DRUGS AFFECTING THE FEMALE

REPRODUCTIVE SYSTEM
CHAPTER 40

KENT AMUEL ROLAND ASOR

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PRESENTATION TITLE
 D R U G S U S E D TO T R E AT
PRESENTATION TITLE

DISORDERS OF THE FEMALE

REPRODUCTIVE SYSTEM

• Estrogen and progestins

• Estrogen receptor modulators
• Fertility drugs
• Oxytocics
• Abortifacients
• ocolytics
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 ESTROGEN
PRESENTATION TITLE

• Actions
- protecting the heart from atherosclerosis
- retaining calcium in the bones
- maintain the secondary female sex characteristics

• Indication
- hormone replacement therapy (HRT)
-palliative and preventive therapy during menopause

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PRESENTATION TITLE ESTROGEN

• Pharmacokinetics
-absorbed through the GI tract and undergoes extensive hepatic metabolism
- excreted in the urine

• contraindication
- - allergies and pregnancy
-idiopathic vaginal bleeding, breast cancer and estrogen dependent cancer,
thromboembolic disorder

• Caution
-breastfeeding, metabolic bone diseases, renal insufficiency, hepatic
impairment

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PRESENTATION TITLE ESTROGEN
• Adverse effect
- GI tract
- Systemic effects of estrogens

• Drug-to-Drug Interactions
- Drugs that enhance hepatic metabolism
- Corticosteroids

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PRESENTATION TITLE
E S T R O G E N R E C E P TO R
M O D U L ATO R S

• Actions
- Modulating effects on estrogen receptors
- Used to stimulate specific estrogen receptors to increase bone
mineral density
• Indications
- Postmenopausal osteoporosis
• Pharmacokinetics
- Well absorbed in the GI tract, metabolized in the liver
- Excreted in the feces

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 C O N T.
• Contraindications
PRESENTATION TITLE

- Known allergy, pregnancy, and lactation

- Patients with history of venous thrombosis or smoking
• Adverse Effects
- GI upset
- Changes in fluid balance: headache, dizziness, and visual changes
- Estrogen receptor stimulation: hot flashes, skin rash, edema, and
vaginal bleeding
• Drug-to-Drug Interactions
- Cholestyramine
- Highly protein-bound drugs
- Warfarin

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 PROGESTINS
• Actions
PRESENTATION TITLE

- Transform the proliferative endometrium into a secretory

endometrium -Inhibit the secretion of FSH and LH - Prevent follice
maturation and ovulation
- Inhibit uterine contractions
• Indications
- Contraception
- Treatment of primary and secondary amenorrhea Fertility protocols
• Pharmacokinetics
- Well absorbed, undergo hepatic metabolism and are excreted in the
urine

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 P R O G E S T I N S C O N T.
PRESENTATION TITLE

• Contraindications
-Allergies, pregnancy, idiopathic vaginal bleeding, breast or
genital cancer, history of thromboembolic disorders, PID, sexually
transmitted disease, endometriosis, or pelvic surgery

• Adverse Effects
Varies based on route of administration

• Drug-to-Drug Interactions
Barbiturates, Carbamazepine, Phenytoin, or Rifampin

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 F E RT I L I T Y D R U G S .
PRESENTATION TITLE

• Actions
- Directly or by stimulating the hypothalamus to increase FSH and LH levels, leading to ovarian follicular
development and maturation of ova

• Indications
- Infertility in men and women

• Pharmacokinetics
- Well absorbed, undergo hepatic metabolism and renal excretion

• Contraindications
- Primary ovarian failure
- Thyroid or adrenal dysfunction
- Ovarian cysts
- Pregnancy, idiopathic uterine bleeding, and known allergy

• Caution
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- Breast feeding, thromboembolic disease, or respiratory disease

 F E RT I L I T Y D R U G S ( C O N T. )
PRESENTATION TITLE

• Adverse Effects

- Increase risk of multiple births and birth defects

- Ovarian overstimulation
- Headache, fluid retention, nausea, bloating
- Uterine bleeding, ovarian enlargement
- Gynecomastia

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 O X Y TO C I C S
PRESENTATION TITLE

• Actions
- Affect neuroreceptors sites to stimulate contractions of the uterus

• Indications
- Prevention and treatment of uterine atony after delivery
• Pharmacokinetics
- Rapidly absorbed, metabolized in the liver, and excreted in urine
and feces

• Contraindications
- Allergy and early pregnancy
- Cephalopelvic disproportion

• Caution
- Coronary artery disease, hypertension, lactation, and previous
13 Cesarean section
 O X Y TO C I C S ( C O N T. )
PRESENTATION TITLE

• Adverse Effects
- Excessive effects: uterine hypertonicity and spasm
- GI upset (nausea)
- Headache
- Blood pressure changes
- Water intoxication

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 A B O RT I FA C I E N T S
PRESENTATION TITLE

• Actions
- Stimulate uterine activity
- Dislodge any implanted trophoblast and preventing implantation
of fertilized egg

• Indications
- Termination of pregnancy at 12-20 weeks

• Pharmacokinetics
- Well absorbed, metabolized in the live and excreted in the urine

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 A B O RT I FA C I E N T S
PRESENTATION TITLE

• Caution
Asthma, hypertension, or adrenal disease - Acute vaginitis or
scarred uterus

• Adverse Effects
- Abdominal cramping
- Heavy uterine bleeding
- Perforated uterus or uterine rupture
- Headache, nausea, vomiting, diarrhea, diaphoresis, backache,
and rash

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 A B O RT I FA C I E N T S
PRESENTATION TITLE

• Uses
- Relax the uterine smooth muscle and prevent contractions
leading to premature labor and delivery
- Usually reserved for use after 20 weeks of gestation; neonate has
a chance of survival outside the uterus • Prototype
- Only one in US: Ritodrine (Yutopar); withdrawn because of
serious side effects

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