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Pharmacology II > Hormone Replacement Therapy > Flashcards

Hormone Replacement Therapy Flashcards

1
Q

What THREE human estrogens are used in HRT?

A

Estradiol
Estrone
Estriol

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2
Q

What FOUR synthetic estrogens are used in HRT?

A

Ethinyl Estradiol
Mestranol
Conjugated Estrogens
Diethylstillbestrol

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3
Q

________ contain a phenolic ring that allows them bind to estrogen receptors

What are examples of these?

A

Phytoestrogens

Soy
Red Clover
Flaxseed
Alfalfa
Black Cohosh
Dong Quai
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4
Q

What should you monitor when using black cohosh?

A

LFTs

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5
Q

What are FOUR oral Estrogens used in HRT?

A 
Conjugated Estrogens (Premarin)
Esterified Estrogens (Menest) 
Estropipate (Ogen) 
Micronized Estradiol (Estrace)
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6
Q

What are SIX progesterones used in HRT?

A 
Dydrogesterone
Medroxyprogesterone acetate 
Micronized progesterone
Norethindrone
Norgestrel 
Levonorgestrel
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7
Q

When are estrogens indicated in HRT?

A

For relief of vasomotor symptoms in menopause

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8
Q

What minor ADRs are associated with Estrogen use in HRT?

Major?

A

Minor:

Nausea
Headache
Breast Tenderness

Major:

CHD
CVA
VTE
Breast CA

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9
Q

What risks are associated with using Estrogen in HRT?

A

Increased risk of stroke/clotting (VTE)
Increased risk of developing endometrial cancer
Dementia

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10
Q

How should Estrogens used in HRT be managed with surgery?

What is this preventing?

A

They should be held 4-6 weeks prior to surgery to prevent venous thromboembolism

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11
Q

_______ is indicated for use in pre-menopausal women with acquired, generalized hypoactive sexual desire disorder.

A

Flibanserin

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12
Q

T/F: Flibanserin should be used in post-menopausual women

A

False

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13
Q

Should Flibanserin be used with alcohol or P450 Inhibitors?

A

No

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14
Q

What ADRs are associated with Flibanserin?

A

Sedation
Hypotension
Syncope
CNS Depression

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15
Q

What are FIVE Selective Estrogen Receptor Modulators (SERMs)?

A
  1. Tamoxifen
  2. Toremifene
  3. Raloxifene
  4. Ospemifene
  5. Bazedoxifene
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16
Q

What is a common indication for SERM use?

A

Metastatic Breast CA

17
Q

What is a unique indication for Ospemifene use?

A

Dyspareunia (Due to vaginal atrophy)

18
Q

What is a patient taking Tamoxifen at risk for?

A
  1. Hypercalcemia
  2. Uterine Malignancies / Hyperplasia / Polyps
  3. DVT / PE
  4. Liver Abnormalities
  5. Ocular disturbance
19
Q

What ADRs are seen with Tamoxifen?

A 
Vasomotor Symptoms
Hair Loss
Vaginal Atrophy
Nausea
Vomiting
20
Q

T/F: Tamoxifen interacts with Warfarin

A

True

Also with Rifampin

21
Q

Toremifene is indicated in women with metastatic breast cancer who are ____-menopausal and have ______-receptor positive tumors

A

Post-menopausal

Estrogen receptor positive tumors

22
Q

What ADRs are seen with Toremifene?

A 
Hot flashes
Nausea
Sweating
Cataracts
Clots
Elevated LFTs
23
Q

What cardiac ADR is seen with Toremifene?

A

Prolonged QT

24
Q

Raloxifene is often used for breast cancer ______ in ____-menopausal women

A

Prevention

Post-menopausal

25
Q

Should Ospemifene be used in patients with a history of DVT, PE, MI, CVA, or pregnancy?

A

No

26
Q

Bazedoxifene is often used for the prevention of post-menopausal ________

A

Osteoporosis

27
Q

Fulvestrant is a ______ _______ ________ _______ used in post-menopausal women with hormone receptor positive metastatic breast CA

A

Steroidal estrogen receptor antagonist

28
Q

What are THREE Aromatase Inhibitors?

Are these Non-steroidal or steroidal?

A

Anastrozole (non-steroidal)
Exemestane (non-steroidal)
Letrozole (steroidal)

29
Q

Which has a higher efficacy with advanced breast CA…

Aromatase Inhibitors or SERMs?

A

Aromatase Inhibitors

30
Q

Do Aromatase Inhibitors work best in pre or post menopausal women?

A

Post-menopausal

Pharmacology II (2 decks)

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