Flashcards in Review - Estrogens and Anti-Estrogens - SERMs Deck (21):
Where do conjugated equine estrogens (premarin) come from?
Urine of pregnant mares.
What is premarin used for?
1. Vasomotor symptoms associated with menopause.
2. Vulvar and vaginal atrophy
3. Abnormal uterine bleeding
Name one synthetic nonsteroidal estrogen.
How do estrogens affect serum lipids?
1. Increased TGs
2. Incr. HDL
3. Decr. LDL
Estrogen use is contraindicated in which settings?
1. History of DVT
2. History of or current pulmonary embolism
3. Active or recent stroke
4. Active or recent MI
5. Breast Ca
6. Estrogen-dependent tumors
7. Hepatic dysfunction
How do estrogens increase blood coagulation?
1. Decr. antithrombin III
2. Incr. II, VII, IX, X
How do estrogenic compounds work as contraceptives?
What are aromatase inhibitors used for?
What is clomiphene used as?
How does clomiphene work?
Antiestrogen that induces ovulation by inhibiting negative feedback of estrogen on the hypothalamus and pituitary ---> this suppression leads to increasing release of LH and FSH.
What are the potential side effects of clomiphene?
1. Multiple births (10%)
2. Hot flushes (10%)
3. Ovarian hyperstimulation (7%)
4. Reversible visual disturbances (2%)
Can tamoxifen increase endometrial cancer risk?
YES - it has stimulatory effects on endometrial tissue.
Can raloxifene increase endometrial cancer risk?
NO - selective estrogen effects on the breast and bone.
How does raloxifene affect serum lipids?
1. Decreases total and LDL cholesterol
2. No effect on HDL or TGs
What must you tell a female patient who is using hormonal contraception when she is given a prescription for antibiotics?
Antibiotics may decrease the effectiveness of OCPs.
Recommended back up use of other contraceptive method.
Which OCPs are used to palliate the effects of polycystic ovary syndrome (PCOS)?
Combination OCPs (often in combination with oral hypoglycemics).
What are the therapeutic uses of progestins?
2. HRT (with estrogens)
3. Control of uterine bleeding
5. Suppression of post partum lactation
Which progestins also possess androgenic activity?
How often is depot medroxyprogesterone given?
Every 3 months (13wks)
How long does the levonorgestrel contraceptive subdermal implant last?