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7 Cards in this Set
- Front
- Back
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CONTRACEPTIVES
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1. Estrogen/Progestin Combination (Oral, ring, patch)
2. Progestin (Oral, Implantable, Injectable) 3. Postcoital Contraception (Plan B) |
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Estrogen/Progestin Combination Therapy
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No LH/FSH surge- prevent ovulation, change endometrium to prevent implantation, thicken cervical mucus to prevent sperm passage
1. Oral- 3 types (monophasic- on for 28 days off 7, biphasic, triphasic- progestins have 3 doses to mimic real menstruation) 2. Nuva Ring 3. Ortha Evra patch- less effective in women who weigh over 198lbs *3X higher clot risk due to higher estrogen content Estrogens= ethinyl estradiol and mestranol (50mg ie low dose) Side Effects- Nausea and Vomiting, Cramping, Fluid Retention, Headache, Breast Discomfort, Thrombosis, Gallbladder disease, HTN, Impaired glucose tolerance, Cervical and Breast Cancer Progesterones= norgestrel, norethindrone, levonorgestrel, desogestrel, norgestimate, gestodene, and drosperinone Side Effects: Spotting and breakthrough bleeding, Weight Gain, Acne, Hirsutism, Reduction in HDL:LDL ratio, Impaired glucose tolerance |
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Progestin Therapy
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only some prevent ovulation, change endometrium to prevent implantation, thicken cervical mucus to prevent sperm passage
1. ORAL: “Minipill” taken continuously 2. Injectable: “Depot Provera” intramuscular injection that lasts for 3 months *increase risk of osteoporosis if used for more than 2 years 3. Implantable: “Implanton” is an implantable rod just under the skin of the medial aspect of the upper arm that lasts for 3 years 4. Postcoital Contraception (Plan B)- given in very high doses (750 Ìg levonorgestrel) to block ovulation and endometrial changes- 2 dose must be within 72hrs of sex |
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HORMONE REPLACMENT THERAPY
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Estrogens (If there is an intact uterus progestins are used to reduce risk of uterine cancers)
*doses are lower than contraceptive use (5-10Ìg) Benefits: reduction of vasomotor symptoms (hot flashes) and reduced osteoporosis Risks: increased risk of pulmonary embolus, breast cancer, stroke, and endometrial cancer |
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CONTRAGESTATION (Abortion pill)
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Anti-Progestin- Mifepristone
antagonist of progesterone and glucocorticoid receptors- causes endometrial shedding. * given with a prostaglandin to induce contraction of the uterus **must be given within 49 days of the last menstrual period |
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FERTILITY DRUGS
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Anti-estrogen- Clomophene
an antagonist of the estrogen receptor in the pituitary and hypothalamus increasing the surge of LH due to inhibition of negative feedback effects of high estrogen levels *induces ovulation and increases the risk of multiple births |
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SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMs)
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able to selectively target specific tissues with no effect on other tissues with estrogen receptors
ex- Tamoxifen (Nolvadex- an estrogen antagonist in breast tissue to inhibit proliferation of breast cancer tissue without any agonist side effects in the rest of the body ex. Raloxifene (Evista)- an estrogen antagonist in the breast and uterus, and agonist in the bone- prevents breast cancer, uterine cancer, and osteoporosis |
