Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHRM 825 - Exam 4 > LECUTE 35 & 36: menopausal hormone therapy (mht) > Flashcards

LECUTE 35 & 36: menopausal hormone therapy (mht) Flashcards

(43 cards)

Start Studying
1
Q

Define premenopausal

A

The time period of endocrine changes BEFORE cessation of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define perimenopausal

A

The period of endocrine changes SURROUND the menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define postmenopausal

A

The time period of endocrine changes AFTER cessation of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you determine a “final” menstrual period?

A

diagnosis confirmed after 12 consecutive months of amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should systemic MHT be avoided (based on PMH of the patient)?

A

Avoid systemic MHT for women with:

  • MODERATE TO HIGH breast cancer risk (1.67% to >5%)
  • High 10-year CVD (> 10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the ABSOLUTE contraindications of MHT

A
  • Unexplained vaginal bleeding
  • Pregnancy
  • Estrogen-dependent malignancies
  • Endometrial cancer
  • Breast cancer
  • Stroke
  • Active thromboembolic disorders
    (or prior history)
  • Active liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List the RELATIVE contraindications of MHT

A
  • Uterine leiomyoma
  • Migraine headaches with aura
  • Seizure disorders
  • Diabetes
  • Hypertriglyceridemia (>400 mg/day)
  • Active gallbladder disease
  • High risk for heart disease
  • Family history of breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Estrogen monotherapy should only be used for what type of (female) patient?

A

(female) patients who DO NOT have a uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of product should be prescribed exclusively for women experiencing vulvovaginal atrophy?

A

Topical vaginal products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If women have a uterus, what should be prescribed in addition to estrogen?

A

a progestin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Initiation of treatment should be limited to women meeting what guidelines?

A

< 60 YO or within 10 years of last period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List medications available for combined estrogen & progestin via continuous cyclic therapy

A

Premphase® (oral)
Combipatch® (transdermal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe continuous cyclic therapy

A

also called “sequential treatment”
estrogen is administered daily & progesterone is administered as least 12-14 days of a 28 day cycle

preferred in recently menopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe continuous long cycle therapy

A

“cyclic withdrawal”
estrogen administered daily & progesterone co-administered with estrogen for at least 12-14 days every other month

limited safety data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List the methods of administration for combined estrogen & progestin therapy

A
  • Continuous cyclic therapy
  • Continuous long cycle (RARE)
  • Continuous combined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe continuous combined therapy

A

Daily estrogen & progesterone

  • Recommended for women >2 years post-final menstrual period
  • BEST long-term endometrial protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List medications available for combined estrogen & progestin via continuous combined therapy

A

ORAL:
Prempro®
Fyavolv® / Jinteli®
Angeliq®
Activella® / Mimvey®
Bijuva®

TANSDERMAL
ClimaraPro®
Combipatch®

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List types of progestin that can be taken PO for endometrial protection

Study These Flashcards
A

medroxyprogesterone (Provera®)
norethindrone acetate (Aygestin®)
micronized progestin (Prometrium®)

19
Q

List types of progestin that can be administered vaginally/intrauterine-ly for endometrial protection

Study These Flashcards
A

levonorgestrel (Mirena IUD®)
progesterone gel (Crinone®)

20
Q

List oral estrogen monotherapy products

Study These Flashcards
A

Premarin® (conjugated estrogens)
Menest® (esterified estrogen)
Estrace® generics (micronized estradiol)

21
Q

List transdermal estrogen monotherapy products

Study These Flashcards
A

Climara®
Lyllana®
Menostar®
Minivelle®
Vivelle-dot®
Dotti®

22
Q

List topical (GEL) estrogen monotherapy products

Study These Flashcards
A

EstroGel®
Divigel®
Elestrin®

23
Q

List topical (SPRAY) estrogen monotherapy products

24
Q

List intravaginal (CREAM) estrogen monotherapy products

Study These Flashcards
A

Estrace®
Premarin®

25
List intravaginal (INSERT) estrogen monotherapy products
Imvexxy®
26
List intravaginal (TABLET) estrogen monotherapy products
Vagifem® Yuvafem®
27
List intravaginal (RING) estrogen monotherapy products
Estring® Femring®
28
List IM injection estrogen monotherapy products
Depo-Estradiol® (estradiol cypionate) Delestrogen® (estradiol valerate)
29
List treatments available for the treatment of genitourinary syndrome of menopause (GSM)
first line (non-hormonal): - lubricants (short DOA, frequent applications needed) - vaginal moisturizers (2-3 applications / week) second line (estrogen): - topical (cream*, tablet*, ring) - low-dose oral contraceptive *Low-dose vaginal estrogen (minimal systemic exposure) do not require progestin for endometrial protection
30
What drugs are available for the treatment of moderate-severe dyspareunia?
Ospemifene (Osphena) - SERM Prasterone (Intrarosa)
31
What is the black box warning for Ospemifene (Osphena)?
Endometrial cancer Stroke VTE
32
What are common side effects of Ospemifene (Osphena)?
Vaginal discharge, endometrial hyperplasia HOT FLASHES (7% - 12%)
33
List non-pharmacological treatments that can be used to treat vasomotor symptoms
Black cohosh - not recommended for long-term use Dong quai
34
List drugs that can be used off-label for pharmacological treatment of vasomotor symptoms
Gabapentin Oxybutynin SSRI/SNRI - Paroxetine (Brisdelle) Fezolinetant (Veozah™) Bioidentical HRT - Bijuva®
35
What is the issue with using gabapentin to treat vasomotor symptoms?
sedation
36
List some advantages / disadvantages of using Oxybutynin to treat vasomotor symptoms
ADVANTAGES: - Can be used for women with breast cancer (no interaction with tamoxifen) - Can help with urinary incontinence DISADVANTAGES: - Anticholinergic effects Older age = more sensitive to these effects Studies show decreased cognitive ability with long-term use
37
List some advantages / disadvantages of using Paroxetine (Brisdelle) to treat vasomotor symptoms
- Is a strong CYP2D6 inhibitor - cannot be used with Tamoxifen - Takes ~2 weeks for effects (helps with hot flashes) - If not working well, STOP, could cause withdrawal symptoms
38
List the contraindications for Fezolinetant (Veozah™)
- Known cirrhosis - Severe renal impairment or end-stage renal disease - CONCOMITANT USE WITH CYP1A2 INHIBITORS (vv severe drug interaction !!)
39
What is the dosing for Fezolinetant (Veozah™)?
45 mg PO once daily
40
What testing should be done for patients taking Fezolinetant (Veozah™)?
liver function test before initiation & at 3, 6 & 9 months If LFT / total bilirubin level >/= 2 x ULN CONTRAINDICATED !!
41
Should MHT be initiated for women within 10 years since menopause & low 10-year CVD (< 5%)
YES, may use MHT (oral or transdermal)
42
Should MHT be initiated for women within 10 years since menopause & moderate 10-year CVD (5-10%)?
yes, BUT, avoid oral estrogen & prefer transdermal administration
43
Should MHT be initiated for women with high 10-year CVD (> 10%)?
NO, avoid systemic MHT If genitourinary symptoms, may consider low-dose vaginal estrogen / other treatments

PHRM 825 - Exam 4 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions