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Pharm Part II > E2: Endocrine Pt 2: Sex hormones > Flashcards

E2: Endocrine Pt 2: Sex hormones Flashcards

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1
Q

This seems like it would be one of her layup questions: Natural Estrogen: a steroid, called ________….Produced and secreted by the ______

A

estradiol…. ovary

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2
Q

What are the 3 main,ongoing duties of Estrogen (estradiol)?

A

1.Promotes growth of endometrium 2.and mammary ducts 3. secondary sex characteristics

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3
Q

INTERESTING!!! IN Estrogen Replacement therapy—The estradiol structure is rapidly inactivated in GI tract and liver By placing an _______ group (C=CH) at C 17, the derivative is orally active…Called ________(e.g. found in ORAL CONTRACEPTIVES and other female hormone products)

A

ethinyl…..ethinyl estradiol

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4
Q

Conjugated equine estrogens (Premarin)..haha horse pee….Effective in treatment of vasomotor symptoms of ________

A

menopause

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5
Q

Conjugated equine estrogens (Premarin)..haha horse pee….May also be beneficial to prevent bone loss with __________

A

osteoporosis

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6
Q

What are 4 common side effects of Conjugated equine estrogens (Premarin) (haha horse pee)? (NOT the SERIOUS SIDE EFFECTS)

A

1.Peripheral Edema 2. Breast Tenderness 3.Bloating 4.Headache

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7
Q

What are the 2 SERIOUS side effects of Conjugated equine estrogens (Premarin) (haha horse pee)?

A

1.Increased risk for endometrial (uterine) cancer 2.Taking estrogen (such as Premarin) after menopause may also increase risk for breast cancer…wow holy shit

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8
Q

KEY STUDY TIP: Esterified Estrogens (Estratab; Menest) same effects as _______ at _____ of the dose

A

Premarin…1/2 the dose

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9
Q

Combination HRT Drugs: What is the brand name for adding Estrogen and Progesterone?…what are the generic drug names???

A

PremPro…Premarin (conjugated equine estrogen) + Provera (MED-roxy-progesterone)

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10
Q

Combination HRT Drugs: What is the purpose of adding progesterone to estrogen?

A

reduces risk for endometrial cancer!

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11
Q

Aunt Sue!! When taking JUST estrogen for HRT, Women on HRT saw cholesterol levels go down, but they suffered increases in ________ and no reduction of heart disease!!!

A

blood clots

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12
Q

Hmmmmmm…Nurses Health Study found that estrogen in combination with progestin may increase risk of _____ BUTTTT…..This outweighs long term use to prevent ______

A

stroke….. osteoporosis

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13
Q

NIH PremPro Study: NIH recommeded STOPING PremPro because of these 4 results… (more than 16K women studied!!) the benefits of less colorectal cancer and less bone fracture DO NOT outweigh these 4 risks!!

A

1.Heart Disease 2.Stroke 3.Pulmonary embolism 4.invasive breast cancer

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14
Q

What is the recommendation/indication for DURATION of HRT use today?

A

Short term use: less than 5 years for symptoms of menopause

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15
Q

Where is natural Progesterone produced and secreted?

A

the corpus luteum

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16
Q

What does Progesterone physiologically induce?

A

induces a secretory endometrium…its the pregnancy hormone!

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17
Q

What are the 4 indications for Progesterone Replacement Drugs?

A

1.Tx of Menstrual Disorders 2.Prevention of habitual abortion 3.Tx of Endometriosis 4.Contraception

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18
Q

Oral progesterone is almost completely inactivated in the ______….Synthetic modification is necessary to produce the orally active forms of progesterone

A

liver

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19
Q

What are the two synthetic preparations of Progesterone?

A
  1. Nor-eth-in-drone (oral contraceptives) 2.Med-roxy-progesterone (Provera)
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20
Q

What are the 3 indications for Med-roxy-progesterone (Provera)?

