Pharm Block 2(rproductive system #2)

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When are progesterone antagonist used?
How do they work?
Adverse effect?
• Delay or prevent ovulation
- • Used for early termination of
- pregnancy
- – 90% effective in up to 49 days
- pregnancy ( morning after pills)
- - They are competative inhibitors
- – May cause severe vaginal bleeding
What does the feed back loop for Pregesterone look like?
What are Estrogens effects in the reproductive cycle?
What about progesterone?

-Estrogen stimulates prolifeation for Implantation of embryo

- progesterone stimulates secretion to nourish the embryo until implantation.
What are Estrogen nd Progesterones effect on LH and FSH release?
Estrogens: Reduce amplitude

Progestins: Reduce frequency
name some estrogen oral contraceptives.
Estrogens
- – Ethinly estradiol (EE)
- – Mestranol
name some progestin oral contraceptives.
- – Norethindrone
- – Norgestrel
- – Levonorgestrel
- – Desogestrel
- – Etonogestrel (metabolite of desogestrel)
- – Drospirenone
What is a monophasic Oral contraceptive? what is Di/triphasic?
- • Monophasic
- – Same amount of estrogen and progestin throughout the
- cycle
- • Biphasic and Triphasic
- – Variable amount of estrogen and progesterone in phases
What are some Benifits of OCs?
– Decrease risk of ovarian cancer
- – Decrease risk of endometriosis
- – Decrease osteoporosis
What are some Adverse effects of OCs?
- - Increase risk of venous thromboembolism
- • Smokers
- • Preexisting hypertension
- – Increase risk of cancer?
- • Breast, endometrial, cervical, ovarian, . . .
- • Older high-dose OCs
- • Newer low-dose OCs
What is Estrogen and Progesterones effect on Osteoporosis?

is there an increased risk of breast cancer when using OCs?

estrogen Decreases Osteoporosis more by itself then when combined with Progensterone.

No there is no increased risk. But done use them if patient has Breast cancer or has history of it.
What are the progestin only OCs?

What are some advantaes of these?
- -Norethindrone
- -leconorgesterol
- -medroxyprogesterone acetate
these are good for women with high risk factors (smokers)
When do you NOT use Progestin Only OCs?
- – Thromboembolic disease
- – Cerebrovascular disease
- – MI
- – Coronary artery disease
- – Congenital hyperlipidemia
- – Carcinoma of the breast or female reproductive tract
- – Any hormone-dependent/responsive neoplasias
- – Abnormal undiagnosed vaginal bleeding
- – Known or suspected pregnancy
- – Past or present liver tumors or impaired liver function
Name the androgen antagonists?
what should they be used with?
When do you use them?

What is Spironolactone?
When do you use it?
Flutamide, Bicalutamide, Nilutamide

Use with GnRH

Use for prostate cancer and hirsutism
- Spironolactone- it i an aldosterone antagonist with Weak androgen antagonistic effects.
- use it for Gynecomastia in men.
What are the 5 alpha reductse inhibitors?

How do they work?
When do you use them?
Fiinasstride and Dutasteride
- They Block the conversion of Testosterone to to DHT (active form).
- use to treat benign prostate hyperplasia.