Pharm 1a

Question 1

whats the primary treatment for MHT?

Answer 1

Estrogen

Question 2

whats MHT?

Answer 2

Menopausal Hormone Therapy

Question 3

What are the names of estrogen MHTs?

Answer 3

Estr- Etradiol, estrogens (EE,CE), Estropipate

Question 4

Estrogen MOA?

Answer 4

binds estrogen receptors (a and b) which enter to nucleus and cause increase in gene and proteins.

Question 5

Estrogen causes decreases in what molecules?

Answer 5

Cholesterol, antithrombin III, osteoclast activity

Question 6

Estrogen causes increases in what molecules?

Answer 6

Triglycerides, clotting factors, platelets, Na, Thyroid

Question 7

LARGE SE for estrogen?

Answer 7

endometrial proliferation

Question 8

due to SE of estrogen what do you do? in which patients? what can it lead to without?

Answer 8

W/ intact uterus also give progestin to oppose the unopposed tissue proliferation. which is a precursor to endometrial hyperplasia/carcinoma

Question 9

Progestinic naming?

Answer 9

Medoxyprogesterone, methyltestosterone, progesterone

Question 10

Progestinic MOA?

Answer 10

Oppose estrogens effects

Question 11

MHTs timeline (history)

Answer 11

40-60 estrogen 70 add progesterone 80s. clin use expanded 90s increased research/ life

Question 12

WHI is what

Answer 12

womens healthy initiative

Question 13

WHI: Hormone effects on what 3 things? 2 types of patients?

Answer 13

Effect on: heart disease, Osteoporosis-related fractures, and risk of various cancers. CE + MPA and CE only patients.

Question 14

Summary message from findings? minimizes what? not used for? cancers?

Answer 14

MHT very effectively minimizes vasomotor symptoms and vaginal changes. MHT not used to prevent CVD or dementia. Benifit on bone and colon cancer outweighed by risks

Question 15

1. MHT good for who? age? severity? administration?

Answer 15

young <59, mod/severe menopause, patch better than oral

Question 16

2. Vag symptom only. treatment? administration?

Answer 16

low doses of vaginal estrogen (topical)

Question 17

3. W/ uterus treatment? W/out?

Answer 17

W/ use progestin and estrogen. W/out use just estrogen

Question 18

4.At risk for blood clot/stroke. treatment? risk less likely with what group?

Answer 18

Both treatments increase risk of stroke/ blood clot. risk increase with either group but risk is less in 50-59 age group

Question 19

5. Women at increased risk of? which group?

Answer 19

Breast cancer with estrogen with progestin therapy. after 3-5 years of continuous use

Question 20

do the risks/benefits go away after use?

Answer 20

yes several years after MHT is stopped

Question 21

MHT what dose should be used? for how long?

Answer 21

use the lowest dose possible to control symptoms, treat for shortest duration possible and instinctively re-evaluate at least yearly for ongoing need for therapy