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19 Cards in this Set
- Front
- Back
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Interceptive oral contraception can be a mixture of estrogen+progesterone or may be (estrogen/progesterone) only.
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Interceptive oral contraception can be a mixture of estrogen+progesterone or may be ESTROGEN only.
The mechanism of interceptive OC is uncertain but probably alters tubal and uterine motility sufficiently to interfere with implantation. |
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The "minipill" method of OC is based on giving a daily low dose of:
a) estrogen b) progestin c) E + P |
The "minipill" method of OC is based on giving a daily low dose of:
b) progestin |
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The biphasic and triphasic combination OC's are given in low constant doses for days 5-25 of the menstrual period. The pill taken at day 20 compared to the pill taken at day 5:
a) is exactly the same b) has the same [E] but higher [P] c) has the same [P] but higher [E] |
The biphasic and triphasic combination OC's are given in low constant doses for days 5-25 of the menstrual period. The pill taken at day 20 compared to the pill taken at day 5:
b) has the same [E] but higher [P] |
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What is the function of the estrogen in a combination-type OC?
What is the function of progestin in the combinatin-type OC? |
In combination-type OC's, the estrogen is primarily effective for inhibiting ovulation and the progestin ensures proper withdrawal bleeding.
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What are the 17-ethinylated estrogens?
What are the 19-nortestosterones? |
17-ethinylated estrogens include 17-ethinylestradiol and mestranol. They are orally active and used in oral contraceptives, hormone replacement therapy, and prevention of post-menopausal osteoporosis.
19-nortestosterones are chemical derivatives of testosterone but act like progesterone. They are orally useful. The prototype is norethindrone. They are used in oral contraceptives, and as treatment in the case of dysfunctional uterine bleeding and threatened or habitual abortion. |
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When choosing the right oral contraception for your patient:
a) use the lowest estrogen concentration that is effective b) use the lowest progestin concentration that is effective |
When choosing the right oral contraception for your patient:
a) use the lowest estrogen concentration that is effective |
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Oral contraceptives may cause lipid alterations and increases in these 2 laboratory tests...
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(1) increased clotting factors
(2) increased TBG and total T4 |
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What are the three significant drug interactions associated with OC's?
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(1) anticoagulants + OC's : OC's may increase clotting factors which may diminish effect of oral anticoagulants
(2) hepatic microsomal enzyme inducers + OC's : drugs that induce liver enzymes may increase the rate of inactivation of steroids (3) Antibiotics + OC's : long term broad spectrum antibiotics may reduce GI flora which normally produces enzymes that regenerate active steroids from inactive Phase II conjugates |
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You prescribe your patient a 14 day supply of a broad spectrum antiobiotic. You ask her if she takes oral contraceptives and she does. Why should youtell her to use an alternative form of contraception while she is on the antibiotic?
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Long term broad spectrum antibiotics may reduce GI flora which normally produces enzymes that regenerate active steroids from inactive Phase II conjugates.
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Identify if the following side effects are associated with (a) estrogen excess, (b) estrogen deficiency, (c) progestin excess or (d) progestin deficiency.
(1) delayed withdrawal bleeding (2) early breakthrough bleeding (3) depression, fatigue, acne, hirsutism, increased appetite (4) edema, nausea, breast tenderness, hypertension |
(1) delayed withdrawal bleeding = progestin deficiency
(2) early breakthrough bleeding = estrogen deficiency (3) depression, fatigue, acne, hirsutism, increased appetite = progestin excess (4) edema, nausea, breast tenderness, hypertension = estrogen excess |
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The combination type OC's are associated with several adverse effects. Name them.
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(1) cardiovascular disease
(2) increased glucose intolerance (3) hypertension (4) increased incidence of hepatoma (5) increased incidence of gall bladder disease |
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Combination-type OC's increase a woman's risk of cardiovascular disease. Describe, more specifically, this risk.
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--OC's increase clotting factors, putting woman at risk of thrombophlebitis and thromboembolism
--2-5x risk of myocardial infarction --2-20x risk of stroke --cardiovascular risk is greatly compounded by other risk factors such as age, obesity, hypertension, smoking |
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While combination-type OC's have several adverse effects, they also have many beneficial effects. Name some of these benefical effects.
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Combination-type OC's decrease the incidence of..
--ovarian cancer --endometrial cancer --benign breast tumors --PID --ectopic pregnancy --dysmenorrhea --menstruation related iron deficiency anemia |
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What are the absolute contraindications to use of oral contraceptives?
What are the relative contraindications? |
ABSOLUTE CONTRAINDICATIONS
--hx of thromboembolic disease --impaired liver function or obstructive jaundice --estrogen dependent neoplasia --genital bleeding --pregnancy --women > 35yo and smoke > 15 cigarettes/day RELATIVE CONTRAINDICATIONS --migraine --hypertension --diabetes --epilepsy |
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The efficacy as an anti-ovulatory agent and the serious cardiovascular side effects of OC's are due to the:
a) estrogenic component b) progestin component |
a) estrogenic component
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This semi-synthetic progestin is useful as pharmacologic contraception and is a long-acting injection given every 13 weeks.
a) norethindrone b) medroxyprogesterone c) progesterone |
This semi-synthetic progestin is useful as pharmacologic contraception and is a long-acting injection given every 13 weeks.
b) medroxyprogesterone |
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What are some conditions that may cause female infertility but are amenable to pharmacological treatment?
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--hyperprolactinemia (bromocryptin)
--polycystic ovary syndrome (cycling OC's, clomiphene) --unfavorable cervical mucus (topical estrogen) --endometriosis (GnRH analogs) --luteal phase dysfunction (hCG or progesterone) --anovulation (clomiphene, FSH/LH) |
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Clomiphene is a(n):
a) progesterone agonsit b) estrogen agonist c) progesterone receptor antagonist d) estrogen receptor antagonist Why is it useful in anovulatory infertility therapy? |
Clomiphene is an:
d) estrogen receptor antagonist Clomiphene is useful in anovulatory infertility therapy because it normalizes feedback communication. |
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Your patient is having a difficult time getting pregnant. You discover that she is anovulatory due to pituitary hypofunction. What do you use as anovulatory infertility therapy?
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You would use FSH/LH to stimulate the ovaries directly.
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