Hormonal contraceptives — Flashcards

Flashcard 1: Combined contraceptives are contraindicated in patients > 35 years old who _____

Answer: smoke

Flashcard 2: Ethinyl estradiol, DES, and mestranol are examples _____ analogs

Answer: estrogen

Flashcard 3: Oral _____ contain high doses of estrogen and progesterone (or progesterone alone) which prevent ovulation via inhibition of FSH and LH

Answer: contraceptives

Flashcard 4: What is the mechanism by which combined contraceptives (progestins + estradiol) act as a contraceptive? _____

Answer: Inhibit ovulation

Flashcard 5: What drug class do mifepristone and ulipristal belong to?

Answer: Anti-progestins

Flashcard 6: mestranol

Answer: estrogen

Extra: hypognadism, ovarian failure, menstrual abnormalities, HRT in postmenopausal women, androgen-dependent prostate cancerestrogen receptor-positive breast cancer, hx DVTbinds estrogen receptorincreased risk of endometrial cancer, vaginal bleeding in postmenopausal women

Flashcard 7: Clomiphene mechanism of action (MOA)

Answer: SERM

Extra: Uses: Infertility and PCOS Mechanism: Partial agonist at estrogen receptors in hypothalamus; prevents normal feedback inhibition, increasing LH and FSH release which stimulates ovulation. Side effects: Hot flashes, ovarian enlargement, multiple pregnancy, visual disturbances.

Flashcard 8: tamoxifen

Answer: SERM

Extra: ER-positive breast cancerantagonist at estrogen receptor; specific for breast tissue

Flashcard 9: raloxifene

Answer: SERM

Extra: Clinical use: Osteoporosis (reduces bone resorption). \nMechanism: Selective Estrogen Receptor Modulator (SERM). Agonist at bone; Antagonist at breast and uterus (no increased risk of endometrial cancer).

Flashcard 10: What are the clinical uses and mechanism of action of progestins?

Answer: Uses: contraception, endometrial cancer, abnormal uterine bleeding. Mechanism: binds progesterone receptor; reduces proliferation of endometrium, thickens cervical mucus.

Extra: Progestins (e.g., levonorgestrel, medroxyprogesterone) are used to oppose estrogen's effects on the endometrium, reducing the risk of endometrial hyperplasia/cancer. In contraception, they thicken cervical mucus to inhibit sperm penetration and may inhibit ovulation.