ENDOCRINE- DOPAMINE + GONADOTROPHIN Flashcards
What is tx for endometriosis?
Danazol
Function of Gonadotrophin?
Causes pituitary gland in brain to make LH + FSH.
This makes testosterone + oestrogen, progesterone.
What other condition is Danazol used in?
Relief of severe pain + tenderness in benign fibrocystic breast disease.
If other methods fail.
What is a condition danazol is unlicensed in?
hereditary angioedema
Long term treatment
List 2 LH releasing hormone antagonists?
Cetrorelix and ganirelix
What are Cetrorelix and ganirelix used in?
Treatment of infertility
What 6 conditions are Gonadorelin analogues used in?
-Endometriosis
-Precocious puberty
-Infertility
-Male hypersexuality with severe sexual deviation
-Anaemia due to uterine fibroids (together with iron supplementation)
breast cancer, prostate cancer + before intra-uterine surgery
What are Gonadorelin analogues given with in anaemia?
Iron supplements
Use of leuprorelin acetate and triptorelin for 3 to 4 months before surgery helps do what?
Reduce fibroid size, uterine volume + reduces bleeding
What is tamoxifen used in?
Adjunct in the treatment of mastalgia
When should treatment for breast pain be reviewed?
Every 6 months + continue if needed.
Symptoms recur in about 50% of women within 2 years of withdrawal.
What are 3 natural oestrogen?
Estradiol
estrone
estriol
What are 2 fake oestrogen?
ethinylestradiol
mestranol
What is tibolone?
Both oestrogenic, progestogenic + weakly androgenic
What 3 menopausal symptoms do oestrogen with progesterone help?
Atrophy of vagina
Vasomotor instability
Osteoporosis
What drug can be used for vasomotor symptoms but has large SEs?
Clonidine
What type of cancer is increased by use of HRT?
Breast cancer (higher in combo HRT)
endometrial cancer
ovarian cancer ()
When is risk of endometrial cancer higher with HRT?
Lower risk when using combo HRT
What cancer is at increased risk with combo HRT?
Breast cancer
What cancer does tibolone increase risk of?
Endometrial
What 3 conditions can arise due to HRT?
VTE
Stroke
Coronary HD
What HRT is given to women without uterus?
Continuous Oestrogen
What two types of HRT is given to women with uterus?
Oestrogen + cyclical progestogen (for last 12-14 days)
Continuous oestrogen + progestogen
What HRT is avoided in perimenopausal phase or within 12 months of last period?
Continuous combo HRT and Tibolone
When to stop HRT before elective surgery?
Stop 4-6 weeks before
start when mobile
What to do if patient on HRT has non elective surgery?
Prophylactic VTE + stockings
What 7 cases to stop HRT?
Sudden breathlessness or Chest pain
Severe stomach pain - liver?
DVT
Headache,
Jaundice
BP > 160 mmHG
Prolonged immobility
