pharm Flashcards
most potent estrogen secreted by the ovary and the primary estrogen present in the premenopausal woman
estradiol
a metabolite of estradiol with 1/3 estrogen potency. primary circulating estrogen after menopause created from conversion of andostendione in peripheral tiss
estrone
what are the therapeutic uses of estrogens
contraception (in combo c/ progestin); postmeno hormone replacement-vasomotor instability, vag atrophy; 1 hypogonad or premature menopause
ADE of estrogens
nausea, breast tender, postmeno bleed, inc risk thromboembolic event, stroke, endometrial CA
what can be done to offset risk of endometrial CA in postmeno c/ uterus
combo progestogen
what risks are combo therapy ass. c/
inc breast CA, MI, PE
what manmade prep from horses urine is used in prostate CA palliation
premarin
if pt wanted to avoid systemic effects of estrogen what med forms could she use
vag ring, topical cream, supossitory
if a pt had liver Dz what med form would you choose/be cautious of
transdermal patch skips first pass
combination of estrogen and progesterone daily
prempro
14 days estrogen, 14 days estrogen and progesteron
premphase- may cycle
what med may be effective in pt who do not respond to estrogen/progesterone
estrogen/ testosterone- may inc libido
estrogen antagonist binds to estrogen receptor but not productive-results in down regulation of estrogen
tamoxifen
what selective estrogen receptor modulator used in breast CA is also used for osteoporosis and has little effect on the endometrium
raloxifene
what are some non-hormonal preparations for menopause
gabapentin (neurontin); SSRI (paroxitine (paxil), venlafaxine (effexor), escitalopram (lexapro); isoflavones, black cohosh
what med is used in secondary amenorrhea as a progestin challenge
provera- medroxyprogesterone
what micronized progesterone is rapidly absorbed and has a shorter 1/2 life
prometrium
injectable form of contraception x 3mo
depo-provera
what anti progestin is used for medical abortion and has a restricted distribution in the US
mifepristone RU486
injectable ED drug relaxes smooth muscle
alprostadil (Caverject, Muse)
inhibits phosphodiesterase (PDE-5) and enhances effects of nitric oxide
sildenafil (viagra)
PDE with slower onset but longer 1/2 life
tadalafil (cialis)
GnRH agonist used for prostate CA
leuprolide (lupron)
antiandrogen agent Tx prostate Ca- competes c/ natural hormone for binding- used c/ leuprolide
flutamide (eulexin)
what prostate drugs work by reducing sz of gland
5alpha reductase inhibitors
finasteride (proscar), dutasteride (avodart)
A1 receptor blockers - dec tone in smooth m. of bladder neck to improve flow BPH, HTN
prazosin, terazosin, alfuzosin, tamulosin(kidney stones)
what are the anticholinergic drugs used for incontinence- reduce bladder spacticity
tolterodine tartrate, oxybutynin, trospium chloride
ADE- dry, dizzy
tx for BV avoid alcohol
metronidazole
antifungal vaginitis c/ ADE of QT prolong, hepatotox
miconazole, clotrimazole, fluconazole
