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Therapeutics > Module 2 lecture 1 > Flashcards

Module 2 lecture 1 Flashcards

1
Q

define pre menopausal, perimenopausal and post menopausal

A

Pre menopausal- time period of endocrine changes before cessation of menstruation

perimenopausal- The period of endocrine changes surrounding menopause

postmenopausal- The time period of endocrine changes surrounding menopause

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2
Q

What are some clinical representations of menopause

A

Hot flashes
Night sweats
sleep disturbances
vaginal dryness
mood changes

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3
Q

Absolute contraindications to menopausal hormone therapy

A

pregnancy
Endometrial or breast cancer
stroke
Active thromboembolic disorders
active liver disease

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4
Q

Estrogen monotherapy principle

A

estrogen monotherapy is only for women without a uterus

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5
Q

Why is estrogen monotherapy used in women without uteruses

A

They do not have to worry about endometrial cancer

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6
Q

Name 4 estrogen monotherapy drug ROA

A

Oral
topical
transdermal
Intravaginal
Intramuscular

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7
Q

Name 3 oral estrogen monotherapy drugs

A

Premarin, estraca and menest

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8
Q

Why do oral estrogen monotherapy drugs have more sideeffects

A

1st pass metabollism

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9
Q

Name estrogen monotherapy transdermal products

A

Vivelle-dot, vivelle, Alora, climara, menostar, minivelle

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10
Q

Why are transdermal products favored?

A

Less side effects, less risk of stroke and thromboembolism

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11
Q

What are some characteristics of intravaginal products for estrogen monotherapy

A

minimal systemic absorption (except for 1 exception)
helps vaginal dryness

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12
Q

What is the only intravaginal estrogen monotherapy that is systemically absorbed

A

Femring.

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13
Q

can we give women with uterus intact intravaginal products? Why?
What intravaginal product will require us to give her progesterone

A

We can usually give wome with uterus intact intravaginal products. This is due to their minimal systemic absorption in the body. The exception to this ofcourse is femring. We will need to give progesterone along with that product.

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14
Q

Name IM estrogen monotherapy drugs

A

Estradiol cypionate
Estradiol Valerate

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15
Q

Which drugs should be prescribed for women experiencing vaginal dryness

A

Topical vaginal products

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16
Q

Women with uterus intact should be prescribed a __________ in addition to estrogen to decrease risk of endometrial cancer

A

progestin

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17
Q

Estrogen is more favorabe the earlier you take it T/F

A

True

18
Q

T/F women with uterus intact had a significantly higher chance of breast cancer compared to women with hysterectomy

A

True

19
Q

Estrogen + progesterone increases the risk of

A

CHD (stroke, heart attack, venous thromboembolism) and breast cancer

20
Q

Women below 60 y/o within 10 years of menopause have no evidence of CHD in estrogen only treatment. T/F

A

True

21
Q

4 methods of administering combined estrogen and progestin

A

Continuous cyclic therapy
continuous long cycle
continuous combined
intermittent combined

22
Q

which method mimics natural menstrual cycle

A

Continuous cyclic

23
Q

how often is progesterone administered in continuous cyclic treatment

A

atleast 12-14 days in a 28 day cycle

24
Q

Which method is preferred in recently menopausal women

A

continuous cyclic

25
Q

Name 2 continuous cyclic drugs and ROA

A

Premphase- oral
combipatch- transdermal

26
Q

What is the difference between continuous cycle and continuous long cycle

A

continuous long has less bleeding. This is because progesterone is administered every other month resulting in 6 bleedings per year.

27
Q

How do we administer continuous combined therapy

A

daily estrogen + progesterone

28
Q

Which treatment has the best long term protection for endometrial cancer

A

continuous combined

29
Q

How does continuous combined affect endometrium?

A

atrophy of endometrium. Less bleeding. Best protection for endometrius.

30
Q

continuous combined drugs

A

Prempro, fyavolv, jinteli, angeliq, activella, amabelz, climara pro

31
Q

How is intermittent combined administered

A

3 days of estrogen and 3 days estrogen + progesterone (pulsed progesterone)

32
Q

Why do we pulse progesterone in intermittent combined therapy

A

pulsing prevents downregulation of progesterone receptors

33
Q

Drug for intermittent combined therapy

A

prefest

34
Q

What are some oral progestins for endometrial protection

A

medroxyprogesterone
norethindrone acetate
micronized progestins

35
Q

What is so special about the micronized progestins

A

resemble invivo progesterone

36
Q

What is an estrogen & SERM drug

A

Duavee

37
Q

Is estrogen & SERM hormonal?
what does it treat?
Side effects?
effect on endometrial cancer?

A

It is Non- hormonal
Treats menopausal symptoms and prevents bone less in women with intact uterus
side effects include GI disorders and muscle spasms

38
Q

WHat are some SSRI/SNRI drugs

A

paroxetine, citalopram, escitalopram

39
Q

WHat are SSRIs and SNRIs mainly used for

A

Hot flashes non hormonal

40
Q

What is one treatment of moderate to severe dyspareunia (painful intercourse)

A

Ospemifene (SERM)

41
Q

Black box warning for ospemifene

A

Endometrial cancer
stroke
VTE

Therapeutics (46 decks)

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