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PHAR 300 (Kim) > Women Contraception > Flashcards

Women Contraception Flashcards

1
Q

Estrogen and progestins are used for

A

Contraception
Ovulation induction
Hormone replacement therapy
Cancer replacement therapy

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2
Q

Gonadotripic-Releasing Hormone (GnRH) is a

A

PEPTIDE hormone (amino acids structure)

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3
Q

FSH regulates/stimulate:

A

Follicles growth and maturation

Steroidogenesis (Cholesterol side chain cleavage & aromatase activity in granulosa cells.)

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4
Q

Granulosa cells are

A

Intracellular

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5
Q

Theca cells are

A

Extracellular

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6
Q

Corpus Luteum produce

A

progesterone (until placenta begins take over)

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7
Q

Aromatase also named:

A

Estrogen synthase

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8
Q

Aromatase activity

A

convert Testosterone to Estradiol

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9
Q

LH act on

A

Theca cells

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10
Q

LH regulate/stimulate:

A

Steroid synthesis

FSH receptors

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11
Q

Steroidogenesis pathway:

A

Cholesterol –> (side chain cleavage reaction) –> progesterone –> testosterone –> (aromatase reaction) –> estradiol.

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12
Q

Two estradiol receptors:

A

human estrogen receptor alpha (hER alpha)

‘’ beta (hER beta)

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13
Q

Estrogen action

A

bind to lipophilic p+ in circulation –> enters cells –> interact with hER (receptor) in nucleus or cytoplasm –> DNA target genes.

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14
Q

Difference between ER alpha and beta isoforms

A

different response elements (ligand)
different co-activators
Beta isoforms have other mechanisms like non-genomic mechanisms

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15
Q

Effect of estrogen:

A

Local effects: Myometrium, Uterus, In the brain (control temperature, moodiness)
System effects: p+, carbohydrate and lipid metabolism, water and electrolyte balance, blood clotting, fat distribution, bone maturation…

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16
Q

Progesterone action:

A

Bind to hPR –> interact with the progesterone response element in DNA –> affect genes

17
Q

Non-genomic pathway of progesterone

A

progesterone bind to membrane receptor–> activate secondary messengers intracellular –> biological function

(MORE RAPID THAN USUAL ACTION)

18
Q

Exemple of hPR post-transcriptonally modified:

A

alternatively spliced (generate hPR alpha & beta isoform)

19
Q

Major functions are similar. The difference in the role of Progesterone is

A

It antagonizing the action of estrogen in the fallopian tubes and on myometrium.

20
Q

What lead to a dramatic surge of LH?

A

When the FSH decreases.

21
Q

What stimulate the ovulation of the mature follicule>

A

LH surge

22
Q

After ovulation what happen to LH and FSH?

A

LH goes down

FSH restores back to normal.

23
Q

When is the progesterone rise:

A

Low level 1st to 14th days of menstrual cycle and rise after.

24
Q

What is the Combination oral contraception:

A 
Leveonorgestrel (analogue progesterone)
Ethinyl Estradiol (analogue estradiol)
25
Q

Mechanism of action of the oral contraceptive pills

A

Maintain constant level of estradiol so prevent the surge of estradiol –> prevent the surge of LH (INHIBIT OVULATION)

26
Q

Estrogen positive feedback (increase level of LH and FSH) occurs when?

A

it is at high concentration (near end of the follicular phase)

27
Q

Midcycle LH surge stimulate

A

mature follicule rupture and ovulation (occyte)

28
Q

Mechanism of action of oral pills at different levels:

A 
Regulate higher brain centers
Hypothalamus: decrease GnRH pulses
Pituitary: decrease responsiveness, supresses FSH release and follicule growth/developpment
Follopian tube
Ovary
Endometrium
Cervial mucus.
29
Q

Oral contraception absolute contra-indication:

A 
History of breast cancer
History of blood clot
Liver or Kidney disease
Unexplained uterine bleeding
Smoker over age of 35
30
Q

Morning after pill mechanism of action:

A

Block fertilization or Block the implantation!

31
Q

Need to be take when?

A

In 72hours!

32
Q

Plan B differentiation of other morning pills?

A

only progestin pills

33
Q

Ulipristal acetate is

A

a selective progesterone receptor modulator (SPRM)

Act as an Antagonist/agonist (mixed reaction)

34
Q

Estrogen and progesterone are metabolized by?

A

Cytochrome P450 enzymes

35
Q

Drugs that can interacte with P450 enzymes are?

Because?

A

Barbiturates
Phenytoin
Rifampicin (anti-bacterial drugs)

bc they are inducer of P450
So contraception drugs are more metabolized, less efficace.

36
Q

Why broad-spectrum antibiotics such as Ampicillin, tetracycline and Neomycin can decrease efficacy of oral contraception?

A

Bc Kill intestinal bacteria in the GI tract
(Glucuronidases present in the bacteria flora to breakdown glucuronides) –> Oral pill are reabsorbed with the recycling of biles acids.

37
Q

Glucuronides is make by

and is made into?

A

Liver

conjugates

PHAR 300 (Kim) (19 decks)

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