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CHAPTER 13

Quiz Yourself

1. Estradiol is the primary female hormone. It causes the endometrium to proliferate


and thicken. Progesterone prepares the uterus to receive a fertilized ovum. Oxytocin
stimulates the uterus to contract during labor. Follicle-stimulating hormone
(FSH) causes the follicle of the ovary to secrete estradiol. Luteinizing hormone
(LH) causes the follicle to rupture and release a mature ovum.

2. Monophasic oral contraceptive drugs: This category has one phase of treatment of
progestin and an estrogen in each tablet.
Examples: Alesse, Brevicon, Demulen, Desogen, Loestrin, Lo/Ovral, Lybrel,
Modicon, Norinyl, Ortho-Cept, Ortho-Cyclen, Ortho-Novum, Ovcon, Ovral,
Seasonale, Yasmin, YAZ.
Biphasic oral contraceptive drugs: This category has two phases with changing doses
of a progestin but a fixed dose of an estrogen.
Examples: Mircette, Ortho-Novum 10/11, Seasonique.
Triphasic oral contraceptive drugs: This category has three phases of varying
doses of hormones.
Examples: Cyclessa, Estrostep, Ortho-Novum 7/7/7, Ortho Tri-Cyclen,
Tri-Levlen, Triphasil.

3. Seasonale is a monophasic oral contraceptive, while Seasonique is a biphasic oral


contraceptive. Their hormone tablets are taken continuously for three months, followed by
seven inert tablets. This means that the patient has a menstrual period only four times a
year, as opposed to every month when taking other oral contraceptive drugs.

4. Drugs for chronic diseases, such as hypothyroidism, diabetes mellitus, or hypertension,


or antibiotic drugs for acute infections, as determined by the physician, can be given
during pregnancy to protect the health of both the mother and fetus. Pregnant women
are prescribed prenatal vitamins, iron, and folic acid.

5. In the late 1950s, the drug thalidomide was developed in West Germany and used
extensively to treat morning sickness. The FDA refused to approve its use in the
United States without further studies. Before these additional studies could be
completed, evidence against the safety of the drug began to accumulate. Over 8,000
babies were born in Europe with deformed extremities (seal limbs, or phocomelia).

6. Endometriosis develops when endometrial tissue from the uterus travels through the
fallopian tubes and implants on the outer surface of the ovaries and other abdominal
organs and on the walls of the pelvic cavity. During each menstrual cycle, this tissue
thickens and then sloughs off, forming more implants in the abdominal cavity,
along with old blood and tissue debris. Hormone drugs are used to suppress the
menstrual cycle for several months, during which time the endometrial implants
shrink and fade.
7. Menopause causes symptoms of vaginal dryness, hot flashes, and fatigue, which can
be treated by hormone replacement therapy (HRT), which can also reduce the risk
of osteoporosis and keep cholesterol levels low. However, HRT that includes estrogen is
also associated with an increased risk of breast and endometrial cancer, blood clots,
stroke, heart attack, and dementia.

8. Ovulation-stimulating drugs cause several mature ova to be released from the ovary at
the same time. However, a pregnancy with multiple babies can endanger the life of the
mother and/or the babies. Some obstetricians recommend elective removal of one
or more of the growing fetuses prior to delivery, but this creates an ethical and
moral dilemma. For in vitro fertilization as part of an assisted reproductive technology
program, the release of multiple mature ova increases the chance for successful harvesting of
ova from the mother, fertilization of several ova, and successful implantation of fertilized ova
back in the mother. However, using only some of the fertilized ova, while the rest are frozen
(or possibly used in research), also creates ethical and moral issues.

9. RhoGAM is an immunoglobulin drug given to an Rh-negative mother after the


birth of an Rh-positive infant; it prevents the mother from making antibodies during
the next pregnancy and causing hemolytic disease of the newborn in a subsequent
pregnancy. It is also given to women who have had a miscarriage, spontaneous or
induced abortion, or amniocentesis. It is given to the woman, not the newborn.

10. Premenstrual syndrome (PMS) is characterized by dysmenorrhea, breast tenderness,


edema from fluid retention (bloating), and mild mood changes. It is treated with
combination drugs that contain an analgesic drug for dysmenorrhea, a diuretic
drug to treat fluid retention, and an antihistamine drug with a weak diuretic effect and
a sedative effect. Premenstrual dysphoric disorder (PMDD) includes similar physical
and emotional symptoms, but to a much greater degree than PMS, with depression,
anxiety, and sleep disturbances that significantly interfere with life. PMDD is treated with
antidepressant drugs, antianxiety drugs or with the oral contraceptive drug
YAZ, as well as drugs used for PMS.

11. Implanon is a progestin-only contraceptive drug that is an implant that is inserted


under the skin. Mirena is a progestin-only contraceptive drug that is a T-shaped
device that is inserted into the uterus. NuvaRing is a contraceptive drug with
fixed doses of a progestin and an estrogen in the form of a ring that is inserted in the
vagina. Ortho Evra is a contraceptive drug with fixed doses of a progestin and an
estrogen in the form of a transdermal patch (Ortho Evra) that is applied to the skin.

12. a. estrogen hormone replacement therapy for menopause


b. triphasic oral contraceptive drug
c. prostaglandin drug used to ripen the cervix during labor
d. estrogen hormone replacement therapy for menopause
e. monophasic oral contraceptive drug
f. topical anti-infective drug used to treat vaginal bacterial infections
g. topical anti-infective drug used to treat vaginal yeast infections
h. monophasic oral contraceptive drug
i. uterine stimulant drug used during labor and to treat postpartum bleeding
j. combination hormone drug used to treat menopause symptoms
k. monophasic oral contraceptive drug also approved to treat acne and premenstrual
dysphoric disorder.

Clinical Applications Questions


1. a. Prempro
b. Combination hormone replacement therapy drug
c. It means 0.125 mg of an estrogen drug and 2.5 mg of a progestin drug.
d. 30
e. Take one by mouth each day
f. Symptoms of menopause and prevent osteoporosis

2. a. Vivelle
b. transdermal patch
c. estradiol
d. estrogen hormone replacement therapy drug