Obs&Gynae Meds

Question 1

Tamoxifen

Answer 1

Osterogen receptor antagonist
S/E can cause endometrial changes
ovarian cysts

Question 2

Oxybutynin

Answer 2

Antimuscarinic
Relaxes M2 +M3 of the bladder (detrusor muscles)
PO
S/E; Dry mouth, constipation, blurred vision, nausea and vomiting.
5mg 2-3 daily (immediate release)

Question 3

Mirabegron

Answer 3

Beta-3-adrenergic receptor

Relaxes the detrusor muscles of the bladder

Question 4

Combined oral contraceptive pill (COCP)

Answer 4

Acts on the hypothalamic pituitary axis

• prevents synthesis and stimulation of FSH and LH
• cervical mucus increases
• endometrium is hostile to implantation

S/E: VTE, MI, stroke, breast cancer, cervical cancer

Contraindications: migraine with aura, VTE in hx or family history, vascular disease, smokers >35, BMI>35, diabetes

Question 5

Mini-pill (POP)

Answer 5

cervical mucus becomes impenetrable to the sperm, becomes more viscous
ovulation is inhibited in 60% of the cases

Good alternative to COCP, must be taken every day and at the same time to be effective

S/E: can produce irregular menstruation, increase risk of an ovarian cyst

Question 6

Minerva coil

Answer 6

Suppressant effect on the endometrium (prevents implantation) = endometrial atrophy
Decreases sperm penetration of the cervical mucus

Contraindicated: infections (PID), uterine abnormalities, gynae cancers

Question 7

Depo-provera

Answer 7

Suppress ovulation, makes the endometrium unsuitable for ovulation

Contraindications: current breast cancer, arterial disease, pregnancy, unexplained vaginal bleeding

S/E: irregular bleeding, bone mineral density, CVP, breast cancer, weight gain

Question 8

GnRH analogues

Answer 8

Removes the pusitile nature of GnRH
Bind to the receptors saturating them, flare effect of LH and FSH followed by down regulation
Suppression of LH and FSH

Only for 6 months as can lead to osteoporosis

Eg Goserelin (zoladex)

Question 9

Co-cyprindol

Answer 9

Treatment of PCOS
Treats acne and hirsutism
Anti-androgen (suppresses the androgen blockers)
1 tablet for 21 days on first day of menstrual cycle

Question 10

Elformithine

Answer 10

Treatment of PCOS

Topical cream for the removal of facial hair

Question 11

Clomifene

Answer 11

Inhibits oestrogen receptors in the hypothalamus inhibiting the negative feedback loop of oestrogen on GnHR
50mg OD for 5 days

Question 12

Syntometrin

Answer 12

Synotcin+ ergometrin
Combination of synthetic oxytocin and ergometrine which is an alpha adrenergic receptor agonist.
Cause the uterus to contract