10. Hormone Therapies Flashcards
What is the different usage of Hormone therapies?
- Thyroid Disease
- Menopausal Hormone Therapy
- Contraception
- Selective Estrogen Receptor Modulators (SERMs)
What are the two major thyroid hormones?
Triiodothyronine (T3; most active) and Thyroxine (T4)
What are the drugs to treat hypothyroidism?
- Levothyroxine [Synthroid®, Levoxyl®]
2. Liothyronine [Cytomel®]
What are the drugs to treat hyperthyroidism?
- Propylthiouracil (PTU)
1. Methimazole [Tapazole®]
Which is the #2 highest selling drugs in America?
Levothyroxine Sodium
T/F Levothyroxine Sodium makes synthetic T4 for thyroid hormone replacement.
True
What kind of adverse effects to the eyes do Levothyroxine Sodium cause?
Ptosis, diplopia and EOM paresis
What are the CNS adverse effects of Levothyroxine Sodium?
Pseudotumor cerebri (children) and hallucination
Which drug causes profuse sweating (diaphoresis), sudden hair loss (alopecia), weight loss and headache?
Levothryroxine Sodium
What is the drug interaction of Sympathomimetics with Levothyroxine Sodium?
Additive. Both causes hypertension.
What are the menopausal therapies?
- Estrone [Menest] “MOST COMMON”
- Estradiol
- Mestranol [Necon]
What is the indication for using Estrone?
Menopause, Breast Cancer, Prostate Cancer, Osteoporosis prevention
The mechanism of action of estrone is binds to _______receptors, developing and maintaining female sex characteristics and reproductive systems.
estrogen
T/F Estrone doesn’t have “BLACK BOX” warnings.
False.
BLACK BOX: Endometrial Cancer, Stroke, DVT, MI, Invasive Breast Cancer.
What are some common adverse effects of Estrone?
Headache/migraine, elevated BP, weight changes, fluid retention, contact lens intolerance, vision changes
What is the drug interactions of Azole Antifungals with Estrone?
Impaired metabolism
What can Estrone do to steroids?
it can increase steroids adverse effects
What can Estrone do to Anti-hyperlipidemic drug like Omega 3 fatty acids?
it antagonize it. LDL levels are elevated with hormone regulating therapies.
What is contraindicated for taking Estrone?
Hypertension
Smoker
Migraine [with aura] > [without aura]
What is the most common contraceptive drug?
Drospirenone/Ethinyl Estradiol [Yaz®]
How does the contraceptive groupings are done?
it’s done by activity profiles: monophasic, biphasic, triphasic, and four phasic vs progestin only.
What conditions do we use YAZ (contraceptive) for?
Contraception, Acne Vulgaris, Dysmenorrhea (painful cramps), Endometriosis (uterus grows outside the uterus) and Polycystic ovary syndrome (PCOS).
What is Polycystic ovary syndrome (PCOS)?
A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
The mechanism of actions of YAZ Suppresses ___ and ____, inhibiting ovulation; alters cervical mucus and endometrium.
Luteinizing hormone (LH) Follicle-stimulating hormone (FSH)
T/F There’s a Black Box warning in YAZ?
True, Smoking and CV events
What are the possible severe adverse effects for taking YAZ?
MI, stroke, ocular lesions
What are the common adverse effects of taking YAZ?
Headache, weight changes, BP elevated, increased cholesterol, contact lens intolerance
T/F YAZ Impaired metabolism of Cyclosporine
True. it causes an increase K+ levels.
Tetracyclines, Penicillins, Cephalosporins, Macrolides, Quinolones causes YAZ to
Decreased efficacy
T/F Ascorbic Acid causes YAZ to increase metabolism.
False. it’s decrease metabolism
What is Selective Estrogen Receptor Modulators (SERMS)?
- They have the ability to inhibit or stimulate estrogen receptors depending on the tissue.
- It uses for management of breast cancer, osteoporosis, menopause and anovulation
What are the different SERMS drugs?
Tamoxifen [Soltamox®] “MOST COMMON”
Clomiphene [Serophene®, Clomid®]
Raloxifene [Evista®]
T/F The indication for taking Tamoxifen is for metastatic breast cancer.
True
The mechanism of action of Tamoxifen is to bind to estrogen receptors, producing ______ and ______ effects.
estrogenic, anti-estrogenic
What are some common adverse effects for taking Tamoxifen?
dizziness (unique), headache (same with Estrone andn YAZ) and VA changes (same with estrone)
What are some severe adverse effects when taking Tamoxifen?
Thromboembolism (unique), stroke (same with Estrone and YAZ)
Pancytopenia (reduce in red and white blood cells. Unique)
Retinopathy (unique), cataracts (unique)
Which of the hormone therapy medications discussed here can cause cataracts?
Tamoxifen
What is the drug interaction of NSAIDs and YAZ?
Additive hyperkalemia
