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Pharmacology · USMLE Step 1

USMLE Pharmacology: Reproductive and Hormonal Drugs

Contraceptives, SERMs, and hormone therapy drugs with mechanism of action, distinct from the diabetes and thyroid focus of the endocrine drugs deck.

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What is the primary mechanism by which combined oral contraceptives (COCs) prevent pregnancy?
They suppress the LH surge, preventing ovulation.
Which hormone component of combined oral contraceptives thickens cervical mucus to impede sperm?
The progestin component.
How do progestin-only pills prevent pregnancy?
By thickening cervical mucus and thinning the endometrium.
Leuprolide belongs to what drug class?
GnRH agonist.
What happens to gonadotropin release with continuous, non-pulsatile GnRH agonist therapy?
GnRH receptors downregulate, suppressing LH and FSH release.
What is the flare effect seen at the start of GnRH agonist therapy?
A transient rise in testosterone or estrogen before sustained hormone suppression occurs.
Leuprolide is used in the treatment of which cancer?
Prostate cancer.
Besides prostate cancer, leuprolide is used to treat which gynecologic condition?
Endometriosis.
Ganirelix and cetrorelix belong to what drug class?
GnRH antagonists.
What is the main clinical use of GnRH antagonists such as ganirelix?
Preventing a premature LH surge during controlled ovarian stimulation for IVF.
What is the mechanism of action of mifepristone?
It is a progesterone receptor antagonist.
What is the main clinical use of mifepristone?
Medical abortion, given together with misoprostol.
What role does misoprostol play in medical abortion regimens?
As a prostaglandin E1 analog, it ripens the cervix and induces uterine contractions.
What is the mechanism of action of ulipristal acetate?
It is a selective progesterone receptor modulator.
What is the main clinical use of ulipristal acetate?
Emergency contraception.

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