Women's Health Drugs

Question 1

Hormonal Contraceptives

Answer 1

Progestin+/- estrogen
Mechanism: supress LH/FSH secretion, preventing follicular development and ovulation
Side effects:
-bleeding (progestin-only>combo)
-weight gain, acne, hirsutism (if androgenic progestin)
-Urethral dilation
-bactiuria
-amenorrhea
Less frequent:
-MI
-stroke
-jaundice
-depression
Benefits:
-reduce ovarian cysts, ovarian/endometrial cancer, breast disease 
-reduce ectopic pregnancy 
-reduce menstrual symptoms
-reduce acne/hirsutism (if not androgenic progestin)

Question 2

Non-Oral contraceptives

Answer 2

• Transdermal patch (ortho evra)- combo, monthly patches
• Vaginal Ring (NuvaRing)- insert ring 3/4 weeks in month instead of taking pills
• Subdermal implant (Implanon, Nexplanon)- inserted to upper arm, secretes progestins for 3yr
• Injectable (Depo Provera)- inject progestin every 3 months. Increased risk of weight gain, osteoporosis, menstrual irregularities, depression
• IUD
• Sterilization

Question 3

Mifepristone

Answer 3

“Morning after” pill, ie Plan B

Mechanism: progesterone receptor antagonist causing corpus luteum degradation

Question 4

Clomiphene

Answer 4

Class: SERM
Mechanism: partial estrogen receptor agonist, inhibiting normal estrogen negative feedback, causing increased gonadotropin
Use: stimulate ovulation for pregnancy in oligomenorrhea, amenorrhea
Side effects: hot flashes, nausea/vomiting, weight gain, depression, fatigue- basically menstruation

Question 5

Leuprolide

Answer 5

Class: GnRH agonist
Mechanism:
Use: 2nd line after clomiphene for ovarian stimulation, like in IVF

Question 6

Ceftriaxone

Answer 6

Class: 3rd gen cephalosporin
Mechanism: ß-lactam, inhibit wall biosynthesis (bactericidal)
Use: gonorrhea + chlamydia, in conjunction with azithromycin/doxycycline

Question 7

Azithromycin

Answer 7

Class: macrolide
Mechanism: Inhibit 50S ribosome subunit blocking protein synthesis (bacteriostatic)
Use: chlamydia/gonorrhea as secondary agent to ceftriaxone

Question 8

Doxycycline

Answer 8

Class: tetracycline analog
Mechanism: Inhibit protein synthesis targets 30S subunit (bacteriostatic)
Use: gonorrhea/chlamydia secondary to ceftriaxone

Question 9

Metronidazole

Answer 9

Class: nitroimidazole
Mechanism: activation by PFOR forms toxic nitro radical, damages DNA causing apoptosis
Use: trichomoniasis (Protozoa + anaerobes)
Side effects:
-nausea/headache/dry mouth
-vomiting/diarrhea/insomnia/vertigo/dysuria
-rare: neutropenia, pancreatitis, CNS toxicity
Contraindications: CNS disorder, alcohol, pregnancy, nursing

Question 10

Acyclovir, valacyclovir, famcyclovir

Answer 10

Class: antivirals
MEchanism: guanosine analogs competitively inhibit viral DNA pol and cause chain termination
Use: genital herpes
Side effects: GI