A

1.Abnormal Uterine Bleeding 2.Secondary Amenorrhea 3.Endometrial Cancer

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21
Q

Testosterone is responsible for: Maintain the ______,

male _______ sex characteristics (androgenic effects), and ________ bulk (anabolic effect)

A

testes…. secondary… Muscular

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22
Q

Much like progesterone, testosterone is metabolized by the liver if taken orally…so we can _____ it! (whats the name)

A

methylate it! (methyl testosterone)

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23
Q

What are the 4 indications for Testosterone Tx?

A

1.Delayed male poooberty 2.Hypogonadism 3.female breast cancer 4.loss of libido in postmeno WOMEN!

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24
Q

ANOTHER really common indication for testosterone Tx is male “menopausal” symptoms…when does this usually begin?

A

40’s or 50’s

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25
What is a normal Testosterone range for a MAN?
250-800ng/dl
26
What is a normal Testosterone range for a WOMAN?
15-40ng/dl
27
What is a normal Testosterone range for a POSTMENOPAUSAL WOMAN?
0-20ng/dl
28
What are 4 common conditions observed with male aging?
1.obesity 2.type 2 DM 3.Pain 4.Depression
29
_________ is a Clinical syndrome which comprises both symptoms and biochemical evidence of T deficiency
HypoGonadism
30
Testosterone status is linked to ________ of male population
general health
31
Testosterone status is a biomarker for presence of these 3 occult diseases....
1. Atherosclerosis 2. cancer 3.early death
32
How many Testosterone drugs are there? What are 3 of them?
10!!!...1.Androderm 2.Fortesta 3.Testim
33
BOOOOOM: BENEFITS OF TESTOSTERONE TX!!!!Decreases _______, Increases _______
fat mass...muscle power GIVE ME SOME!
34
BOOOOOM: BENEFITS OF TESTOSTERONE TX!!!! Really benefits these 4 signs of diabetes!
1.insulin resistance 2.HbA1C 3.Lipids 4.Libido
35
RISKS of Testosteron Tx (psh who cares, look at those benefits!) Impairs ability to generate ________ testosterone, Problems with ______, Increase in size of ______, Water retention, Worsening of sleep ______, Polycythemia, Increased risk for blood _____, Cardiovascular risks?, ________ cancer?
endogenous... fertility... prostate... apnea... clots.... Prostate
36
WOW lots of oral side effects to this Tx if taken buccally: Bitter taste, gingival edema, gingival or mouth irritation, gingival tenderness, taste perversion (dysgeusia)
Testosterone
37
Testosterone tx is normally not indicated in women (in fact there are no American FDA approved products); however, what group IS indicated for it? How long is the tx?
postmenopausal women with hypoactive sexual desire disorder...3-6 month trial
38
What are the two brand names for Estrogen (esterified) and methyl testosterone?
CovAryx, EEMT
39
Estrogen (esterified) and methyl testosterone: _______ administered Taken DAILY for ___ weeks, then 1 week off....Indicated for moderate-to-severe _______ symptoms associated with menopause not improved by estrogens alone....What schedule? C-___ (can't touch this)
Orally...3... vasomotor...C-III
40
Anabolic steriods: Exhibit more anabolic effects: no _______ effects...WOOO Increases muscle mass = can increase mass by ____%
androgenic...30%
41
Anabolic steroids: Probably allows for formation of more ________ cells....Schedule ____ controlled substance
striated muscle...III
42
What are 4 anabolic steroids?
1.Nandrolone Phen-pro-pionate 2.MethANDROstenolone 3.Oxandrolone 4.StanozoLOL
43
What are the 4 side effects of anabolic steroids?
1.Mental depression 2.Sodium Retention 3.Cholestatic Jaundice 4.Temporary impotence
44
THE DOWN LOW on Progestational contraceptives: Contain _________...___% effective....Usually taken on days ___ through ____ of the menstrual cycle (21 days)...7 days of ______ (sugar pill) during menstruation
