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Clin Med 2 > Hormones 3 > Flashcards

Hormones 3 Flashcards

1
Q

What are the pharmacological uses of estrogen and progesterone?

A
  • contraceptives
  • OP
  • hypogonadism
  • failure of ovarian development
  • menstrual irregularities
  • endometriosis
  • carcinoma
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2
Q

Pharmacology: contraceptives

A

Alter control between pituitary and ovarian hormones

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3
Q

Pharmacology: OP

A

Estrogen replacement

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4
Q

Pharmacology: hypogonadism

A

Combo of estrogen and progesterone

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5
Q

Pharmacology: hypogonadism

Combo of estrogen and progesterone to address

A
  • low ovarian function

- bleeding abnormalities

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6
Q

Pharmacology: failure of ovarian development may be the result of

A

Hypopituitarism

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7
Q

Pharmacology: failure of ovarian development

A

estrogens given at time of puberty to encourage development of secondary sex characteristics

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8
Q

Pharmacology: menstrual irregularities

A
  • amenorrhea

- dysmenorrhea

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9
Q

Pharmacology: endometriosis

A
  • progesterone and estrogen/progesterone combos

- to help shrink growths

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10
Q

What is endometriosis?

A
  • deposits of uterine tissue that develop in other regions
  • scar tissue
  • difficulty getting pregnant
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11
Q

Pharmacology: carcinoma

A
  • metastatic BC treated by estrogen for men and postmenopausal women
  • progesterone for treating uterine cancer and other metastases
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12
Q

HRT: benefits

A
  • improves bone mineralization

- may improve plasma lipid profile » reduce the risk of CVD in postmenopausal women

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13
Q

HRT: no bueno stuff

A

Increased risk of

  • stroke
  • thromboembolism
  • altered blood clotting
  • PE
  • some cancers
  • nausea
  • LE swelling
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14
Q

HRT: timing of tx

A

start HRT when women are ≤ 60 and within 10 years of reaching menopause

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15
Q

HRT: cognitive benefits?

A
  • no benefit in protecting cognitive decline of Alzheimer’s

- mixed results in other cognitive studies

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16
Q

How might HRT impact normal menstrual function?

A
  • altered normal menstrual function with prolonged use

- unpredictable changes in bleeding pattern

17
Q

HRT: increased risk for certain cancers

A
  • can’t use estrogen with estrogen-sensitive BC

- importance of screening for women on contraceptives

18
Q

HRT: nausea

A

Usually transient

19
Q

SERM =

A

Selective
Estrogen
Receptor
Modulator

20
Q

What do SERMs do?

A
  • bind to and activate estrogen receptors on certain tissues

- block the effects on other tissues

21
Q

Why might SERMs be a beneficial tx in cancer?

A
  • can reduce carcinogenic effects of estrogen on breast and uterine tissue
  • produce favorable effects on bone mineralization and cardiovascular function
22
Q

Examples of SERMs

A
  • Tamoxifen

- Raloxifene

23
Q

Raloxifene is primarily used to treat

A

OP

24
Q

Side effects of Raloxifene

A
  • hot flashes
  • bone/joint pain
  • GI issues
  • “flu-like” sx
25
Q

What do anti-estrogens do?

A

block effects of estrogen by occupying the receptor

26
Q

What are the examples of anti-estrogens?

A
  • Clomiphene

- Fulvestrant

27
Q

Clomiphene

A
  • treats infertility by promoting ovulation

- mechanism is complex, but related to negative feedback loop

28
Q

Fulvestrant

A

Antiestrogen used to treat estrogen-sensitive BC

29
Q

What are antiprogestins used for?

A

termination of pregnancy and tx of

  • uterine fibroids
  • endometriosis
  • Cushing syndrome
30
Q

What do antiprogestins block?

A

Glucocorticoid receptors

31
Q

example of antiprogestin

A

Mifepristone

32
Q

What does Mifepristone do?

A
  • terminates pregnancy

- must be taken within first 7 weeks of pregnancy

33
Q

Korlym

A
  • Tx of hyperglycemia due to increased cortisol in Cushing syndrome
  • antiprogestin
34
Q

Hormonal contraceptive components

A

Varying levels of estrogen/progesterone combos

35
Q

What is inhibited with hormonal contraceptives?

A
  • LH
  • FSH

No ovulation!

36
Q

Adverse effects of hormonal contraceptives have decreased with newer drugs due to

A
  • less estrogen

- better forms of progestins

37
Q

Risks of hormonal contraceptives

A
  • thromboembolism

- cardiovascular events (usu associated with risk factors of smoking, HTN, hyperlipidemia)

38
Q

Hormonal contraceptives may protect against

A
  • endometrial/ovarian cancers

- relationship to BC more complicated

Clin Med 2 (78 decks)

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