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
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.
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.