330 Test 3 Flashcards
Toremifene SERM (all info)
- Orally-active non-steroidal SERM
- Used for palliative treatment of metastatic breast cancer in postmenopausal women with ER-positive tumors
- Competitive ER antagonist in breast tissue, estrogen agonist in bone tissue and on lipid metabolism
- Can induce ovulation like Clomiphene
- Adverse effects: hot flashes, N and V, uterine cancer, thromboembolic events
Toremifene SERM used for palliative treatment of
metastatic breast cancer in postmenopausal women with ER-positive tumors
Toremifene SERM is used for palliative treatment of metastatic breast cancer in postmenopausal women with
ER-positive tumors
Toremifene SERM is a competitive ER agonist in
breast tissue
“ER” means
estrogen receptor
Toremifene SERM is an ER antagonist in
bone tissue and on lipid metabolism
Toremifene SERM can induce
ovulation
Toremifene SERM adverse effects
hot flashes
N and V
UTERINE cancer
thromboembolism
premarin
conjugated estrogen
prempro
estrogen + medroxyprogesterone (has progesterone)
a combination of conjugated estrogens, which is a mixture of female sex hormones, and medroxyprogesterone, another female hormone, called progesterone
prempro
Treats hot flashes and other symptoms of menopause or low amounts of estrogen. Prevents osteoporosis (thinning of the bones) after menopause. Also treats symptoms of advanced breast or prostate cancers
premarin
Premarin/Prempro (all info)
- Increase in bone density and decrease in LDL
- Side effects include nausea, fluid retention, breast tenderness, cramps
- When estrogen is used only, it may cause uterine cancer
- When estrogen is used with progesterone, may cause breast cancer
- Risk increase in patients over 35
Premarin/Prempro- increase __ __ and decrease __
increase bone density
decrease LDL
Premarin/Prempro- side effects
nausea, fluid retention, breast tenderness, cramps
Premarin/Prempro- when estrogen is used alone can cause __ cancer
uterine
Premarin/Prempro- when estrogen is used with progestin it can cause __ cancer
breast
Premarin/Prempro- risk increases over the age of
35
menopause can be treated with p___ or p___
premarin or prempro
Estrogen side effects (all info)
- Increased risk of thromboembolism
- Increased incidence of cerebral and coronary thrombosis; increased risk of MI
- Reversible hypertension
- Increased risk of vaginal and possibly breast cancers
- Irregular vaginal bleeding
- N and V, breast tenderness, weight gain, dizziness, headaches
Estrogen side effects- increased risk of t____
thromboembolism
Estrogen side effects- increased risk of M_
MI
Estrogen side effects- reversible
hypertension
Estrogen side effects- irregular
vaginal bleeding (aka break through bleeding. Occurs before or after menses)
Estrogen side effects- common side effect in beginning of treatment
nausea
Max treatment time for estrogen replacement therapy
4 years
Estrogen drug interactions (all info)
- barbis, tetracyclines, and phenytoin decrease serum estrogen
- increased toxicity with corticosteroids
- nicotine increases the risk of thrombi and emboli
- grapefruit juice inhibits metabolism of estradiols
Estrogen drug interactions- barbis, __ and __
barbis, tetracyclines and phenytoins decrease serum estrogen
Estrogen drug interactions- increased toxicity with
corticosteroids
Estrogen drug interactions- __ increases the risk of thrombi and emboli
nicotine
Estrogen drug interactions- grapefruit juice inhibits
metabolism of estradiol
Estrogen contraindications (all info)
- vascular disease
- vascular thromboembolism
- pregnancy
- breast carcinoma
ER positive tumor cells are tumor that grow in the presence of
estrogen
used to block growth of ER positive tumors by functioning as an antagonist
SERM
SERM functions as an ___ with tumors and an ___ with bones
antagonist with tumors
agonist with bones
norethindrone physiological actions
- prepares the uterus for implantation
- decreases cervical secretions
- increases thickness of cervical secretions
- breast development
- increases body temperature
norethindrone is important for ___ therapy to ensure implantation
invitro
norethindrone effect on body temp
increases
norethindrone side effects
- thromboembolitic disorder
- increased BP
- cramps
- breast enlargement
- breakthrough bleeding
norethindrone clinical uses (all info)
- replacement therapy
- long-term ovarian suppression
- oral contraceptives
2 main categories of oral contraceptives
- estrogen + progesterone (combination pill)
2. progesterone only (mini pill)
Oral contraceptives work by preventing
ovulation
Oral contraceptives increase what hormones
progesterone and estrogen
Oral contraceptives decrease what hormones
LH and FSH
Progesterone and estrogen trick the body into thinking
that it’s already pregnant
oral contraceptive that has progesterone and estrogen is aka
combination pill
oral contraceptive that has progesterone only is aka
mini pill
3 types of combination oral contraceptives
monophasic
diphasic
triphasic
combination pill mechanism of action
suppression of ovulation and increase cervical secretion
administration schedule of combination pills
21 pills, starts on day 5 and ends on day 25
With oral contraceptives, even though there’s no ovulation there’s still
bleeding
combination oral contraceptive that has the same estrogen and progesterone dose throughout
monophasic
combination oral contraceptive that has the same estrogen dose throughout but 2 different progesterone doses
diphasic
combination oral contraceptive that has the same estrogen dose throughout but 3 different progesterone doses
triphasic
which type of combination oral contraceptive most closely mimics what happens naturally
diphasic
Beneficial effects of combination oral contraceptives (all info)
- less ovarian cysts (because there’s no ovulating)
- less endometrial and ovarian cancer
- less pelvic inflammatory disease and ectopic pregnancy
- less PMS, endometriosis, and dysmenorrhea
- less iron deficiency, duodenal ulcer, rheumatoid arthritis
combination oral contraceptive drug interactions
antibiotics such as ampicillin and tetracyclines
oral contraceptive interaction with antibiotics such as ampicillin and tetracyclines can
reduce the efficacy of the oral contraceptive
Normally, intestinal bacteria help recycle estrogen. Therefore the use of ___ can reduce the amount of estrogen
antibiotics can reduce the amount of estrogen
contraceptive that works the same as the combination bill except that its inserted once a cycles on day 5
Nuvaring
contraceptive nursing implications
- assess blood pressure before and during therapy
- exclude thrombophlebitis, breast cancer, and pregnancy prior to therapy
- encourage patient to quit smoking
- warn patient to use an alternate form of birth control during the 1st 3 weeks of therapy and when on certain antibiotics
- advise patient to report signs of fluid retention, thromboembolitic disorders or abnormal vaginal bleeding
- warn patient that oral contraceptives do not protect against HIV or other sexually transmitted diseases
contraceptive nursing implications- assess
BP
contraceptive nursing implications- exclude pregnancy, breast cancer, and __ before therapy
thrombophlebitis
contraceptive nursing implications- encourage patient to quit
smoking
contraceptive nursing implications- warn patient to use another form of birth control while taking certain antibiotics and
during the first 3 weeks of therapy
contraceptive nursing implications- advise patient to report signs of
fluid retention, thromboembolitic disorders, abnormal vaginal bleeding
contraceptive nursing implications- warn patient that they don’t protect against
STDs
