Reproductive Health Flashcards
Brand
Conjugated Estrogen
Premarin
Brand
Estradiol Oral
Estrace
Brand
Estradiol transdermal patch
- Alora
- Climara
- Minivelle
- Menostar
- Vivelle-DOT
- Estraderm
Indication
Conjugated Estrogens
- Abnormal uterine bleeding
- Breast Cancer
- Postmenopausal osteoporosis prevention
- Amenorrhea due to hypoestrogenism(secondary)
MOA
Conjugated Estrogens
- The estrogen replaces the estrogens produced by the body responsible for the development and maintainance of the fame reproductive system and secondary sex characteristics.
- Responsible for modulation of gonadotropins(luetenizing hormone and follicle stimulating hormone) through negative feedback
Major contraindications
Conjugated Estrogens
- Angioedema or anaphylactic reaction to estrogens or any component of the formualtion
- Undiagnosed abnormal genital bleeding
- DVT or PE
- Breast cancer
- Estrogen dependent tumor
- Hepatic impairment
- Anitrhombic deficiency
- Thrombophilic disorders
- Pregnancy
Black box warnings
Cnnjugated Estrogens
- Endometrial cancer
- Breat cancer
- Cardiovascular disease
- Dementia
Adverse reactions
Conjugated Estrogens
- > 10%:Weight change, headache,migraine,depression,disorder of menstruation, breast pain
- 1-10%: Edema,vasodilation,abdominal pain,hirtuism, diarrhea,nausea,stomach cramps, vomitting,backache
Serious ADRs
Conjugated estrogens
- Heart disease
- HTN
- MI
- Breast cancer
- Diabetes mellitus
- Hypercalcemia
- Venous thromboembolism
- Anaphylaxis
- Cerebrovascular accident
- Cervical cancer
- Malignant neoplasm of endometrium of corpus uteri
- Ovarian cancer
- PE
Key counselling points
Conjugated estrogens
- Discuss potential long-term adverse effects of hormone therapy including MI, STROKE,DVT, PE, and breast cancer
- Take at bedtime to minimize side effects
- Take with/without meals.
ADRs
Estradiol
Common:
* 1-10% weight chnage, nausea,vomitng, disturbance in mood,swelling of breast and depression
Rare
* Heart disease,MI,DM,venous theomboembolism,anaphylaxis,cerebrovascular accident,PE,breast,endometrial or ovarian cancer
Key counselling Point
Estradiol
- Report abnormal vaginal bleeding or sign/symptoms of a thromboembolic disorder.
- Do not smoke during therapy as this increases the risk of thromboembolic events
ADRs
Estradiol transdermal patch
> 10%: edema,applicaton site reaction
Brand name
Progesterone
Prometrium
Brand name
Medroxyprogesterone
- Provera-oral
- Depo-Provera injection
Indication
Progesterone
- Preventio of estrogen-induced endometrial hyperplasia(oral) while conjugated estrogens are administered
- Secondary physiologic amenorrhea(oral or gel)
- assisted reproduction for infertile women(gel/insert)
MOA
Progesterone
Transforms proliferative emdometrium into secretory endometrium.Systemically administered progesterone inhibits gonadotropin production ,which in turn prevents follicular maturation and ovulation
Major Contraindication
Progesterone
- Abnormal vaginal bleesing
- History of estrogen or progesterone-dependent neoplasia
- Active or history of DVT or PE
- Known or suspected pregnancy
BBW
Progesterone
Should not be used for the prevention of cardiovascular disorders, dementia or breast cancer
ADRs(common)
Progesterone
- > 10%: weight changes,headache,amenorrhea,breat tenderness, abdominal pain
- 1-10%: nausea,asthenia,feeling nervous,break through bleeding
ADRs(rare)
Progesterone
- thromboembolism(DVT,PE)
- thrombophlebitis
- osteoporosis
Key counselling points
Progesterone
If using for amenorrhea, menstrual bleeding should occur 3-7 d after last oral dose.Report if menstruation does not occur within 7 d after last dose.For vaginal formualtion, avoid using other vaginal drugs within 6 h before or 6h after using
Brand name
Ethinny Etradiol/Etongestrel Ring
Nuva ring
