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ENRP > MHT, SERM, TSEC Pharmacology > Flashcards

MHT, SERM, TSEC Pharmacology Flashcards

1
Q

MHT stands for?

A

Menopausal Hormone Therapy

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2
Q

What are some symptoms of menopause?

A

Hot flashes/sweating
Vaginal dryness
Sleep disturbances
UI

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3
Q

What are the general options for MHT?

A

Estrogen +/- Progestin

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4
Q

Women with an intact uterus must also get what with MHT?

A

Estrogen + PROGESTIN

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5
Q

With MHT, women with an intact uterus get?

A

ESTROGEN + PROGESTIN

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6
Q

What does Progestin do?

A

Opposes the effects of Estrogen

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7
Q

What are the 4 Estrogenic forms with MHT?

A
  • Estradiol
  • Conjugated Estrogens
  • Esterified Estrogens
  • Estropipate
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8
Q

What are the 4 Estrogenic forms with MHT?

A
  • Estradiol
  • Conjugated Estrogens
  • Esterified Estrogens
  • Estropipate
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9
Q

What are the 3 Progestin forms with MHT?

A
  • Medroxyprogesterone
  • Methyltestosterone
  • Progesterone
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10
Q

What are the 3 Progestin forms with MHT?

A
  • Medroxyprogesterone
  • Methyltestosterone
  • Progesterone
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11
Q

What 3 things can Estrogen DECREASE?

A
  1. Cholesterol
  2. Anti-thrombin III
  3. Osteoclast activity
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12
Q

What 5 things can Estrogen INCREASE?

A
  1. Triglycerides (hdl-c)
  2. Clotting factors
  3. Platelet aggregation
  4. Na+/fluid retention
  5. TBG
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13
Q

The Women’s Health Initiative Studies examined the beneficial/risks of MHT. What were the 2 trial groups?

A
  1. With a uterus

2. Without a uterus

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14
Q

With the WHIs, the women with an intact uterus received what therapy?

A

Estrogen + Progestin

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15
Q

With the WHIs, the women without a uterus received what therapy?

A

Estrogen only

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16
Q

Estrogen + Progestin… what are the HARMS?

A 
Breast cancer
CAD
Gallbladder disease
Stroke/VTE
Dementia
UTI
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17
Q

Estrogen + Progestin… what are the HARMS?

A 
Breast cancer
CAD
Gallbladder disease
Stroke/VTE
Dementia 
UTI
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18
Q

Estrogen + Progestin… what are the BENEFITS?

A

– decreases risk of:
Colorectal cancer
Fractures
Diabetes

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19
Q

Estrogen + Progestin… what are the BENEFITS?

A

– decreases risk of:
Colorectal cancer
Fractures
Diabetes

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20
Q

Estrogen only… what are the HARMS?

A

Gallbladder disease
Stroke/VTE
Dementia
UI

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21
Q

Estrogen only… what are the BENEFITS?

A

– decreases risk of:
Breast cancer
Fractures
Diabetes

22
Q

What are 2 harms that are present with Estrogen + Progestin and NOT present with Estrogen only/

A

Breast cancer

CAD

23
Q

What is MHT best at treating?

A

Vasomotor symptoms

Vaginal dryness

24
Q

What is MHT best at treating?

A

Vasomotor symptoms

Vaginal dryness

25
Q

Why must women with an intact uterus also be on a Progestin?

A

It opposes Estrogens effects

– stops the endometrial hyperplasia that is occurring with just estrogen

26
Q

If a menopausal woman presents with vaginal symptoms only, what is a better treatment option than MHT?

A

Topical estrogen cream

27
Q

What happens several years after MHT is stopped?

A

Risks and benefits are eliminated

28
Q

If you are going to use MHT, how should you use it?

A

Lowest dose for the shortest duration possible

29
Q

SERM stands for?

A

Selective Estrogen Receptor Modulator

30
Q

TSEC stands for?

A

Tissue Selective Estrogen Complexes

31
Q

Generally, what do SERMs and TSECs do?

A

Pro-estrogen on some tissues and Anti-estrogen on others

32
Q

What are the 2 SERMs?

A

Ospemifene

Clomiphene

33
Q

What are the 2 SERMs?

A

Ospemifene

Clomiphene

34
Q

What is 1 TSEC?

A

Bazedoxifene

35
Q

What is 1 TSEC?

A

Bazedoxifene

36
Q

SERMs are Anti-estrogen where?

A

Breast

Endometrium

37
Q

What are TSECs?

A

SERMS + Estrogen component

38
Q

What are 2 indications for the use of Ospemifene?

A
  1. Dyspareunia (pain with sex)

2. Vaginal dryness

39
Q

If a patient presents with dyspareunia and vaginal dryness, what SERM should you prescribe?

A

Ospemifene

40
Q

MOA for Ospemifene?

A

Pro-estrogen at vagina and endometrium

41
Q

What are 2 indications for the use of Bazedoxifene?

A
  1. Vasomotor symptoms in a woman with a uterus

2. Prevention of osteoporosis in a woman with a uterus

42
Q

Bazedoxifene should be used with a woman with or without a uterus?

A

WITH

  • vasomotor symptoms
  • prevention of osteoporosis
43
Q

MOA for Bazedoxifene?

A

Pro-estrogen physiologically and in bone

44
Q

Which drug can destroy HER2 cells?

A

Bazedoxifene

45
Q

What are 3 indications for the use of Clomiphene?

A
  1. Infertility in anovulatory women
  2. Irregular ovulation or luteal phase defects
  3. PCOS
46
Q

What are 3 indications for the use of Clomiphene?

A
  1. Infertility in anovulatory women
  2. Irregular ovulation or luteal phase defects
  3. PCOS
47
Q

MOA for Clomiphene?

A

Anti-estrogenic
= blocks (-) feedback from estrogen on the hypothalamus
–> increases release of gonadotropins

48
Q

Which drug blocks the negative feedback from estrogen on the hypothalamus in order to increase the release of gonadotropins?
(anti-estrogenic)

A

Clomiphene

49
Q

A woman presents with infertility due to anovulation. What should she be treated with?

A

Clomiphene

50
Q

A woman with a uterus presents with vasomotor symptoms and wants to prevent osteoporosis. What should she be treated with?

A

Bazedoxifene

ENRP (45 decks)

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