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4 main categories of reproductive hormones
- progestins
- androgens
- gonadotropic
- estrogen
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gonadotropic hormones are secreted by:
anterior & posterior pituitary lobes
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gonadotropic hormones include
- 1. follicle stimulating hormone
- 2. luteinizing hormone
- 3. luteotropic hormone
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stimulates ovarian follicle dev’p & sperm production
follicle stimulating hormone
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works w/ FSH to induce secretion of estrogen & dev’p of corpus luteum
Luteinizing hormone
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stimulates production of progesterone by the corpus luteum & milk secretion by mammary glands “lactogenic hormone”
LTH (luteotropic hormone)
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male hormones that are secreted mainly in the interstitial tissue of the testes in the male and secondarily in the adrenal glands of both sexes
androgens
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____ stimulate the development of male characteristics (masculinization), include testosterone and androsterone
androgens
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removal of the testicles
castration
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an inadequets production of androgens in the male may be due to:
pituitary malfunction, atrophy, or injury
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characteristics of eunuchoid include:
- retarded development of sex organs
- abscence of beard adn body hair
- high pitched voice
- lack of muscular development
-
_____ may also result in impotence or deficient sperm production (oligospermia)
hypogonadism
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uses of androgens include:
- congenital: delayed puberty in males
- replacement: diminished hormone (male menopause)
- acquired: hypogonadism (orchitis etc)
- palliative treatment: females with advanced metastatic carcinoma of the breast, danazol
-
enlarged breast tissue in males
gynecomastia
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SI of ____:
-edema
- acne
-alopecia
-gynecomastia
-hirsutism (unusual hair growth)
-deep voice
-stunted growth
-jaundice
-increase LDL
-decrease HDL
insulin resistance
androgens
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a serious side effect of illegal synthetic testosterone use (anabolic steroids)
psychosis (with delusion, paranoia, depression, mania, aggresion)
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all androgen agents fall under what classification category for abuse.
C-III abuse potential
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to avoid secondary exposure to children with testosterone gel what must be done:
wash hands with soap and warm water after every application
cover application site with clothing once gel has dried
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PE for _____:
-use according to directions
- report decreased ejaculatory volume and excessive sexual stimulation especially in geriatric patients
-female sexual effects expect hirutism
-stunted growth
androgens
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erectile dysfunction meds:
- sildinafil (viagra)
- tadalafil (cialis)
- vardenafil (levitra)
-
how are PDE (phosphodiesterase)inhibitors given and why?
orally for erectile dysfunction/impotence
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medications that require sexual arousal for success
viagra, levitra, cialis
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the first PDE inhibitor approved to treat ED?
Sildenafil (viagra)
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SE of ____:
-HA, flushing, dizziness, vision abnormalities
-hearing loss, tinnitus
-cardiovascular events (angina, syncope, tachycardia, hypotension)
PDE inhibitors
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CI of _____:
-if erection persist more than 4hrs, seek medical assistance ASAP
* may indicate tissue damage and permanent potency loss
-older adults and PT's with cardiovascular risk factors
PDE inhibitors
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IA with _______:
-grapefruit juice (potentiates hypotension effects)
-nitrates, antiarryhtmics, macrolides, antifungals, quinolones
PDE inhibitors
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female sex hormone produced mainly by the ovary and secondarily by the adrenal gland
estrogen
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responsible for the development of female secondary sexual characteristics including breast enlargement and for the mentrual cycle.
