Obat-obat Gangguan Haid

Kepustakaan
Goodman and Gilmans, The Pharmacological Basis Of Theurapeutics, Eleventh Ed, 2006 Farmakologi Dan Terapi, Edisi 5, 2007

C. Hormon kelamin dan antagonisnya

Estrogen dan antiestrogen : 1. a. Estrogen: estradiol, estradiol valerate, estradiol cypionate, ethinyl estradiol, mestranol, quinestrol, estrone, estrone sulfate, equilin, b, Senyawa nonsteroid dengan aktivitas estrogenik: diethylstilbesterol,

p,p'-DDT, bisphenol-A, genistein. 2. Selective estrogen receptor modulators (SERMS) : tamoxifen, raloxifene, toremifene. 3. Antiestrogen: clomiphene, fulvestrant 4. Estrogen syntesis inhibitors: fortnestane, exemestane, anastrozole, letrozole, vorozole

 Progestin dan antiprogestin : 1.a. Progestin: progesterone, senyawa pregnane (17 alfa acetoxy progesterone), senyawa estranes (19nortestosterone), senyawa gonane (norgestrel). b. Steroid : medroxyprogesterone acetate (MPA), megestrol acetate., norethindrone acetate.

2. Antiprogestin: mifepristone, onapriston, (kombinasi antiprogestin-prostaglandin: sulprostone, gemeprost, misoprostol)

 Kontrasepsi : a. Kombinasi oral (progestinestrogen): monofasik, bifasik, trifasik. b. Progestin only : oral, parenteral: MPA, implants: norethinrone

Estrogen-progestin
Endogenous hormon produce physiological actions: - Developmental - Neuroendocrine for ovulation - Fertilitation - Mineral, carbohydrate, protein, lipid

Estrogen
Two major uses: - combination oral contraceptive - MHT (menopausal hormone therapy)

MHT
Vasomotor: hot flashes, inapropriate sweating, paresthesias Osteoporosis: estrogens reduce bone resorption Vaginal dryness and urogenital atrophy Cardiovascular disease Others: thinning of the skin etc

Menopausal Hormone Regiment

1960-1970 Estrogen Replacement Therapy (estrogen alone) increasing endometrial carcinoma 1980 Hormon Replacement Therapy (include progestin), now referred as Menopausal Hormon Therapy

Selective Estrogen Receptor Modulators and Anti-Estrogen

Antiresoptive effect on bone Decrease total cholesterol, LDL and lipoprotein, but does not increase HDL and TG Therapeutic Uses: breast cancer (tamoxifen), Osteroporosis (raloxifene), infertility (clomiphene)