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Phar 301 > Aging and menopause > Flashcards

Aging and menopause Flashcards

1
Q

What are the 3 interventions in basic mechanisms of aging?

A

Diet - Caloric restriction; antioxidants
Lifestyle - exercise
Hormones?

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2
Q

What are the 3 major age-related diseases?

A

Cardiovascular disease
Cancer
Osteoporosis

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3
Q

What are the 3 hormones used in anti-aging hormonotherapy?

A

Estradiol
Progesterone
Testosterone

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4
Q

In recent years, years of active life in women AFTER menopause has (increased/decreased)

A

Increased

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5
Q

What happens to hormone levels of [FSH, LH, Estrone, Estradiol] after menopause?

A

FSH, LH: shoot up

Estrone, Estradiol: drop down

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6
Q

What are sources of Estrogen before menopause?

A

Ovaries (mainly) and Adipose tissue (a bit)

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7
Q

What are the sources of estrogen after menopause?

A

Adipose tissue (only)

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8
Q

How does estrogen exert effects on cells?

A

Enters cells
Binds to estrogen receptor
Enters nucleus
Changes DNA transcription with coactivators

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9
Q

Which tissues are affected by estrogen? (6)

A 
Brain
Heart
Breast
Liver
Uterus
Bone
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10
Q

How does each Isoform of Progesterone act on a cell? Which way is faster?

A

Isoform A enters nucleus directly to exert transcriptional changes

Isoform B acts on membrane receptors to activate secondary messengers

Secondary messengers much faster than Genomic changes

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11
Q

What are the targets of Progesterone action?

A 
CNS
Hypothalamus/Anterior Pituitary
Metabolism
Vagina
Mammary glands
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12
Q

What are the two types of Menopausal hormone therapy?

A

HRT - Estrogen-progestin combination

ERT - Estrogen-alone (post hysterectomy)

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13
Q

What is the time course of Menopause-related Symptoms?

A 
Weeks-months: 
-Hot flashes
-Insomnia
-Moodiness
Months-Years:
-Vaginal atresia
Bladder Dysfunction
Skin Atrophy
Years-Decades
Cardiovascular disease
Osteoporosis
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14
Q

Can HRT reduce the amount of weekly hot flashes?

A

Yes

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15
Q

How can you treat vaginal dryness during menopause?

A

Treat with low dose local estrogen

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16
Q

How does estrogen affect bone remodelling?

A

Decreases effect of Osteoclasts - increases bone formation

During menopause, decreased estrogen increases osteoclast activity causing increased bone resorption

17
Q

Can HRT help maintain spinal bone density?

A

Yes

18
Q

What is a non-hormonal way to prevent fractures in elderly women?

A

Vitamin D3/Calcium

But also diet, exercise, etc

19
Q

What do bisphosphonates such as alendronate do?

A

Inhibit osteoclast function

20
Q

What are SERMs and what are they used for?

A

Selective Estrogen Receptor Modulators

Pharmacologic therapy for osteoporosis

21
Q

What are the 5 characteristics of the “ideal” SERM?

A 
Strengthens bones
Lowers LDL cholesterol and raises HDL cholesterol
Relieves Hot Flashes
Reduces Breast cancer risk
Reduces uterine cancer risk
22
Q

How does Raloxifene modulate Bone, Lipid, Breast, and Endometrium Estrogen receptors?

A

Bone & lipids: agonist

Breast & endometrium: Antagonist

23
Q

Between HDL and LDL, which is the Good cholesterol and which is the bad?
How does Estrogen affect levels of each?

A

HDL: good
LDL: bad

Estrogen increases HDL while decreasing LDL

24
Q

Can estrogen containing HRT decrease Cardiovascular disease?

A

Maybe

25
Q

Does HRT put you at risk of stroke?

A

Yes but it’s rare

26
Q

Does HRT decrease your risk of colon cancer?

A

Yes but

27
Q

Does HRT benefit post-menopausal symptoms of cognitive aging, dementia or depression?

A

No

28
Q

Does HRT decrease your risk of Breast cancer?

A

It’s complex…

29
Q

When should you prescribe HRT?

A

When the benefits outweigh the risks

30
Q

Do we know much about testosterone in aging men?

A

Not really, more research is being done on women

Phar 301 (23 decks)

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