NGR 6172 Pharm Exam 2 Questions With Complete
Solutions
phytoestrogens (isoflavones, lignins, coumestans)
plant-based compounds with weak estrogenic activity
commonly used as a 'natural' way to manage menopausal
symptoms
selective estrogen receptor modulators (SERMs)
tamoxifen, toremifene, raloxifene, bazedoxifene
drugs that activate ERs in some tissues & block in others -
developed to provide the benefits of estrogen but prevent the
drawbacks
progesterone biosynthesis
produced by the ovaries and placenta
acts before gestation to prepare the uterus for implantation of a
fertilized ovum & helps maintain uterus during pregnancy
acts on: endometrium, endocervical glands (viscous/scant),
breasts, body temp
progesterone during pregnancy
- suppress contraction of uterine smooth muscle (sustains
pregnancy)
,- suppresses contraction of GI smooth muscle (constipation)
- promotes growth and proliferation of alveolar tubules in breast
structures that produce milk
- suppression of arterial pco2, altered serum bicarb, elevation of
serum pH
- suppresses maternal immune system (preventing immune
attack on the fetus)
progesterone
uses: menopausal hormone therapy, dysfunctional uterine
bleeding, amenorrhea, endometrial hyperplasia/carcinoma,
support during IVF
AE: breast tenderness, HA, abd discomfort, arthralgia,
depression
hormone therapy (estrogen/progesterone)
uses: tx of vasomotor symptoms, genitourinary syndrome of
menopause, prevention of osteoporosis
flibanserin (addyi)
1st drug approved for female sexual interest-arousal disorder
(FSIAD) not associated with relationship issues, mental health
problems, or medication side effects
not indicated for women who are postmenopausal
AE: CNS depression, hypotension
,requires a risk evaluation program for providers to be able to
prescribe
combo oral contraceptives (ethinyl estradiol/norethindrone)
MOA: reduce fertility by inhibiting ovulation
estrogen suppresses release of FSH, progestin suppresses LH
also thickens cervical mucus and alters endometrium making it
less hospitable
AE: thromboembolic disorders, cancers (some protection vs
some risk), htn, abnormal uterine bleeding, stroke in women w
migraines, estrogen excess (nausea, breast tenderness, edema),
progestin excess (increased appetite, fatigue, depression)
drug interactions by OCs
- reduced effect: warfarin, hypoglycemic agents
- increased effect: theophylline, TCAs, diazepam,
chlordiazepoxide
levomefolate
metabolite of folic acid added to many OCs to refuse the risk of
neural tube defects if pregnancy does occur
what to do if a dose of OC is missed
- if 1 or more pills are missed in the FIRST WEEK, take 1 pill
ASAP and continue the pack. use additional protection for 7
days
, - if 1 or 2 pills are missed during SECOND/THIRD WEEK, take
1 ASAP and continue with the active pills, but skip placebo pills
and go straight to a new pack
- if 3 or more pills are missed during SECOND/THIRD WEEK,
follow the same instructions but use additional protection for 7
days
progestin-only OCs (minipills)
do not contain estrogen (do not cause thromboembolic disorders,
HA, nausea, or other AEs)
less effective and more likely to cause irregular bleeding
nexplanon
subdermal etonogestrel implants (synthetic progestin)
depot medroxyprogesterone acetate (DMPA)
depo shot given IM or subq to protect against pregnancy for 3
months by inhibiting secretions of gonadotropins
MOA: - inhibits follicular maturation and ovulation, - thickens
cervical mucus, - causes thinning of endometrium
AE: similar to other progestin-only meds. irregular/absent
menstruation, weight gain, bloating, HA, depression, decreased
libido, reversible bone loss
copper IUDs
TCu380A or Paraguard
Solutions
phytoestrogens (isoflavones, lignins, coumestans)
plant-based compounds with weak estrogenic activity
commonly used as a 'natural' way to manage menopausal
symptoms
selective estrogen receptor modulators (SERMs)
tamoxifen, toremifene, raloxifene, bazedoxifene
drugs that activate ERs in some tissues & block in others -
developed to provide the benefits of estrogen but prevent the
drawbacks
progesterone biosynthesis
produced by the ovaries and placenta
acts before gestation to prepare the uterus for implantation of a
fertilized ovum & helps maintain uterus during pregnancy
acts on: endometrium, endocervical glands (viscous/scant),
breasts, body temp
progesterone during pregnancy
- suppress contraction of uterine smooth muscle (sustains
pregnancy)
,- suppresses contraction of GI smooth muscle (constipation)
- promotes growth and proliferation of alveolar tubules in breast
structures that produce milk
- suppression of arterial pco2, altered serum bicarb, elevation of
serum pH
- suppresses maternal immune system (preventing immune
attack on the fetus)
progesterone
uses: menopausal hormone therapy, dysfunctional uterine
bleeding, amenorrhea, endometrial hyperplasia/carcinoma,
support during IVF
AE: breast tenderness, HA, abd discomfort, arthralgia,
depression
hormone therapy (estrogen/progesterone)
uses: tx of vasomotor symptoms, genitourinary syndrome of
menopause, prevention of osteoporosis
flibanserin (addyi)
1st drug approved for female sexual interest-arousal disorder
(FSIAD) not associated with relationship issues, mental health
problems, or medication side effects
not indicated for women who are postmenopausal
AE: CNS depression, hypotension
,requires a risk evaluation program for providers to be able to
prescribe
combo oral contraceptives (ethinyl estradiol/norethindrone)
MOA: reduce fertility by inhibiting ovulation
estrogen suppresses release of FSH, progestin suppresses LH
also thickens cervical mucus and alters endometrium making it
less hospitable
AE: thromboembolic disorders, cancers (some protection vs
some risk), htn, abnormal uterine bleeding, stroke in women w
migraines, estrogen excess (nausea, breast tenderness, edema),
progestin excess (increased appetite, fatigue, depression)
drug interactions by OCs
- reduced effect: warfarin, hypoglycemic agents
- increased effect: theophylline, TCAs, diazepam,
chlordiazepoxide
levomefolate
metabolite of folic acid added to many OCs to refuse the risk of
neural tube defects if pregnancy does occur
what to do if a dose of OC is missed
- if 1 or more pills are missed in the FIRST WEEK, take 1 pill
ASAP and continue the pack. use additional protection for 7
days
, - if 1 or 2 pills are missed during SECOND/THIRD WEEK, take
1 ASAP and continue with the active pills, but skip placebo pills
and go straight to a new pack
- if 3 or more pills are missed during SECOND/THIRD WEEK,
follow the same instructions but use additional protection for 7
days
progestin-only OCs (minipills)
do not contain estrogen (do not cause thromboembolic disorders,
HA, nausea, or other AEs)
less effective and more likely to cause irregular bleeding
nexplanon
subdermal etonogestrel implants (synthetic progestin)
depot medroxyprogesterone acetate (DMPA)
depo shot given IM or subq to protect against pregnancy for 3
months by inhibiting secretions of gonadotropins
MOA: - inhibits follicular maturation and ovulation, - thickens
cervical mucus, - causes thinning of endometrium
AE: similar to other progestin-only meds. irregular/absent
menstruation, weight gain, bloating, HA, depression, decreased
libido, reversible bone loss
copper IUDs
TCu380A or Paraguard
