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Therapeutics > Lecture 12: Estrogens > Flashcards

Lecture 12: Estrogens Flashcards

1
Q

Estrogens

A

-development and maintenance of female reproductive tissues
-regulation in CNS (temp, mood)
-effects in peripheral tissues (bone, cardiovascular, liver)

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2
Q

Progesterone

A

-development/maintenance of female tissues
-maintenance of pregnanct
-effects in other tissues (brain)

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3
Q

17B-estradiol

A

-most potent estrogen
-produced mostyl in ovaries of premenopausal women
-synthesized most in placenta during pregnancy

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4
Q

17B-estradiol plasma levels

A

-varies with menstrual cycle
-5-85 ng/dL

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5
Q

17B-estradiol states

A

-most bound to SHBG
-free (2%)

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6
Q

Granulosa cells

A

-produce estrogen

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7
Q

corpus luteum

A

-produces estrogen and progesterone

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8
Q

Menstrual Cycle

A
  1. early follicular phase
  2. late follicular phase
  3. luteal phase
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9
Q

early follicular phase

A

-estrogen suppresses FSH

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10
Q

late follicular phase

A

-estrogen stimulates LH and FSH surge
=ovulation
=forms corpus luteum

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11
Q

luteal phase

A

-estrogen and progesterone suppress LH and FSH

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12
Q

If pregnancy does not occur,

A

-corpus luteum degenerates
-estrogen and progesterone production by corpus luteum declines
=menstruation

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13
Q

if pregnancy occurs,

A

-embryo secretes hCG
-hCG acts like LH
=stimulates corpus to produce progesterone during first trimester

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14
Q

high progesterone levels support

A

maintenance of endometrium

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15
Q

pregnancy tests

A

-chromatographic immunoassays of hCG in urine

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16
Q

Estrone and Estiol synthesis

A

-synthesized in liver and peripheral tissues
-from androstenedione
-aromatase

17
Q

17B-estradiol synthesis

A

-in ovaries
-from testosterone
-aromatase

18
Q

types of estrogens

A

-natural
-synthetic
-phyto
-environmental

19
Q

natural estrogens

A

-17B-estradiol (most potent)
-estrone
-estriol (least potent)

20
Q

Synthetic estrogens

A

-drugs with estrogenic activities
-steroidal or nonsteroidal

21
Q

phytoestrogens

A

-estrogen-mimetic compounds in plants
-“flavonoids”

22
Q

environmental estrogens

A

-compounds used to make plastic
-bisphenols, alkylphenols, phthalate phenols

23
Q

Metabolism of estrogen

A

-in liver
-hydroxylation in A ring

24
Q

Excretion of estrogen

A

-to bile then to urine
-conjugated estrogens in bile can be hydrolyzed and reabsorbed

25
Q

oral estrogens

A

-high ratio of hepatic to peripheral effects

26
Q

physiological effects of estrogen

A

-female maturation
-endometrial
-metabolic and cardiovascular
-enhance blood coagulation
-CNS (mood)

27
Q

Role of estrogen in female maturation

A

-development of vagina, uterus, uterine tubes
-breast growth
-accelerated growth phase and epiphyseal closure
-grow hair
-alter body fat distribution
-pigment skin (nipples, genitals)

28
Q

endometrial effects of estrogen

A

-develop endometrial lining
-prolonged exposure = hyperplasia and abnormal bleeding

29
Q

Metabolic effect of estrogen

A

-decrease bone reabsorption rate
-synthesize transcortin and SHBG
-increase HDL
-decrease LDL

30
Q

osteoporosis cause

A

estrogen deficiency

31
Q

Clinical uses of estrogens

A

-hormone replacement therapy (postmenapause)
-osteoporosis
-contraception
-replacement therapy in hypogonadism

32
Q

Hormone replacement therapy in postmenapausal women

A

-relieve CNS effects (hot flashes)
-relieve urogenital atrophy symptoms (dry cooch)
-relieve mood, insomnia, depression, nervousness

33
Q

osteoporosis

A

-post-menapausal only
-estrogens decrease rate of bone reabsorption

34
Q

Replacement therapy in patients with primary hypogonadism

A

-no ovaries
-chromosomal disorders (turner syndrome)
-castration (oophorectomy)

35
Q

turner syndrome

A

absence of one or all sex chroosomes

36
Q

Adverse effects of estrogens

A

-uterine bleeding
-endometrial carcinoma
-breast cancer
-nausea, headache, retention, weight gain

37
Q

Uterine bleeding due to estrogen

A

-endometrial hyperplasia
-estrogen should be given cyclically
-prevent by admin of progestin each cycle

38
Q

Progestin effect on estrogen adverse effects

A

-prevent uterine bleeding
-reduce risk of endometrial carcinoma
-not effective for breast cancer

Therapeutics (78 decks)

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