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Questions and Case Studies – Reproductive Pharmacology

by Pravin Shukle, MD
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    00:01 Let's go on and do a question.

    00:03 Let's start off with question number one.

    00:05 A 16-year-old woman presents to the ER 10 hours after coitus.

    00:10 She wants an emergency contraceptive.

    00:12 Choose the best option.

    00:15 A, the Yuzpe method; four estrogen tablets and one progestin tablet.

    00:20 B, diethylstilbestrol or DES.

    00:24 C, ethynyl estradiol.

    00:28 D, norgestrel.

    00:31 Or E, mifepristone Good for you.

    00:36 You chose E.

    00:38 In terms of the Yuzpe method itself, it's outdated.

    00:41 It was not as effective as newer therapies, but it does still work.

    00:45 DES is an important drug for you to know because it caused so many serious adverse reactions and these adverse reactions are actually multi-generational.

    00:56 Review the section on DES in the endocrinology reproductive pharmacology lectures before you write your exams.

    01:04 Ethinyl estradiol is a common component in most oral contraceptive agents.

    01:08 It is not as effective in emergency contraceptive treatment.

    01:14 Norgestrel is a first-generation progestin.

    01:16 It is not as effective as mifepristone, Norgestrel is a first-generation progestin.

    01:16 It is not as effective as mifepristone, which is also called RU 486.

    01:22 When combined with misoprostol, mifepristone is 95% effective.

    01:28 So, it is now the treatment of choice in this situation.

    01:34 Let's move on to the next question.

    01:35 Which drug is an effective treatment for a man with stage III prostate cancer? Is it, A, leuprolide; B, stanazolol; C, anastrozole; D, a testosterone patch; or E, finasteride? Good for you.

    01:56 You chose leuprolide.

    01:58 Now, the other agents are not appropriate.

    02:00 Stanazolol is an anabolic steroid.

    02:04 Testosterone patch is not appropriate in this case.

    02:07 You may actually exacerbate prostate cancer.

    02:09 And finasteride is a 5-α-alpha inhibitor, so it's more used for hair loss than it is for prostate cancer.

    02:19 Let's move on to the next question.

    02:21 A SERM is a drug that, A, works on both the estrogen and progesterone receptors B, acts as both an estrogen antagonist and an estrogen agonist; C, acts as both an estrogen antagonist and a testosterone antagonist; D, acts as both an estrogen antagonist and an LH antagonist; or E, acts as both an estrogen antagonist and an FH antagonist.

    02:53 Good for you.

    02:54 It acts as both an estrogen antagonist and an agonist.

    02:58 It is a confusing set of drugs to look at because you're acting both to block and to activate a receptor, and it sometimes can get very confusing.

    03:07 Just remember drugs like tamoxifen tend to be estrogen receptor blockers in breast tissue and agonists in uterine tissue, which is why it's a drug of choice – first-line drug of choice in women with ER positive estrogen breast cancer because it doesn't harm or inhibit the estrogen receptors in the uterus.

    03:29 Good for you.

    03:31 Well, that's it.

    03:32 That's the end of our lecture.

    03:33 I'm sure that you're going to do really well on your exams.

    03:36 Good luck.


    About the Lecture

    The lecture Questions and Case Studies – Reproductive Pharmacology by Pravin Shukle, MD is from the course Reproductive Pharmacology. It contains the following chapters:

    • Case Study 1: Reproductive Pharmacology
    • Question 1: Reproductive Pharmacology
    • Question 2: Reproductive Pharmacology

    Author of lecture Questions and Case Studies – Reproductive Pharmacology

     Pravin Shukle, MD

    Pravin Shukle, MD


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