Review - Estrogens and Anti-Estrogens - SERMs Flashcards Preview

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Flashcards in Review - Estrogens and Anti-Estrogens - SERMs Deck (21):
0

Where do conjugated equine estrogens (premarin) come from?

Urine of pregnant mares.

1

What is premarin used for?

1. Vasomotor symptoms associated with menopause.
2. Vulvar and vaginal atrophy
3. Abnormal uterine bleeding

2

Name one synthetic nonsteroidal estrogen.

Diethylstilbestrol (DES)

3

How do estrogens affect serum lipids?

1. Increased TGs
2. Incr. HDL
3. Decr. LDL

4

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
8. Pregnancy

5

How do estrogens increase blood coagulation?

1. Decr. antithrombin III
2. Incr. II, VII, IX, X

6

How do estrogenic compounds work as contraceptives?

Suppress ovulation

7

What are aromatase inhibitors used for?

Breast Ca

8

What is clomiphene used as?

Fertility drug

9

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.

10

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%)

11

Can tamoxifen increase endometrial cancer risk?

YES - it has stimulatory effects on endometrial tissue.

12

Can raloxifene increase endometrial cancer risk?

NO - selective estrogen effects on the breast and bone.

13

How does raloxifene affect serum lipids?

1. Decreases total and LDL cholesterol
2. No effect on HDL or TGs

14

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.

15

Which OCPs are used to palliate the effects of polycystic ovary syndrome (PCOS)?

Combination OCPs (often in combination with oral hypoglycemics).

16

What are the therapeutic uses of progestins?

1. Contraception
2. HRT (with estrogens)
3. Control of uterine bleeding
4. Dysmenorrhea
5. Suppression of post partum lactation
6. Endometriosis

17

Which progestins also possess androgenic activity?

1. Norethindrone
2. Norgestrel

18

How often is depot medroxyprogesterone given?

Every 3 months (13wks)

19

How long does the levonorgestrel contraceptive subdermal implant last?

5 yrs

20

How do we prevent endometrial cancer in women taking HRT estrogen?

By combining estrogen with a progestin.

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