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UNMC PA Pharmacology > Sex Steroids and HRT > Flashcards

Sex Steroids and HRT Flashcards

1
Q

All sex hormones share similar structures to ____

A

Adrenal steroids

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2
Q

Main role of progestins

A

Promote gestation

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3
Q

Sex steroids act on which receptors?

A

Nuclear transcription factor receptors (effects protein synthesis)

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4
Q

Which sex steroids have active metabolites that are used as drugs?

A

Estrogen
Testosterone

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5
Q

Estrogens stimulate growth of ____

A

Endometrium

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6
Q

Estrogen provides feedback inhibition on anterior pituitary to suppress ___ release

A

FSH

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7
Q

Progestins inhibit ___ growth

A

Endometrial

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8
Q

Functions of progestin

A

Inhibit endometrial growth
Maintain vascular supply and secretory capacity

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9
Q

Progestin feedback inhibition on anterior pituitary suppresses ___ release

A

LH

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10
Q

Withdrawal of ____ leads to menstruation/abortion

A

Progestins

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11
Q

Physiologic effects of estrogen

A

Sexual maturation
Stimulation.of long bone growth
Decreases bone resorption
Improve lipid profiles/decrease CV risk
Increases risk of clotting

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12
Q

Clinical uses of estrogen

A

Hypogonadism/hypopituitarism
Postmenopausal
Birth control
Menstruql disorders

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13
Q

Estrogen drug used mainly for HRT and hypogonadism

A

Estradiol

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14
Q

Routes of administration for estradiol

A

Oral
Slow release IM injections (Depo)
Topical (vaginal creams or transdermal patches)

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15
Q

Main use of conjugated estrogens

A

HRT

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16
Q

Conjugated estrogens contain which active metabolites of estrogen?

A

Estrone and estriol

17
Q

Ethinyl estradiol main use

A

Synthetic estrogen used in almost all contraceptives
Also HRT

18
Q

Estrogen side effects

A

Nausea
Edema
Breast tenderness
Migraines
Liver disease
Increased risk of clotting
Gynecomastia and feminization in males

19
Q

Estrogens increase risk of which cancers?

A

Endometrial and breast

20
Q

Why should estrogens not be prescribed alone?

A

Need to be prescribed with progestins to reduce risk of cancer from estrogen

21
Q

Clinical uses of progestins

A

Replacement therapy with estrogens
Birth control (alone or with estrogen)
Abnormal Uterine bleeding
Endometriosis
Dysmenorrhea

22
Q

Type of progestin in IUDs

A

Progesterone

23
Q

Benefit of medroxyprogesterone acetate

A

Mainly progesterone-like effects with little/no androgen or estrogen activity

24
Q

Synthetic progestin that is structurally related to testosterone

A

Norethindrone

25
Q

Adverse effects of all progestins

A

Menstrual changes
Nausea
Bloating
Potential teratogen

26
Q

Adverse effects of nor-progestins

A

Androgenic effects
Acne
Weight gain
Masculinization
Worsened lipid profile

27
Q

Postmenopausal HRT uses

A

Alleviate symptoms of menopause
Prevent/treat osteoporosis

28
Q

When can estrogen be used alone without progesterone

A

Pre-puberty for enhancing bone growth
If uterus has been removed

29
Q

Side effects of HRT

A

Return of menstrual bleeding
Increased risk of cancer and CV risk (mitigated by local administration)

30
Q

Current recommendation on when to use HRT for Postmenopausal women

A

Short-term use (<5 yrs) of E+P for menopause onset symptoms
Not recommended for long term health maintenance

31
Q

Selective estrogen response modifiers (SERMs) are non-steroidal analogs with ____ properties on estrogen receptors

A

Mixed agonist-antagonist

32
Q

SERM drugs

A

Raloxifene
Tamoxifen

33
Q

Difference between raloxifene and tamoxifen

A

Raloxifene decreases risk of uterine cancer
Tamoxifen increases risk of uterine cancer

34
Q

Similarities between Raloxifene and tamoxifen

A

Decrease osteoporosis
Improve lipids
Decrease breast cancer
Increase risk of clotting
Increase hot flashes

UNMC PA Pharmacology (23 decks)

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