Pharmacology - Chapter 60 - Estrogens and Progestins Flashcards
Estrogens and Progestins are produced by ___.
Ovaries.
During pregnancy, a lot of Estrogen/Progestin is produced by the ____.
Placenta.
Estrogen/Progestin - promote development of…
secondary sex characteristics in females.
Estrogen doesn’t protect against coronary heart disease and osteoporosis. T/F?
False - it does!
Estrogens increase cholesterol excretion by altering bile acids. T/F?
True!
What are the two clinical applications of Estrogen/Progestin?
Contraceptive and Non-contraceptive.
HRT - Estrogens are given….
to replace estrogens lost following menopause.
HRT - Progestins - given to prevent…
adverse effects of estrogens on the endometrium.
Endometrium - functions as a ….
lining for the uterus.
Menstrual Cycle - Day 1-14 =
Follicular Phase.
Menstrual Cycle - Day 15-28 =
Luteal Stage.
Menstrual Cycle - what happens in the ovary?
Several ovarian follicles ripen, one of the ripe follicles ruptures, ruptured follice evolves into a corpus luteum, and if fertilization doesn’t occur, corpus luteum dissolves.
Menstrual Cycle - in the uterus - What happens?
While follicles ripe, endometrium prepares for nidation (implantation) by increasing thickness and vascularity.
Following ovulation, uterus continues to prepare.
If nidation fails, thickened endometrium breaks down, causing menstruation.
Menstrual Cycle - Estrogen and Progesterone - what does it end with?
It ends with the breakdown of the endometrium.
Estrogen - in females, where does it come from?
Ovary.
In males, where does estrogen come from?
Testosterone is converted to estrogens in the liver and peripheral tissues.
What are some adverse effects of Estrogen?
Endometrial hyperplasia, carcinoma, breast cancer.
Prolonged use of estrogen by menopausal women may increase the risk of ____ ____. If used in combination with progestin, the risk is ___.
Endometrial carcinoma/little.
What do SERM’s Do? (Selective Estrogen Receptor Modulators)
Stimulate estrogen receptors in some tissues and block some receptors in others (selective.)
What are the benefits of SERM’s?
Protection against osteoporosis, maintenance of urogenital tract, and reduction of LDL cholesterol.
What are the risks of SERM’s?
Promotion of breast cancer, uterine cancer, and thromboembolism.
What are the 3 SERM’s?
Tamoxifen (Nolvadex), Toremefine (Fareston), and Raloxifene (Evista).
What does Tomixifen do?
It blocks estrogen receptors, inhibits breast cell growth, stimulates estrogen receptors, protects osteoporosis, stimulates increase the risk of uterine cancer and thromboembolism.
Is Toremefine (Fareston) the same as Tomixifen?
Yes!
Raloxifene (Evista) - What does it do?
It does the same stuff as Tomoxifen, but does not stimulate estrogen receptors, so there’s no risk of Uterine Cancer!
Progestins - act like…
progesterone.
Progesterone - produced by…
ovaries and placenta.
What is Progestin used for?
Menopause, uterine bleeding, amenorrhea (absence or abnormal stoppage of menses/periods), endometriosis, premenstrual syndrome.
What are some AE’s of Progestins?
Teratogenic Effects, Spotting, Breakthrough bleeding, breast tenderness, depression, photosensitivity.
What is HRT used for?
Menopause!
What are some benefits of HRT?
Suppresses vasomotor symptoms (hot flashes due to estrogen decline), Prevention of urogenital atrophy, prevention of osteoporosis, protection against Coronary Heart Disease.
What are some risks of HRT?
Uterine cancer, breast cancer.
What are some common Psychological and behavioral symptoms of PMS?
Irritability, Depression, mood change, crying spells, etc.
What are some common physical symptoms of PMS?
Acne, breast tenderness, ankle edema, etc.
PMS Free Interval - usually days __ to ___ of menstrual cycle.
4-12.
Calcium - used during PMS to alleviate…
mood swings!
PMS - what are SSRI’s used for?
Treating depression.
PMS - what is Xanax used for?
Reduces irritability, tensions, etc.
PMS - what are GnRH agonists used for? (Leuprolide)
Reduces breast tenderness, bloating, depression.
PMS - What are Danazol and Bromocriptine used for?
Reducing breast tenderness/migraine.
PMS - what is Spironolactone used for?
Relieves bloating.
PMS - what are analgesics used for?
Reduce pain and cramps!
