Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENRP II > Menopausal Hormone Therapy; Selective Estrogen Modulators and Tissue Selective Estrogen Complexes > Flashcards

Menopausal Hormone Therapy; Selective Estrogen Modulators and Tissue Selective Estrogen Complexes Flashcards

1
Q

what are the symptoms of menopause

A

hot flashes, night sweats, vaginal dryness (painful intercourse) , sleep disturbances, mood disorders, urinary incontinence

anybody who wants MHT needs 1 or more of these signs

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

what disorders have an increased prevelance in menopause

A

cardiovascular effects (ACS, MI)

bone effects (osteoporosis, osteopenia)

when a premenopausal/menopausal patient presents to you, you should be asking about these things

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

the primary therapy for menopausal symptoms is _

A

estrogen

with or without the addition of progestin

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

women with an intact uterus must also be on a _ along with the estrogen)

A

progestin

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

why do women with an intact uterus going through menopause need to be on both estrogen and progestin?

A

because unapposed estrogen increases the risk of endometrial hyperplasia/carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pharmacotherapy during peri-menopause can also commonly consist og _ therapy

A

combinedation hormonal contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

combined hormone contraceptive therapy provides _ regulation and _ protection

A

hormone regulation

pregnancy protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

available formed of estrogen (4)

A
  1. estradiol
  2. conjugated estrogens
  3. esterified estrogens
  4. estropipate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

estradiol is in _ form in the tablet/vaginal ring and _ form in the injectable version

A

acetate

cypionate

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

conjugated estrogens are a blend of many _ derivatives that are derived from estrogens found in the _

A

estrogen

urine

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

esterified estrogens are a combination of _ and _

A

Na+ estrone sulfate (majority)

Na+ equillin sulfate (minority)

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

estropipate is a cyrstalline estrone solubilized sulfate and stabilized with?

A

piperazine

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

progesting _ (enhance/oppose) estrogen effects

A

oppose

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

what are the avaibale progestenic components

A

medroxyprogesterone MPA

methytestosterone

Progesterone

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

medroxyprogesterone MPA is given with what estrogen?

A

CE: conjugated estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

methyltestosterone is given with what estrogen?

A

EE: esterified estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the MOA of exogenous estrogen?

A

bind to the estrogen receptors in various tissues and is transferred to the nucleus which results in increase gene and protein expression that give the physiological responses of estrogen

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

estrogen effect on the endometrium

A

proliferation

increased risk of hyperplasia and carcinoma this is why this is not given alone in someone who still has their uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

estrogen effects on lab results:

cholesterol
antithrombin III
osteoclastic bone activity
triglycerides
clooting factoris
platelet aggregation
sodium/fluid retention
thyroid binding TBG

A

estrogen will work to decrease cholesterol LDL/TC (this is good)

it will decrease antithrombin III activity (break up a clot)

will decrease osteoclastic acivity

will increase HDL and triglycerides (good)

will increase clotting factors and platelet aggregation (higher chance of clotting-not good)

increase sodium and fluid rentention (bloating and puffy)

increase thyroid binding globulin (TBG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

womens health initiative study said that MHTs are benifical or preventative effects are on ? and risks of various _

A

preventative effects on heart disease, osteoposis related fractures

risk of various cancers though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the benefits of both combined MHT and estrogen only MHT (people with no uterus)

A

benefits are a decrease in diabetes and fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a benefit singular to combined MHT (estrogen and progestin in a patient with a uterus)

A

decerase in colorectal cancer

23
Q

what is a benefit to just estrogen MHT

A

decrease in invasive breast cancer

24
Q

what are some harms associated with both combination MHT and estrogen only MHT

A

dementia
gall bladder disease
stroke
VTE
urinary incontience

25
Q

what are some harms associated with just combined MHT

A

increased risk of breast cancer (invasive) and increased risk of coronoary heart disease

26
Q

MHT very effectively minimizes/treates _ symptoms and _ changes

A

vasomotor symptoms

and vaginal changes

27
Q

MHT should not be used to prevent _ or _

A

CVD or dementia

28
Q

MHT benefit on bone and colon cancer are outweighed by _

A

all the other risks

29
Q

for younger women with menopausal symptoms can you give them MHT?

