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aa Orgo > 330 Test 3 > Flashcards

330 Test 3 Flashcards

1
Q

Toremifene SERM (all info)

A
  • 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
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2
Q

Toremifene SERM used for palliative treatment of

A

metastatic breast cancer in postmenopausal women with ER-positive tumors

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3
Q

Toremifene SERM is used for palliative treatment of metastatic breast cancer in postmenopausal women with

A

ER-positive tumors

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4
Q

Toremifene SERM is a competitive ER agonist in

A

breast tissue

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5
Q

“ER” means

A

estrogen receptor

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6
Q

Toremifene SERM is an ER antagonist in

A

bone tissue and on lipid metabolism

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7
Q

Toremifene SERM can induce

A

ovulation

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8
Q

Toremifene SERM adverse effects

A

hot flashes
N and V
UTERINE cancer
thromboembolism

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9
Q

premarin

A

conjugated estrogen

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10
Q

prempro

A

estrogen + medroxyprogesterone (has progesterone)

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11
Q

a combination of conjugated estrogens, which is a mixture of female sex hormones, and medroxyprogesterone, another female hormone, called progesterone

A

prempro

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12
Q

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

A

premarin

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13
Q

Premarin/Prempro (all info)

A
  • 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
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14
Q

Premarin/Prempro- increase __ __ and decrease __

A

increase bone density

decrease LDL

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15
Q

Premarin/Prempro- side effects

A

nausea, fluid retention, breast tenderness, cramps

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16
Q

Premarin/Prempro- when estrogen is used alone can cause __ cancer

A

uterine

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17
Q

Premarin/Prempro- when estrogen is used with progestin it can cause __ cancer

A

breast

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18
Q

Premarin/Prempro- risk increases over the age of

A

35

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19
Q

menopause can be treated with p___ or p___

A

premarin or prempro

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20
Q

Estrogen side effects (all info)

A
  • 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
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21
Q

Estrogen side effects- increased risk of t____

A

thromboembolism

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22
Q

Estrogen side effects- increased risk of M_

A

MI

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23
Q

Estrogen side effects- reversible

A

hypertension

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24
Q

Estrogen side effects- irregular

A

vaginal bleeding (aka break through bleeding. Occurs before or after menses)

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25
Q

Estrogen side effects- common side effect in beginning of treatment

A

nausea

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26
Q

Max treatment time for estrogen replacement therapy

A

4 years

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27
Q

Estrogen drug interactions (all info)

A
  • 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
28
Q

Estrogen drug interactions- barbis, __ and __

A

barbis, tetracyclines and phenytoins decrease serum estrogen

29
Q

Estrogen drug interactions- increased toxicity with

A

corticosteroids

30
Q

Estrogen drug interactions- __ increases the risk of thrombi and emboli

A

nicotine

31
Q

Estrogen drug interactions- grapefruit juice inhibits

A

metabolism of estradiol

32
Q

Estrogen contraindications (all info)

A
  • vascular disease
  • vascular thromboembolism
  • pregnancy
  • breast carcinoma
33
Q

ER positive tumor cells are tumor that grow in the presence of

A

estrogen

34
Q

used to block growth of ER positive tumors by functioning as an antagonist

A

SERM

35
Q

SERM functions as an ___ with tumors and an ___ with bones

A

antagonist with tumors

agonist with bones

36
Q

norethindrone physiological actions

A
  • prepares the uterus for implantation
  • decreases cervical secretions
  • increases thickness of cervical secretions
  • breast development
  • increases body temperature
37
Q

norethindrone is important for ___ therapy to ensure implantation

A

invitro

38
Q

norethindrone effect on body temp

A

increases

39
Q

norethindrone side effects

A
  • thromboembolitic disorder
  • increased BP
  • cramps
  • breast enlargement
  • breakthrough bleeding
40
Q

norethindrone clinical uses (all info)

A
  • replacement therapy
  • long-term ovarian suppression
  • oral contraceptives
41
Q

2 main categories of oral contraceptives

A
  1. estrogen + progesterone (combination pill)

2. progesterone only (mini pill)

42
Q

Oral contraceptives work by preventing

A

ovulation

43
Q

Oral contraceptives increase what hormones

A

progesterone and estrogen

44
Q

Oral contraceptives decrease what hormones

A

LH and FSH

45
Q

Progesterone and estrogen trick the body into thinking

A

that it’s already pregnant

46
Q

oral contraceptive that has progesterone and estrogen is aka

A

combination pill

47
Q

oral contraceptive that has progesterone only is aka

A

mini pill

48
Q

3 types of combination oral contraceptives

A

monophasic
diphasic
triphasic

49
Q

combination pill mechanism of action

A

suppression of ovulation and increase cervical secretion

50
Q

administration schedule of combination pills

A

21 pills, starts on day 5 and ends on day 25

51
Q

With oral contraceptives, even though there’s no ovulation there’s still

A

bleeding

52
Q

combination oral contraceptive that has the same estrogen and progesterone dose throughout

A

monophasic

53
Q

combination oral contraceptive that has the same estrogen dose throughout but 2 different progesterone doses

A

diphasic

54
Q

combination oral contraceptive that has the same estrogen dose throughout but 3 different progesterone doses

A

triphasic

55
Q

which type of combination oral contraceptive most closely mimics what happens naturally

A

diphasic

56
Q

Beneficial effects of combination oral contraceptives (all info)

A
  • 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
57
Q

combination oral contraceptive drug interactions

A

antibiotics such as ampicillin and tetracyclines

58
Q

oral contraceptive interaction with antibiotics such as ampicillin and tetracyclines can

A

reduce the efficacy of the oral contraceptive

59
Q

Normally, intestinal bacteria help recycle estrogen. Therefore the use of ___ can reduce the amount of estrogen

A

antibiotics can reduce the amount of estrogen

60
Q

contraceptive that works the same as the combination bill except that its inserted once a cycles on day 5

A

Nuvaring

61
Q

contraceptive nursing implications

A
  • 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
62
Q

contraceptive nursing implications- assess

A

BP

63
Q

contraceptive nursing implications- exclude pregnancy, breast cancer, and __ before therapy

A

thrombophlebitis

64
Q

contraceptive nursing implications- encourage patient to quit

A

smoking

65
Q

contraceptive nursing implications- warn patient to use another form of birth control while taking certain antibiotics and

A

during the first 3 weeks of therapy

66
Q

contraceptive nursing implications- advise patient to report signs of

A

fluid retention, thromboembolitic disorders, abnormal vaginal bleeding

67
Q

contraceptive nursing implications- warn patient that they don’t protect against

A

STDs

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