Lecture 24: Hormone Replacement Therapy Flashcards Preview

PSIO 469 Exam 04 > Lecture 24: Hormone Replacement Therapy > Flashcards

Flashcards in Lecture 24: Hormone Replacement Therapy Deck (47):
1

Estrogen Actions: Desirable Effects
The Brain:
(3)

- Regulates area that prepares body for reproduction
- Helps maintain stable temperature and avoid hot flashes
- May help protect memory

2

Estrogen Actions: Desirable Effects
The Breasts:

Programs glands to produce milk

3

Estrogen Actions: Desirable Effects
The Liver and Heart:
(2)

- Helps regulate production of cholesterol in the liver
- helps avoid atherosclerosis and heart attacks

4

Estrogen Actions: Desirable Effects
The Uterus:

- Programs the uterus to nourish a fetus

5

Estrogen Actions: Desirable Effects
The Bones:

- Maintains density

6

Estrogen Actions: Undesirable Effects
The Breasts:

-Promotes breast cancer

7

Estrogen Actions: Undesirable Effects
The Uterus:

- Promotes cancer of the uterine lining

8

Pre-Menopause
Before menopause, ovaries produce:

- Estrogen
- Progesterone

9

Pre-Menopause
During years of ovarian estrogen production, women benefit from these activities:
(3)

- Protection against cardiovascular disease
- Estrogen prevents atherosclerotic lesion formation
- Prevents or reversal of bone loss (osteoporosis)

10

Menopause
Average age of menopause in US is:

51

11

Menopause
Common symptoms associated with estrogen deficiency are:

- Hot flashes
- Vaginal Atrophy
- Sleep Disturbance

12

Conjugated Equine Estrogen (CEE)
Premarin is a commercial name for a compound drug consisting primarily of conjugated estrogens for hormone therapy. It consists of

- Estrone (> 50%)
- Equilin (15-25%)
- Equilienin

13

Conjugated Equine Estrogen (CEE)
Estrogen are conjugated because:

- of it being hydrophilic side-groups attached

14

Conjugated Equine Estrogen (CEE)
Estrone sulfate is easily absorbed and converted to ______ by body

Estradiol

15

Conjugated Equine Estrogen (CEE)
Premarin is isolated from

Mare's urine

16

Conjugated Equine Estrogen (CEE)
Prempro is CEE plus this; a synthetic Progesterone.

Medroxyprogesterone acetate (MPA)

17

Progestin helps reduce the risk of endometrial cancer by:

maintaining endometrial atrophy in women with uterus

18

CEE + MPA study was stopped in July 2002
This was because women taking CEE + MPA demonstrated health problems such as:

- increased risk of stroke
- increased risk of venous thromboembolic events
- increased risk of invasive breast cancer

19

Estrogen alone study was stopped in Feb 2004
When women were taking CEE alone, they demonstrated health problems with:

- increased risk of stroke

20

Studies dound the CEE + MPA conferred the following health benefits:
(2)

- Decreased risk of colorectal cancer
- Decreased risk of hip fractures

21

Estrogen also:

- decreases risk of hip fractures

22

The USPTF recommends against routine use of ____ and _____ for the prevention of chronic conditions in ___-_______ women

estrogen; progesterone
post-menopausal

23

Hazard Ratio
The hazard ratio is

explanatory variable on the hazard of an event

24

Hazard Ratio
Hazard ratio is the estimate of:

relative risk (RR)

25

Hazard Ratio
Relative Risk is

Risk of events relative to exposure

26

Hazard Ratio
Relative Risk is calculated by:

Probability of the event occurring in exposed group
Probability of the event occurring in non-exposed group

27

Hazard Ratio
If Relative Risk is 1, then it means:

there is no difference in risk between two groups

28

Hazard Ratio
If Relative Risk is > 1, then it means:

Event is more likely to occur in experimental group than control group

29

Hazard Ratio
If Relative Risk is < 1, then it means:

Even is less likely to occur in the experimental group than control group

30

Global Index Hazard Ratio
These 8 represent first event for each participant among the following:

1. CV Disease
2. Stroke
3. PE
4. Breast Cancer
5. Endometrial Cancer
6. Colorectal Cancer
7. Hip Fracture
8. Death due to other causes

31

Therapeutic Window of Opportunity Hypothesis
Estrogen have _____ effects prior to menopause

beneficial

32

Therapeutic Window of Opportunity Hypothesis
Estrogen have adverse affects when started well beyond the:

menopausal transition

33

Therapeutic Window of Opportunity Hypothesis
Perhaps estrogens may have beneficial effects if initiated around entry to

menopause

34

Atherosclerosis is:

buildup of plaque in blood vessels

35

Plaque consists of:

fat, cholesterol, calcium and other molecules

36

Estrogen and Atherosclerosis
Endogenous estrogens are thought to be _____ against coronary artery atherosclerosis

protective

37

Estrogen and Atherosclerosis
Atherosclerosis begins in ____ and progress with increasing ___.

youth; age

38

Estrogen and Atherosclerosis
Coronary Hear Disease is extremely rare in ____ age women compare to men of the ___ age

fertile; same

39

Estrogen and Atherosclerosis
Women experiencing early menopause or surgically-induced menopause are more likely to develop ___ than premenopausal women of the same age

Coronary Heart Disease (CAD)

40

Thrombus is:

blood clot that is formed in blood vessels when plaque erupts

41

Thromboembolus is:

a piece of thrombus that breaks loose and travels through bloodstream where it can become stuck in a narrow vessels

42

Estrogen and Atherosclerosis
Exogenous estrogens (ET/HT) administered well beyond menopausal transition can have ______ effects.

harmful

43

Effects of exogenous estrogen on complicated plaque can:
(2)

- Increase inflammatory response
- which promotes growth of atherosclerotic plaque
- Increases MMP
- destabilizes and promotes rupture of the plaque

44

MMP is

Matrix Metalloproteinase

45

Current Recommendations
Hormone Therapy should be initiated around:

onset of menopause

46

Current Recommendations
Treating menopausal related symptoms such as:
(3)

- Hot flashes
- Vaginal Atrophy
- Sleep disturbances

47

Current Recommendations
To treat or reduce risk of disorders such as:

- Osteoporosis and/or fractures
- CAD