HRT/SERMS Flashcards Preview

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Flashcards in HRT/SERMS Deck (18)
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1

Estrogens used for MHT

Conjugated Estrogen (horse pee), Synthetic Conjugated Estrogen A&B, Esterified estrogen, Estropipate

2

Progestin only used in MHT

Medroxyprogesteronen (MPA), methyltestosterone (some androgen effects), Progesterone

3

Progestin used in MHT and Birth control pills (low yield?)

-Used for Peri-Menopausal state (because already on BCP)
-Norgestimate (with estradiol)
-Norethindrone/ Norethindrone Acetate (with EE and Estradiol)
-Drospirenone (with EE and Estradiol)
-Levonorgestrel (with estradiol)

4

Side effects of Estrogen therapy

-Decrease Antithrombin III, Increase platelet aggregation/clotting factors (HYPERCOAGABLE)
-Increase HDL and Trig, some others

5

S/E of Estrogen and Progestin therapy

-CHD, Stroke, PE, DVT
-Ovarian/Breast cancer
-Dementia

6

Estrogen and Progestin therapy decreases risk of

-Colorectal/ endometrial cancer
-All fractures

7

S/E of Estrogen Alone

Stroke, VTE

8

Estrogen does not increase risk of

-Breast/colorectal Cancer (however don't use MHT if they have cancer)
-CHD, PE
-Mortality

9

Estrogen decrease risk of

-Hip fractures specifically (not all fractures)

10

General Dosing for Estrogen/Progestin

-Low does, little duration (5 y or less), most specific route as possible (cream for bag dryness)

11

Tamoxifen estrogen agonist or antagonist, indication of use

-SERM
-Estrogen antagonist
-Prevent and treat of ER/breast cancer
-Has cis and trans version (cis-estrogenic agonist, trans-estrogenic antagonist), mostly used in trans form; cis used for osteoporosis. cis can cause endometrial proliferation, clots
-Does not alleviate VMS

12

Toremifene estrogen agonist or antagonist, indication of use

-SERM
-Estrogen antagonist
-Prevent and treat of ER/breast cancer
-Promotes production of transforming growth factor beta
-Does not Alleviate VMS

13

Raloxifene estrogen agonist or antagonist, indication of use

-SERM
-Estrogen agonist
-Prevent/treat osteoporosis
-INVASIVE ONLY Breast cancer prophylaxis (estrogen antagonist in breast)
-Does not alleviate VMS

14

Ospemifene estrogen agonist or antagonist, indication of use

-SERM
-Estrogen agonist
-Treats dyspareunia (vaginal dryness, painful intercourse)

15

Bazedoxifene (not on boards ) estrogen agonist or antagonist, indication of use

-SERM
-Pt with intact uterus
-Estrogen antagonist (interesting, its an estrogen with antagonist effects. Acts like progestin. Used to avoid progestin-androgen effects)
-Treat Vaso motor symptoms associate with menopause
-Prevent post-menopausal osteoporosis

16

SERMS

-Agonist and antagonist of estrogen receptor depending on the tissue

17

Clomiphene MOA, indication

-Pure Anti-estrogen (prevents neg feedback, to increase FSH/LH release)
-Infertility in anovulatory women
-Can cause twins

18

Fluvestrant MOA, indication

-Pure Anti-estrogen
-Metastatic ER and breast cancer (after tamoxifen failure, high cost)