Endocrine Drugs and Medications Q 26

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Progestins have been known to cause which of the following:

  

     A. Decrease HDL level

     B. Increase aspartate transaminase

     C. Increase HDL levels

     D. Decrease aspartate transaminase

    

    

Correct Answer: A. Decrease HDL level

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Progestins decrease HDL levels, which may predispose the client to increased cardiac risk. Progestins are synthetic progestogens. Progestin drugs can be subclassified in two ways: (1) generationally or (2) based upon structural properties.

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Option B: Progesterone enters the cell by passive diffusion through the plasma membrane and binds to the progesterone receptor in the nucleus. When unbound, the progesterone receptor exists as a monomer. After binding progesterone, the receptor undergoes a conformational change and becomes a dimer, which increases receptor binding to DNA.

Option C: Most progestins exert their contraceptive effects by suppressing the secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary gland. This adventitiously alters the menstrual cycle to suppress ovulation.

Option D: Progestins also provide other benefits by secondary mechanisms such as thickening cervical mucus to prevent penetration by sperm, slowing tubal motility by impairing fallopian tube motility, and inducing endometrial atrophy.

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