both estrogen and progestin..99%...days 5-25... placebo
45
Sequential Contraceptives: Contain different amounts of ______ with same amount of _______
progestin... estrogen
46
What is the post-coital (coitus, you mean sex?) aka morning after pill aka plan B made of?
Estrogen alone
47
Which OC Inhibits fertilization and nidation, motility of oviduct altered and endometrium is changed and is for rape/incest?
DES (DiEthyl Stilbesterol)
48
What are the class and generic/brand names for the abortion pill (terminates intrauterine pregnancy)? What is its off label indication?....WHAT IS ITS MECH of action?
Class: RU-486...mi-fep-ri-stone (Mi-Fep-rex)...off label for certain cancers...mech: progesterone ANtagonist
49
What is the long-acting progestin that abolishes menstrual cycle as long as it is given leading to ovarian and endometrial atrophy...What is the dose time?
IM (DepoProvera)...every 3 or 6 months
50
What is the name of the Patch form of contraceptive? What is the SIGNIFICANT risk? How much more [ ]'d is it than other Tx?
patch (Ortho Evra) = significantly higher risk of adverse clotting events/stroke...40x more [ ]
51
Mechanism of Action of OC: Inhibition of ovulation...______ inhibits FSH secretion and thus ovulatory stimulation is inhibited
Estrogen
52
Mechanism of Action of OC: ________ inhibits release of LH thus follicular growth is inhibited
Progesterone
53
Mechanism of Action of OC: _________ alters endometrium development
Progesterone
54
Mechanism of Action of OC: Endometrium must be in right stage of development under the influence of _______ AND _________ for nidation to occur
estrogen AND progesterone
55
Mechanism of Action of OC: Thick, tenacious ______ secreted under the influence of _________ is probably a hostile environment for SPERM
mucus... progesterone
56
How many adverse effects of oral contraceptives are there? What is the major one?
``` 12+....increased risk for MI and stroke... Increased risk for MI and stroke 􏰀 Stroke risk increases if smoker over the age of 35 years 􏰀 Nausea/vomiting 􏰀 Headache 􏰀 Breast pain 􏰀 Weight gain 􏰀 Breakthrough menstrual bleeding 􏰀 Mental depression 􏰀 Fatigue 􏰀 Lack of initiative 􏰀 Ocular conditions 􏰁 Corneal sensitivity 􏰁 Retinal thrombosis 􏰀 Optic neuritis 􏰁 diplopia...in case you were wondering ```
57
DENTAL CONSIDERATIONS of women on OC's: Mimic effects of _______ on the gingiva
pregnancy
58
DENTAL CONSIDERATIONS of women on OC's: Mild inflammation, hyperemia, spontaneous gingival _______
bleeding
59
DENTAL CONSIDERATIONS of women on OC's: Loss of tissue ____
TONE
60
DENTAL CONSIDERATIONS of women on OC's: _______ and ulceration
tenderness
61
DENTAL CONSIDERATIONS of women on OC's: May decrease defense to plaque bacteria resulting in irritation or progression of ________ disease
periodontal
62
OC & Antibiotics-drug interaction? (Really cool mechanism) case reports of antimicrobial-induced OC failure represent normal ___% to ___% rate of pregnancy which occurs with typical OC use = very rare
1% to 3%
63
How to combat the SMALL chance of having an accidental baby while on Ab's...short-term use of antimicrobials = consider _______ non-hormonal contraception at initiation and for duration of antimicrobial therapy (or for 14 days, which ever is longer), plus 7 more days after completion of antimicrobial therapy
additional
64
WHAT ARE THE 6 Antibiotics that are GOOD TO GO while taking OC's (no accidental baby)...
(TDAMFF) 1.Tetracycline 2. Doxy-cycline 3.Amp-icillin 4.Fluconazole 5.FluroQuinolones
65
**add a SECOND form of contraception if the pt is going to take _______ or ______
RG....Rifampin or Gris-eo-fluvin

Pharm Part II (28 decks)

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