Hormones 3

Question 1

What are the pharmacological uses of estrogen and progesterone?

Answer 1

• contraceptives
• OP
• hypogonadism
• failure of ovarian development
• menstrual irregularities
• endometriosis
• carcinoma

Question 2

Pharmacology: contraceptives

Answer 2

Alter control between pituitary and ovarian hormones

Question 3

Pharmacology: OP

Answer 3

Estrogen replacement

Question 4

Pharmacology: hypogonadism

Answer 4

Combo of estrogen and progesterone

Question 5

Pharmacology: hypogonadism

Combo of estrogen and progesterone to address

Answer 5

• low ovarian function

- bleeding abnormalities

Question 6

Pharmacology: failure of ovarian development may be the result of

Answer 6

Hypopituitarism

Question 7

Pharmacology: failure of ovarian development

Answer 7

estrogens given at time of puberty to encourage development of secondary sex characteristics

Question 8

Pharmacology: menstrual irregularities

Answer 8

• amenorrhea

- dysmenorrhea

Question 9

Pharmacology: endometriosis

Answer 9

• progesterone and estrogen/progesterone combos

- to help shrink growths

Question 10

What is endometriosis?

Answer 10

• deposits of uterine tissue that develop in other regions
• scar tissue
• difficulty getting pregnant

Question 11

Pharmacology: carcinoma

Answer 11

• metastatic BC treated by estrogen for men and postmenopausal women
• progesterone for treating uterine cancer and other metastases

Question 12

HRT: benefits

Answer 12

• improves bone mineralization

- may improve plasma lipid profile » reduce the risk of CVD in postmenopausal women

Question 13

HRT: no bueno stuff

Answer 13

Increased risk of

• stroke
• thromboembolism
• altered blood clotting
• PE
• some cancers
• nausea
• LE swelling

Question 14

HRT: timing of tx

Answer 14

start HRT when women are ≤ 60 and within 10 years of reaching menopause

Question 15

HRT: cognitive benefits?

Answer 15

• no benefit in protecting cognitive decline of Alzheimer’s

- mixed results in other cognitive studies

Question 16

How might HRT impact normal menstrual function?

Answer 16

• altered normal menstrual function with prolonged use

- unpredictable changes in bleeding pattern

Question 17

HRT: increased risk for certain cancers

Answer 17

• can’t use estrogen with estrogen-sensitive BC

- importance of screening for women on contraceptives

Question 18

HRT: nausea

Answer 18

Usually transient

Question 19

SERM =

Answer 19

Selective
Estrogen
Receptor
Modulator

Question 20

What do SERMs do?

Answer 20

• bind to and activate estrogen receptors on certain tissues

- block the effects on other tissues

Question 21

Why might SERMs be a beneficial tx in cancer?

Answer 21

• can reduce carcinogenic effects of estrogen on breast and uterine tissue
• produce favorable effects on bone mineralization and cardiovascular function

Question 22

Examples of SERMs

Answer 22

• Tamoxifen

- Raloxifene

Question 23

Raloxifene is primarily used to treat

Answer 23

OP

Question 24

Side effects of Raloxifene

Answer 24

• hot flashes
• bone/joint pain
• GI issues
• “flu-like” sx

Question 25

What do anti-estrogens do?

Answer 25

block effects of estrogen by occupying the receptor

Question 26

What are the examples of anti-estrogens?

Answer 26

- Clomiphene | - Fulvestrant

Question 27

Clomiphene

Answer 27

- treats infertility by promoting ovulation | - mechanism is complex, but related to negative feedback loop

Question 28

Fulvestrant

Answer 28

Antiestrogen used to treat estrogen-sensitive BC

Question 29

What are antiprogestins used for?

Answer 29

termination of pregnancy and tx of - uterine fibroids - endometriosis - Cushing syndrome

Question 30

What do antiprogestins block?

Answer 30

Glucocorticoid receptors

Question 31

example of antiprogestin

Answer 31

Mifepristone

Question 32

What does Mifepristone do?

Answer 32

- terminates pregnancy | - must be taken within first 7 weeks of pregnancy

Question 33

Korlym

Answer 33

- Tx of hyperglycemia due to increased cortisol in Cushing syndrome - antiprogestin

Question 34

Hormonal contraceptive components

Answer 34

Varying levels of estrogen/progesterone combos

Question 35

What is inhibited with hormonal contraceptives?

Answer 35

- LH - FSH No ovulation!

Question 36

Adverse effects of hormonal contraceptives have decreased with newer drugs due to

Answer 36

- less estrogen | - better forms of progestins

Question 37

Risks of hormonal contraceptives

Answer 37

- thromboembolism | - cardiovascular events (usu associated with risk factors of smoking, HTN, hyperlipidemia)

Question 38

Hormonal contraceptives may protect against

Answer 38

- endometrial/ovarian cancers | - relationship to BC more complicated