The drug of choice for induction of ovulation is?

HPSSSB Staff Nurse - 2016

Pharmacology

Easy

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Clomiphene is a selective estrogen receptor modulator (SERM) specifically used to induce ovulation.
It works by blocking estrogen receptors in the hypothalamus, which disrupts the normal negative feedback loop.
This leads to an increased release of Gonadotropin-Releasing Hormone (GnRH), which in turn stimulates the pituitary to secrete more Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH).
The surge in FSH and LH stimulates the ovaries, promoting follicular development and the release of an egg (ovulation).

Option A: Levonorgestrel is a synthetic progestin. Its primary mechanism is to suppress or delay ovulation, making it a contraceptive, not an ovulation-inducing agent.
Option B: Danazol is a synthetic steroid with androgenic properties that suppresses ovarian function by inhibiting the mid-cycle surge of FSH and LH.
Option D: Ethinyl oestradiol is a synthetic estrogen. When used in combined oral contraceptives, it suppresses the release of FSH and LH from the pituitary gland, thereby inhibiting follicular development and preventing ovulation.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological induction of ovulation helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in educating patients undergoing fertility treatments about their medications, including the purpose, dosage, timing, potential side effects, and signs of complications like Ovarian Hyperstimulation Syndrome (OHSS).
Accurate patient teaching on when to expect ovulation and the best time for intercourse is critical to maximizing the chances of conception.
Monitoring for adverse effects is a key safety responsibility. Visual disturbances are a serious side effect of clomiphene that requires immediate cessation of the drug and notification of the provider.

How to Approach the Question

First, identify the core purpose of the question: finding a drug that causes or induces ovulation.
Analyze the options based on their drug class and primary function.
Recall that contraceptives work by preventing ovulation. Levonorgestrel (progestin) and Ethinyl oestradiol (estrogen) are common components of contraceptives. This allows you to eliminate these options.
Evaluate the remaining options. Danazol is known for treating endometriosis by suppressing the ovaries. This is the opposite of the desired effect.
This leaves Clomiphene. Recall that it is a classic fertility drug specifically designed to stimulate the ovaries to produce an egg.
Confirm the choice by remembering its mechanism: it blocks estrogen feedback to increase the hormones (FSH/LH) that drive ovulation.

Concept Tested & Keywords

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E6 Pharmacology Katzung 16e p. 1149-1151

E6 Gynecology Williams p. 38-63

E6 Pharmacology Nursing Lilley 11e Part 2 p. 241-243