A

yes, it can treat troubling menopausal symptoms in the relatively young and within 10 years of menopause

you can individualize this to your patients

they dont have to be on it forevere

start with patch over oral therapy

30
Q

for women with vaginal symptoms only the preffered treatment is?

A

low dose vaginal estrogen topicals

31
Q

both estrogen alone therapy and estrogen with progestin increases risk of _

A

blood clots

counsel your patients

32
Q

alhtough risks of blood clots and stroke increase with either MHT, risk is less in _ year old age group

A

50-59 year old

33
Q

there is an increased risk of _ cancer seen within 2-4 uears of continuous estrogen with progestin therapy

A

breast

for women at risk for breast cancer, maybe shouldnt give them this

34
Q

MHT take home messages

use the _ (lowest/highest) dose possible to control symptoms

treat for the _ (shortest/longest) duration possible and re-evaluate at least yearly )

A

lowest

shortest

make sure you document everything

risks and benefits of MHT are essentially eliminated several years after MHT is stopped

35
Q

what are SERMS

A

selective estrogen receptor modulators

36
Q

what is the goal of a SERM

A

to be proestrogenic at select tissues like the bone, vagina, and hotflashes

but to be anti estrogenic at other sites like the breast or the endometrium

37
Q

whar are TSECS

A

tissue selective estrogen complexes

38
Q

what is the goal of TSECs

A

to combine the unique elements of a SERM with an estrogen compound

39
Q

SERMs are replacing progestin actions of traditional progestin- inclusive

A

MHT

40
Q

what are the SERMs we need to know?

A

ospemifene
clomiphene

41
Q

what is a TSEC we need to know about?

A

Bazedoxifene

this is a combo with conjugated estrogen and selective receptor modulator

not available in a single ingredient compound

42
Q

OSpemifene indications (serm)

A

dypareunia (symptom of menopause due to vaginal atropy)

vaginal dryness

if vaginal dryness is the only issue maybe just topical

43
Q

MOA of ospemifene (SERM)

A

functions as an estrogen agonist by binding to ER in the vagina but anti- estrogenic at the breast

increases vaginal secretions, decreases vaginal pH, reduces pain during intercourse, increase superifical cell growth

44
Q

side effects of ospemifene

A

hot flashes, estrogenic effects of coagulation/endometrial thickening and hyperplasia

45
Q

contrainications of ospemifene

A

AUB, thromboembolic events, estrogen related neoplasia

46
Q

bazedoxifen is used in women with a _ uterus

A

intact

47
Q

bazedoxifence with a conjugate estrogen is used for?

A

menopausal symptoms in women with a uterus

prevention of post menopausal osteoporosis in women with a uterus

48
Q

MOA of bazedoxifene (TSEC)

A

antagonistic affect in the endometrium (prelaces the progestin concept in tradiational MHT) and in breast tissue

agonist/estrogenic physioloigcal effect in bone

does not stimulate endometrial proliferation
destroys HER2 malignant cells

49
Q

TSECS with Conjugated estrogen have replaced what

A

traditional MHT therapy with progestin

this is because they are anti-estrogenic at the places where unapposed estrogen could create problems

less vaginal bleeding compared to progestin therapy

50
Q

side effects of bazedoxifene

A

all estrogen related side effects: DVT, dementia, stoke, gall bladder disease, urinary incontinence

specific: worsening of hot flashes

contraindicated in all estrogen situations

51
Q

what is clomiphene

A

an anti estrogen SERM that is used in infertility and anovulatory women, irregular ovulation, luteal phase defects, PCOS

used in infertility !

52
Q

MOA of clomiphene

A

blocks inhibitory/negative feedback actions of estrogen oon the hypothalamus preventing estrogen from lowering GNRH on the pituitary gonadotropin release (LH and FSH)

increases gonadotropin (LH and FSH) secretion to help stimulate ovaries to develop oocyte follicles

given orally between cycle days 5 and 9

53
Q

side effects of clomiphene used in infertility

A
  1. multiple gestations
  2. ovarian cysts
  3. hot flashes
  4. luteal-phase dysfunction (inadequate progesterone production)

ENRP II (25 decks)

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