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Norethindrone is mildly, moderately or more androgenic than other progesins?
How does Northindrone’s risk of thrombosis compare to other progestins?
Lower risk of thrombosis than with other progestins
Levonorgestrel and norgestrel are mildly, moderately or more androgenic than other progesins?
What are the 2nd gen Progestins?
Levonorgestrel and norgestrel
What generation of Progestins are Levonorgestrel and norgestrel?
What generation of Progestin is Norethindrone?
What are the 1st gen Progestins?
What is the advantage of Levonorgestrel and norgestrel over first generation progestins?
What are the 3rd gen Progestins?
Desogestrel and norgestimate
What generation of progestins are Desogestrel and norgestimate?
Desogestrel and norgestimate are mildly, moderately or more androgenic than other progesins?
How does Desogestrel and norgestimate’s risk of thrombosis compare to other progestins?
What are the 4th gen progestins?
Dienogest and drospirenone
What generation of progestins are Dienogest and drospirenone?
Dienogest and drospirenone are mildly, moderately or more androgenic than other progesins?
How does Dienogest and drospirenone’s risk of thrombosis compare to other progestins?
What are the advantages of Dienogest and drospirenone over earlier generation progestins?
Less likely to cause acne and hirsutism
What are the disadvantages of Drosperinone compared to other progestins?
Risk of hyperkalemia
What are the indications for Estrogen treatment?
- Primary hypogonadism
- Postmenopausal hormonal therapy
- Suppression of ovulation
- Hirsutism and amenorrhea = excessive androgen secretion
What are the adverse effects of Estrogen therapy?
- Endometrial cancer (without progesterone)
- Ovarian cancer (protective effect)
- Breast cancer (only for those with brca1 gene)
- Migraines, gallbladder disease and HTN
- Nausea, breast tenderness
What are the Indications for Progesterone therapy?
- Dysfunctional uterine bleeding
- Hormone replacement
What classes of Fertility Drugs are available?
- Human menopausal gonadotropin (menotropins)
- Chorionic gonadotropin (HCG)
- GnRH analogues
What drug is an Antiestrogen?
What drugs are human menopausal gonadotropins?
How are GnRH analogues administered?
What is the MOA of Oral contraceptives?
- 1) Estrogens and/or Progestins inhibit pituitary function and ovulation via negative feedback on Hypothalamus
- 2) Thicker postovulation cervical mucus
- 3) Depresses ovarian function
- 4) Delays maturation of the endometrium altering implantation
- 5) Alters transit of ovum
What is a monophasic oral contraceptive?
What is a diphasic oral contraceptive?
Constant estrogen; 2 doses of progestin
What is a triphasic oral contraceptive?
Constant estrogen; 3 doses of progestin
What is a quadriphasic oral contraceptive?
4 different levels of estrogen/progestin
What are the Biphasic birth control pills?
What are the Triphasic birth control pils?
- Estrostep Fe
- Ortho Tri-Cyclen LO
- Ortho-Novum 7/7/7
What are the Quadriphasic birth control pills?
- Quartette (91 days)
What are the progesterone only birth control pills?
Ortho Micronor, Nor-QD
What is ethinyl diacetate?
- Norethindrone with 2 acetates
- Converted in the body to norethindrone
What is Mestranol?
Prodrug, it gets converted into ethinyl estradiol
Why do some birth control pills have levomefolate?
- Rraise Folic acid conc.
- Prevent spina bifida
If you have HTN, why would you not want to use drosperinone?
Potential androgenic activities, further raise BP
What groups are progesterin only (Norethindrone or Norgestrel) pills a good choice for?
Thromembolic or Nursing
How should the morning after pill be given?
- Used to be 2 pills
- Now, 1 pill and 2 pills if 72 hours after intercourse
What are the adverse effects of Norethindrone or Norgestrel only pills?
Break through bleeding