osteoporosis, fertility, thyroid, contraceptive drugs

parathyroid hormone

produces PTH

calcitonin produced by

follicular cells produce thyroxin and parafollicular cells produce calcitonin

PTH

mobilizes calcium phosphate from bone matrix

calcitonin

stimulate incorporation calcium phosphate into the bone matrix, by activating osteoblasts and inhibiting the activity of osteoclasts

raloxifene

class: selective estrogen receptor modulators
moa: mimic estradiol in some target tissues like bone and kidney
tu: treat post-menopausal osteoporosis and estrogen-receptor positive breast cancer
pt: less risk of producing breast cancer, increase pulmonary

bisphosphonates

alendronate and zoledronate inhibits of osteoclast activity and bone demineralization
non-hormonal treatment of osteoporosis

calcitonin-salmon

more potent and has a longer half-life
inhibits osteoclasts and stimulates osteoblasts

tariparatide

only drug for osteoporosis that increases bone formation
reduce spine and femur fractures

oral calcium salts

ex. calcium chloride
treat low Ca
dietary supplement

vitamin D supplement

ex. ergocalciterol, vitamin D2
prescribed for nutritional rickets, osteomalacia, and hypoparathyroidism

estrogen

moa: estrogen receptor agonists that mimic the biological effects of estradiol
tu: menopause symptoms
pt: breast cancer, CV risk, dementia, CAD, stroke, thromboembolic

progestins

formation of cervical mucous plug reduces implantation

Seasonale

combination oral contraceptive that is taken for 84 days and then no pill for 7 days (period every 3 months)

Lybrel

only combination oral contraceptive that is taken continuously with no scheduled interruption

Progestin-only pills

taken continuously
good option for women in whom an estrogen-containing contraceptive is either contraindicated or causes additional health concerns

Medoxyprogesterone

injected IM and is active for 3 months or longer

Etonogestrel implants

inserted as a subdermal rod that is active for 3 years

combination oral contraceptive or progesterin only pharmacodynamics

moa: estradiol or progesterone receptor agonists that alter events in the menstrual cycle that prevent conception, ovulation, or nidation (implantation) of fertilized egg onto surface of the uterus
tu: birth control, cycle stabilizer, acne, reduce migrain

adverse effects of combination oral contraceptives

increased throboembolic disorders, HTN, uterine bleeding, estrogen/progesterone imbalance

adverse effects of progestin-only oral contraceptives

irregular bleedings
inconsistent cycle
amenorrhea

postcoital or emergency contraceptives

contain progestins that inhibit ovulation or alter the movement of the fertilized egg through the fallopian tubes

clomipene

class: fertility drug
moa: estrogen receptor antagonist that blocks the feedback control of estradiol on the hypothalamus and the pituitary gland
tu: inducting ovulation in a properly selected population of patients

human chorionic gonadotropin

class: fertility drug
moa: hCG is a fetal hormone that mimics the effects of LH in the gonads of males and females
tu: treatment for hypogonadotropic hypogonadism-induced infertility that stimulates spermatogenesis in males and in females it can be admini

human menopausal gonadotropins (hMG)

class: fertility drug
moa: menopausal gonadotropin enhance graafian follicle maturation necessary for ovulatoion

sildenafil (viagra)

moa: cGMP-dependent phosphodiesterase 5 (PDE 5) inhibitors allowing for vasodilation
tu: treats ED

synthroid

L-T4
treatment of hormone replacement therapy for hypothyroidism

perchlorate

blocks the uptake of dietary iodine into follicular cells in the thyroid gland which blocks the synthesis of thyroid hormones

Propylthiouracil

blocks a key enzyme in the follicular cells in the thyroid gland that blocks the synthesis of thyroid hormones

Tocolytics

prevent preterm birth associate with high infant mortality and morbidity

nifidipine

class: tocolytic
moa: calcium channel blocker that inhibits calcium entry into myometrial cells thus reducing calcium-dependent actin-myosin cross-bridge formation

Terbutaline

class: tocolytics
moa: ?2 adrenergic receptor agonist in the myometrium, activates the cAMP second messenger cascade that leads to a suppression of MLCK; the reduction in myosin light chain phosphorylation; and ultimately myometrial smooth muscle relaxati

Magnesium sulfate

tocolytic and it interferes with calcium channels and calcium binding to myosin which ultimately causes myometrial smooth muscle relaxation

oxytocin

enhance uterine contraction
induce or augment labor