Questions and Case Studies – Reproductive Pharmacology

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00:38 In terms of the Yuzpe method itself, it's outdated.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