estrogen
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effects the secretion of the FSH adn LH from the anterior pituitary gland in a complex way.....inhibits lactation and ovulation
estrogen
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estrogen meds
- estradiol (estrace), (vagifem), (estrogel), (depo-estradiol)
- premarin
- menest
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estrogen in combination w/ _______ is used in mgmnt of severe menopausal symptoms that do not respond to estrogen alone
testosterone
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when ____ & ___ are combined the risk of endometrial cancer is substantially reduced
progestin & estrogen
-
is associated w/ increased risk of endometrial carcinoma
estrogen therapy alone
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should not be used to prevent diseases due to risk of stroke or blood clots
estrogen-alone therapy
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should not be used for cardiovascular disease prevention
combined HT
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_____ uses include:
-bcp
-hypogonadism due to oopherectomy
-postmenopausal prevention of osteoporosis if unable to take any other medication
-postcoital use after rape or incest
-inoperable prostate cancer
estrogen therapy
-
SE of ____ with high doses:
-increased risk of thromboembolic disorders, MI, Stroke
-HA, migraine, depression
-increased risk of gallbladder disease
-skin discoloration
- vaginal bleeding
-hypercalcemia
estrogen therapy
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CI for ______:
-anyone w/ hx of many conditions such as htn, liver, sob, breast cancer, DVT vaginal bleeding, visual disturbance, pregnancy
estrogen therapy
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_______ should never be used to treat threatened abortions or if there are any possibilites of pregnancy
estrogens
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estrogen is also cautioned in
diabetes & heavy smokers
-
IA with ______:
-rifampin & isoniazid estrogenic activity
-corticosteroids (potentiates)
-lab tests
-sunscreen with estradiol topical emulsion (increase absorption)
estrogen
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hormone secreted by the corpus luteum and adrenal glands
progesterone
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responsible for changes in uterine endometrium in 2nd half of menstrual cycle in preparation for implantation of fertilized ovum, dev’p of placenta after implantation & dev’p of mammary glands
progesterone
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synthetic drugs that exert progesterone-like activity are called
progestins
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_____ is also used for anorexia, weight loss, cachexia, and associated with aids syndrome
megace
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Uses of ______ include:
-treats amenorrhea & abnormal uterine bleeding
-concentration
-postmenopausal
-adjunctive/palliative therapy for endometrial & breast CA (megace)
-treats paraphilia esp. for pedophilia
synthetic progestin
-
___ has been used IM weekly to monthly to manage paraphilia (sexual deviancy in males) espcially for pedophilia and sexual sadism
depo provera
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Extended cycle oral contraceptives differ from traditional products by decreasing or eliminating the
hormone free interval
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by what primary mechanism do progestin only contraceptives prevent pregnancy
by inhibiting ovulation
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An intrauterine device containing a synthetic progestin is available and releases small amounts of ______ daily, providing 5 years of continuous contraception protection.
progesterone
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During administration of oxytocin, constant maternal and _______ monitoring is required
fetal
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where is the pituitary gland located
at the base of the brain
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Anabolic steroids are classified as ______ by th eDEA due to drug abuse
controlled substance
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what type of contraceptive agent is indicated for breast feeding women?
progestin only preparation
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Postcoital contraceptive agents must be administered within ___ hrs of unprotected intercourse
72
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Depo-Provera injections may be considered among the risk factors for development of _______
osteoporosis
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how much dosing is needed for PDE when treating impotence
maximum 1 dose daily
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side effects such as ______ should be reported when using androgen therapy
- edema
- jaundice
- nausea
- vomiting
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progestin levonorgestral may be prescribed as ______
an emergency contraceptive
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____ is used to treat impotance, congenital and acquired hypogonadism
testosterone
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_____ induces labor causing the uterus to contract
oxytocin
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_____ is used to treat severe preclampsia or eclampsia
magnesium sulfate
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_____ are used for cervical ripening, therapeutic abortion in second trimester, & uterine evacuations in special circumstances
prostaglandins
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used in management for preterm labor
terbutaline (brethine)
???birth=labor???
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____ are most appropriate & effective for relief of vasomotor symptoms as long as women weigh risk & benefits with their doc
Hormone therapies
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used to treat amenorrhea, uterine bleeding, and as contraception
progestin
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the main producers of estrogens
ovaries
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drug used to terminate an unwanted pregnancy
mifepristone
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used to prevent and treat postpartum and postabortion hemorrhage
methergine
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serious fetal side effect of estrogen
toxicity
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type of cancer resulting from prolonged high-dose estrogen use
endometrial
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contraceptives containing two sequences of progestin doses
biphasic
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preparation containing the same proportion of estrogen & progestin in each tablet
monophasic
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