fertility
Progestin used for injection?
Medroxyprogesterone Acetate
Black box with medroxyprogesterone acetate?
Bone health
Longest return to fertility
Implantable progestin rod?
Etonogestrel
Progestin used in Plan B?
Levonorgestrel
Progestin used in IUDs?
Levonorgestrel
Ulipristal Acetate is what?
Progesterone Antagonist
Mifepristone is what?
Progesterone Antagonist
High does vs low dose mifepristone?
Low dose = inhibits ovulation
High Dose = abortifacient
What is added to oral E/P pills to reduce wt gain?
Drospirenone (spironalactone analog)
Drospiredone SE?
More thrombi
Hyperkalemia
Dienogest is marketed as an OC for what specific purpose?
Heavy irregular menses
Relative contraindications of estrogen?
Obesity Thrombophilia Anti-convulsants Migrane w/o aura HTN Depression Lactation
Estrogen methods of delivery?
Pill
Ring
Patch (More breakthrough bleeding)
Ulipristal acetate is effective for how long after intercourse?
120 hrs (Stops ovulation)