N11

PHARMACOLOGY FOR NURSES

~ DRUGS ON REPRODUCTIVE SYSTEM ~

PHYSIOLOGY
 GnRH
o From hypothalamus
 Gonadotropins
o LH
 M – Leydig
 F - Thecal
o FSH
 M – Sertoli
 F - Granulosa
 Sex Hormones
o Gonadal hormones
o Testosterone from testis
o Progestins – from ovaries
o Androgens
 Sex hormones are regulated by the hypothalamic-pituitary-gonadal axis
 BRCA – treatment is aromatase inhibitors which lessens estrogens

FEMALE GONADAL HORMONES

 Estrogens
o Mediated by estrogen receptors (alpha and beta), ligand-regulated
 Takes time for stimulation as essential target is to produce new hormone, therefore very slow process
o Pharmacokinetics
 E2 binds stronglyto alpha globulin
 Lower affinity to albumin
 E2 in liver
 Estrone and estriol
 Hydroxylated derivatives and conjugated metabolites
 Orally administered, high ratio of hepatic to peripheral effects
o Physiologic effects
 Androgen increases LDL – younger males tend to have heart attacks because of cholesterol buildup due to androgen
 Estrogen increases triglycerides
 esTRogen – Triglycerides
o Clinical Application
 Hormonal contraception
 Primary hypogonadism
 Post-menopausal hormonal therapy
o Adverse effects
 Hormonal imbalance
 Estrogen
o When follicles don’t grow, estrogen proliferates  extra thickening of endometrium/lack of
progesterone production
 Adipose tissue also is a source of aromatase  more production of estrogen
 Leads to uterine bleeding
 Endometrial cancer
 Other effect: nausea, breast tenderness
 Progesterone
o Metabolized in liver
o Secretory
o Increased basal body temperature
o Decreases amount of cervical mucus and increases viscosity
o Promote endometrial development during luteal phase
o Anti-estrogen

COCs
 Types
o Usually containing ethinyl estradiol and norethindrone
o Administered with interruption
o Monophasic
 All 21 active pills
o Biphasic
o Triphasic
o All have same effect (mono, bi, and triphasic)