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28 Cards in this Set
- Front
- Back
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Absolute Contraindications to contraceptives?
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1 h/o thromboembolic dx
2 h/o CVA 3 CAD 4 known or suspected breast ca 5 known or suspected estrogen dependent neoplasia 6 pregnancy 7 benign or malignant liver tumor; impaired liver function 8 previous cholelithiasis during pregnancy 9 undiagnosed, abnormal uterine bleeding |
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Estrogen?
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Female hormone produced by the ovaries and released by the follicles as they mature. Responsible for female sexual characteristics, estrogen stimulates and triggers a response from at least 300 tissues, and may help some types of breast cancer to grow. After menopause, the production of the hormone gradually stops.
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Progesterone?
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A steroid hormone secreted by the corpus luteum and by the placenta, that acts to prepare the uterus for implantation of the fertilized ovum, to maintain pregnancy, and to promote development of the mammary glands. Also called corpus luteum hormone, luteohormone, progestational hormone.
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FSH
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Follicle stimulating hormone regulates the development, growth, pubertal maturation, and reproductive processes of the body.
FSH and Luteinizing hormone (LH) act synergistically in reproduction. |
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LH
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Luteinizing hormone (LH, also known as lutropin) is a hormone produced by the anterior pituitary gland. In males, where LH had also been called Interstitial Cell Stimulating Hormone (ICSH), it stimulates Leydig cell production of testosterone.
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Where is FSH synthesized?
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It is synthesized and secreted by gonadotrophs of the anterior pituitary gland.
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In females, an acute rise of LH causes?
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In females, an acute rise of LH called the LH surge triggers ovulation and development of the corpus luteum.
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In males, where LH had also been called Interstitial Cell Stimulating Hormone (ICSH),it stimulates?
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In males, LH stimulates Leydig cell production of testosterone.
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Synthentic estrogens?
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ethinyl estradiol
menstranol |
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Progestins?
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Norethindrone
norethindrone acetate ethanediol diacetate norethynodrel, norestrel, levonorgestrel, desogestrel, gestodene, norgestimate |
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What does progestin do?
MOA? |
1 affects the cervical mucus
and the endometrium, 2 most likely changes tubal transport of oocyte and sperm |
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Estrogenic effects?
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ovulation inhibited by supression of FSH/LH
1.Implantation inhibited by alteration of the endometrium 2.Ovum transport is accelerated 3. Luteolysis may occur as estrogen cuases progesterone levels to fall |
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Progestational effects?
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1 Thick cervical mucus
interferes with sperm transport 2 Capacitation may be inhibited 3 ovum transport may be slowed 4 implantation is hampered by suppression of endometrium 5 ovulation inhibited by hypothalamic-pituitary- ovarian disturbances |
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Advantages of contaceptives?
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1 Decrease menstrual
carmps and pain 2 less menstrual blood flow 3 Improvement in facial acne Women controls her own fertility excellent reversibility and easy to use |
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Other nonconraceptive benefits?
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may provide protection against ovarian and endometrial ca, ectopic preg, PID, functional ovarian cysts endometriosis, uterine fibroids, PMS, benign breast disease, iron deficeincy anemia, toxic shock
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some disadvantages of of contraceptives?
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may lead to mood changes
no protection against HIV expensive rare circulatory complications increased risk of rare liver tumors |
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Possible SE of contraceptives?
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1 Nausea
2 Headaches 3 Breakthrough bleeding |
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Excessive estrogenic effects?
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dysmenorrhea
nausea cholasma CVA DVT Thromboembolic dx PE telangiectasis hepatic adenoma/ adenocarcinoma cervical changes breast tenderness (2ary to increased size) |
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Deficiencies in estrogen?
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1 No withdrawal bleeding
2 decreased duration in menstrual bleeding 3 continuous spotting /bleeding 4 breakthrough bleeding DOC 1-9 5 Atrophic vaginitis |
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Excessive progestational effects?
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1 Breast tenderness
2 Decreased libido 3 Transient HTN 4 Depression 5 Fatigue 6 Increased appetite 7 Decreased duration in menstrual bleeding |
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Combination contaceptives?
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ethinyl estradiol + norgestimate
Ortho cyclen othroTri Cyclen, ortho Tri Cyclen Lo |
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Progestin only pills may be used in women with?
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h/o of migraine headaches, who are breast feeding or have some contraindication to combo pills.
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When prescribing, begin with?
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low dose combined or multiphasic pill (35 mcg or less)
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High amounts of estrogen may cause?
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1 Nausea
2 Edema 3 Breast tenderness May need to lower dose |
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High amounts of progestin may cause?
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1 Wt gain
2 increased appetite 3 Fatigue 4 Depression 5 Acne 6 Hirsuitism May need to lower dose |
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What drugs can decrease the effectiveness of OCs?
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Some
Antibiotics & Anticonvulsants |
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What drugs can cause the effectiveness of OCs to be decreased?
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Warfarin
Insulin and certain oral hypoglycemics |
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Methods of Birth Control?
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1 Condoms
2 Oral Contraceptives 3 Nuva Ring 4 Ortho Evra 5 Spermicides 6 Depo-Provera (DMPA) 7 Implanon 8 IUD 9 Diaphragm/ Cervical Cap 10 Plan B 11 Sponge 12 Sterilzation |
