Flashcards in Reproductive pharm Deck (30):
what is the most potent form of endogenous estrogen in women?
how is estrogen transported in the blood?
bound to albumin and sex binding hormone (they are later broken down by the liver to inactive compounds and excreted in urine)
what is the most important therapeutic benefit of HRT?
estrogen decreases resorption of bone and thus blunts the process of osteoporosis.
- it can also assist with sleep quality in post-menopausal women
Increased risks with HRT?
Stroke and blood clots
decreased risk of fractures
are bio-identical hormones considered synthetic?
yes, they are. They just look similar to the ones produced by the body.
What is the hormone ratio of BiEst?
80:20 ratio of estriol (E3) to estradiol (E2)
What is the hormone ratio of TriEst?
most commonly found in a ratio of 80: 10: 10, estriol (E3), estradiol (E2) and estrone (E1).
What is the source of premarin
obtained from the urine of pregnant mares is a preparation of conjugated estrogens – estrone and equillin.
when is premarin indicated?
for prevention and treatment of osteoporosis and of post-menopausal symptoms such as hot flashes, vaginal dryness and itching.
can be used in women who has not undergone hysterectomy. Do not use in pregnant women.
MOA of premarin?
Alters gene transcription.
Side effects of premarin?
breast pain, increased breast size, palpitations, fever, hives, hoarseness, joint pain, stiffness or swelling, rash, redness of skin, shortness of breath, wheezing, edema and weight gain.....etc.
What pregnancy category are conjugated estrogens/Premarin?
also CI in prior hx of DVT or breast/ovarian/urine cancer
what class is Medroxyprogesterone/Provera?
synthetic variant of progesterone (progestin)
when is provera indicated?
Contraceptive, hormone replacement therapy, dysfunctional uterine bleeding and treatment of endometriosis.
MOA of provera?
alters gene transcription
Why is the progestin component added to HRT?
to prevent the development of endometrial hyperplasia and endometrial cancer.
What is the Depo form of provera?
what are the functions of estrogen and progestin in oral contraceptives?
The estrogen component suppresses ovulation while the progestin prevents implantation in the endometrium and helps to make the cervical mucus impenetrable to sperm.
what is the most commonly used estrogen? progestin?
ethinyl estradiol, Norgestrel
what are the benefits of oral contraceptives?
reduce the risk of colorectal cancer, improves conditions such as PID, dysmenorrhea, PMS, and acne.
May reduce sx of endometriosis, **PCOS, and decrease anemia.
(PCOS- start on insulin, lowing sugar might be what the pts needs!)
Risks/side effects with oral contraceptives?
Increased risk for cardiovascular disease, DVT, hypertension and stroke (especially in women who smoke or who are over 35 years of age. Other side effects include acne, depression, headache, edema, nausea and breast fullness.
What is the MOA of testosterone
alteration of gene transcription
What is the administration route for testosterone
injectable, PO, Sub-lingual, transdermal patches, gels, creams
What is the deal with anabolic steroids
They are synthetic derivatives of testosterone that have far stronger anabolic effects than androgenic effects
What class is Leuprolide (lupron)
Anti-androgenic hormone and anti estrogenic hormone
What are the indications for leuprolide (lupron)
Prostatic cancer, precocious puberty, endometriosis and uterine fibroids, as well as being part of some protocols of I.V.F.
What drug class is finasteride
What is the MOA of finasteride
Limits conversion of T to DHT by inhibiting 5-alpha-reductase II
What are warnings that come with using finasteride
crushed or broken tablets not to be handled by women, esp if they are pregnant or may become pregnant