Antiprogestins and Their Mechanism of Action
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Questions and Answers

What is the primary mechanism of action of antiprogestins like Mifepristone?

  • Enhancing ovulation
  • Increasing endometrial maturation
  • Stimulating progesterone production
  • Competitively inhibiting progestin at progesterone receptors (correct)
  • In what way do antiprogestins like Mifepristone prevent ovulation?

  • Triggering ovulation at an earlier stage
  • Promoting fertilization
  • Competitively inhibiting progestin at progesterone receptors (correct)
  • Blocking the action of luteinizing hormone
  • Apart from termination of early pregnancy, for what other purpose can Mifepristone be used?

  • Enhancing fertility
  • Promoting endometrial thickening
  • Inducing cervical ripening before abortion (correct)
  • Treating menopausal symptoms
  • What effect does the antiglucocorticoid action of Mifepristone provide in cases of in-operable Cushing’s syndrome?

    <p>Offering palliative relief</p> Signup and view all the answers

    How does mifepristone prevent pregnancy?

    <p>By inhibiting the maturation of ovarian follicle</p> Signup and view all the answers

    What is the main clinical use of mifepristone?

    <p>Preventing pregnancy after unprotected sex</p> Signup and view all the answers

    Which enzyme is responsible for metabolizing mifepristone in the liver?

    <p>CYP3A4</p> Signup and view all the answers

    What property of mifepristone contributes to its long duration of action?

    <p>High lipid binding property</p> Signup and view all the answers

    Why is natural endogenous progesterone not orally effective?

    <p>It is highly bound to albumin</p> Signup and view all the answers

    How do synthetic progestins differ from natural endogenous progesterone?

    <p>They are orally effective</p> Signup and view all the answers

    What is a characteristic of norethindrone among the synthetic progestins mentioned?

    <p>Mild androgenic effect</p> Signup and view all the answers

    What is the primary physiological action of progesterone in hormone replacement therapy?

    <p>Prepare the uterus for implantation</p> Signup and view all the answers

    Study Notes

    Mechanism of Action of Antiprogestins

    • Antiprogestins like Mifepristone primarily act by blocking progesterone receptors, inhibiting progesterone's effects on the uterus.
    • This blockade leads to the softening of the uterine lining and potential termination of early pregnancy.

    Prevention of Ovulation

    • Mifepristone prevents ovulation by disrupting the hormonal balance necessary for ovulation to occur.
    • By inhibiting progesterone, it alters the luteal phase, preventing the release of the egg.

    Additional Uses of Mifepristone

    • Beyond terminating early pregnancy, Mifepristone is used in the management of conditions like Cushing's syndrome and facilitating medical abortion when combined with prostaglandins.

    Antiglucocorticoid Action in Cushing's Syndrome

    • Mifepristone’s antiglucocorticoid action interferes with cortisol effects, aiding in symptom management for inoperable Cushing's syndrome.

    Mechanism of Preventing Pregnancy

    • Mifepristone prevents pregnancy by blocking the progesterone that stabilizes the endometrium during the menstrual cycle, thus leading to the breakdown of the endometrial lining.

    Main Clinical Use

    • The foremost clinical application of Mifepristone is as an abortifacient in the medical termination of early pregnancy.

    Metabolism of Mifepristone

    • Mifepristone is metabolized in the liver primarily by the enzyme CYP3A4.

    Duration of Action

    • The long duration of action of Mifepristone is attributed to its strong affinity for progesterone receptors, allowing prolonged effects despite elimination.

    Effectiveness of Natural Progesterone

    • Natural endogenous progesterone is not orally effective due to significant first-pass metabolism in the liver, reducing its bioavailability.

    Synthetic Progestins vs. Natural Progesterone

    • Synthetic progestins are designed to resist metabolism and have modified structures that enhance their effectiveness compared to natural progesterone.

    Characteristic of Norethindrone

    • Norethindrone, a synthetic progestin, possesses properties that allow for extended half-life and increased resistance to breakdown, making it highly effective for contraception.

    Physiological Action of Progesterone in Hormone Replacement Therapy

    • In hormone replacement therapy, progesterone primarily maintains the uterine lining and reduces the risk of endometrial hyperplasia in women receiving estrogen.

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    Description

    Learn about antiprogestins, such as Mifepristone, onapristone, and gestione, and how they competitively inhibit progestin at progesterone receptors to prevent ovulation, fertilization, and implantation. Discover their role in delaying endometrial maturation and the appearance of the implantation window, especially in the context of termination of early pregnancy.

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