What is the starter molecule for all sex hormones?
Primary male hormone?
Primary female hormone?
What enzyme converts testosterone to estradiol?
This is a decapeptide released by the hypothalamus to stimulate the anterior pituitary gland to release LH and FSH?
These are peptides that are closely related to estrogens, progesterone, and testosterone?
_____ levels cause release of an ovum and development of follicular tissue into the CL and then progesterone secretion begins.
What stimulates the development of ovarian follicles?
LH and FSH
How do we inhibit ovulation?
increase estrogen and progesterone so that (-) feedback will decrease FSH and LH
During pregnancy, this steroid maintains the CL and estrogen and progesterone production which prevents ovulation and menstruation?
What can we use GnRH agonists for?
shrinking uterine fibroids
controlling excessive bleeding
Non-standardized "bioidentical" steroid hormones?
What is 17-beta-Estradiol converted to in the liver?
What is estrone converted to in the liver?
Which form of estradiol is excreted in the urine?
Which two forms of estrogen are in equilibrium in the body and can be converted back and forth?
17 Beta Estradiol and Estrone
Transdermal Estradiol spray?
Name the estradiol patches.
Delestrogen generic name?
estradiol valerate in oil
DepoGen generic name?
estradiol cypionate in oil
What are the 2 prodrugs for injection as depot agents?
Estradiol valerate (Delestrogen)
Estradiol cypionate (DepoGen)
This blocks the oxidation of the C17 beta hydroxyl group to a ketone which is a major pathway of metabolic inactivation? (keeps drugs from undergoing 1st pass, so we keep plasma levels high)
ethinyl group (acetylene): triple bonded hydrogen
Equine derived estrogen
Non-steroidal estrogen that has had some controversy?
What is Estinyl indicated for?
vasomotor symptoms of menopause
primary ovarian dysfunction
What is the advantage of HRT?
helps prevent cardiovascular disease
This is a non-steroidal estrogen that still has estrogenic activity?
This drug is contraindicated in women of child bearing age due to risk of causing clear cell adenocarcinoma (CCA) of the vagina?
What was DES historically prescribed for?
This is a fairly new synthetic mixture of 10 different estrogens?
This synthetic conjugated estrogen is indicated for menopause only?
This drug is on the FDA safety monitoring list for possibly causing angioedema?
This conjugated estrogen is indicated for treating menopause and osteoporosis?
Name the 2 esterified estrogens indicated for treating osteoporosis?
Name the 2 estropipate salt estrogens used to treat osteoporosis?
What are the only 2 estrogens that are used in OCs?
T/F: Progestin pill or mini pills have a slightly higher failure rate.
Why do the progestin only pills (mini pills) have a higher failure rate?
b/c they don't contain any estrogen (mestranol or ethinyl estradiol)
Who should/can use the progestin-only pill (mini pill)?
women who are BF
family hx of breast cancer
smokers older than 35
T/F: estrogens can cause blood clots and salt retention.
Name the 2 SERMs.
This SERM is not effective in treating hot flashes?
this SERM is indicated for treating osteoporosis in pm women?
This SERM can cause blood clotting problems, can cause hepatic failure and is metabolized by 3A4?
This drug is an estrogen receptor antagonist that lacks estrogen activity in the breast and uterus, reduces bone resorption and turnover, and increases bone mineral density?
What is Faslodex indicated for?
txt of hormone receptor positive metastatic breast cancer in pm women w/ disease progression even after antiestrogen therapy
This drug is administered once a month, has a half life of 40 days, is highly protein bound, and is met by 3A4?
If a woman wants to take Faslodex, what precaution should she use?
extra protection, but not oral (needs to be a barrier)
This is a very greasy molecule that contains fluorine and could be toxic? (SERM)
This is an estrogen receptor antagonist w/ equal binding to that of estradiol and this results in a DOWN regulation of estrogen receptors in breast cancer cells?
This drug is a reversible inhibitor of the growth of tamoxifen-resistant cell lines?
What is MegAce indicated for?
AIDS wasting syndrome
What is progestin and its analogs indicated for?
abnormal uterine bleeding
AIDS wasting syndrome
This is the primary endogenous substance of the CL?
This promotes follicular maturation and ovulation, inhibits spontaneous uterine contractions, maintains pregnancy, increases the receptivity of embryo implantation, and makes the endometrium secretory?
Which undergoes more enterohepatic recirculation, estrogen or progesterone?
Too much Progestin = ?
Not enough progestin = ?
When can you not take progestins?
impaired liver fxn
breast or prostate cancer
Diabetics should closely monitor glucose levels when taking what steroid?
What is Crinone vaginal gel (ART) used for?
This is an IU contraceptive device w/ barium sulfate and silicone oil?
What is Prometrium used for?
Take this steroid hormone with food if upsets stomach?
This progestin is good for the elderly, bulimic, anorexic, and patients with AIDS cachexia b/c it stimulates appetite?
This drug is used for palliative txt of advanced breast or endometrial cancer or as an appetite stimulant in certain populations?
Makena is an injection for what indication?
preventing preterm birth (it slows down contractions)
What are the 2 brand names of the progestin 17alpha-Hydroxyprogesterone Caproate?
Hylutin is used for?
primary and secondary amenorrhea
dysfunctional uterine bleeding
What is medroxyprogesterone acetate used for?
abnormal uterine bleeding due to hormone inmbalance
chemical castration in men who are creeps
What are Prempro, Premphase and Combipatch used for?
treat moderate to severe vasomotor symptoms of menopause
Name the 3 combo products of estrogen + progestin.
Where does the progestin starting material come from?
name the progestins used in birth control pills.
Aygestin (also treats amenorrhea)
What is the newest moleculare entity progestin used as birth control w/ possibly less side effects?
What are the monophasic OCs?
all tablets contain same amount of estrogen and progestins
could see breakthrough bleeding halfway through cycle
What are the biphasic OCs?
7-10 days one dose, then remainder of cycle gets a double dose of the progestin
What is the triphasic OC?
dose of progestin is increased in 3 phases over course of cycle while estrogen dose stays the same
Do OCs cause an increase or a decrease in anticoagulation?
both, depends on patient
name the 2 progestin only (mini pills)
Micronor/ Nor QD (norethindrone only)
Ovrette (norgestrel only)
What is the only OC approved by FDA to treat acne in women 15 or older?
This is an OC that is levonorgestrel and is 6 Silastic capsules that contain drug shot into the forearm?
This implant OC can last up to 5 years, but eventually need to be surgically removed?
This OC is an NME implant?
This is a 99% effective rod implant that is good for 3 years, is made of a biodegradable polymer inserted subdermally on upper arm?
Name the 3 IUDs.
Name the 2 IM depot OCs.
T-shaped insert good for 1 year, contains 38 mg of progesterone and barium sulfate dispersed in silicone oil for slow release?
T-shaped insert good for less than 5 years, contains 52 mg of levonorgestrel covered by a silicone membrane?
A vaginal ring containing etonogestrel and ethinyl estradiol (progest and estrogen) that is new as of '06?
Inject this drug IM once a month. contains medroxy and estradiol cypionate?
Inject this drug IM every 3 months. contains only medroxy?
Use this up to 5 days after an accident? Not an abortifactant.
First skin patch for birth control?
Spearmint flavored chewable tablet OC?
Analog of spironolactone?
91 day regimen OC, recommend a preg test once a month if using?
Newest continuous OC that prevents menstruation?
New postmenopausal product that might control hyperlipidemia and hot flashes?
New 4-phasic OC that might mimic mother nature better?
What can be used to treat female sexual dysfunction?