Women's Health- Quiz 2

Question 1

Estrogens
Examples
Strength

Answer 1

Examples: Estradiol, Estrone, Estriol, ethinyl estradiol

Strength: Estradiol most potent from ovary (premenopausal), Estrone 1/3 potency of Estradiol.

Question 2

Estrogens
Most prevalent in pre/postmenopause
Estrogen made by the placenta
Metabolism

Answer 2

Most prevalent in premenopause: Estradiol

Most prevalent in postmenopause: Estrone

Estrogen made by the placenta: Estriol

Metabolism: PO high first pass, transported by albumin and sex hormone binding globulin. Glucoronide and sulfate conjugation

Question 3

Estrogens
MOA
Uses
ADE

Answer 3

MOA: activated steroid-receptor complex interacts with nuclear chromatin to initiate
hormone specific RNA synthesis

Uses: post menopausal hormone therapy, contraception, replacement in the premenopausal patients ie, hypogonadism, premature menopause, surgical menopause

ADE: Nausea, breast tenderness, VTE, MI, breast and endometrial CA

—Estrogen can cause cholestasis which presents as itching, dark urine, and pale BMs

Question 4

Estrogen
Elimination

Answer 4

Excreted in the urine

Question 5

SERMS
Examples

Answer 5

Selective estrogen receptor modulators
-ifen or -ifene

Examples: tamoxifen, raloxifene, clomiphene, ospemifene

Question 6

SERMS
MOA
Uses

Answer 6

-Tamoxifen & raloxifene: compete with estrogen on estrogen receptors in the breast.
-Raloxifene does NOT stimulate endometrial growth
-Clomiphene: partial estrogen agonist, increasing GrH, causing ovulation

Uses:
—-Tamoxifen: metastatic breast CA, prophylactic risk reduction in breast ca
—-Raloxifene: prophylactic risk reduction in breast ca, osteoporosis tx post menopausal
—–Clomiphene: infertility

Question 7

SERMS
ADE

Answer 7

ADE: tamoxifen: hot flashes and nausea, endometrial hyperplasia and malignancies. Lots of drug interactions

Raloxifene: hot flashes and leg cramps, DVT, PE.

Clomiphene: multiple gestation (twins)

Ospemifene: stimulate endometrial growth

Question 8

Progestogens
Examples
MOA
Uses
Pharmacokinetics
ADE

Answer 8

Examples: desogestrel, dienogest, drospirenone, levonorgestrel, norethindrone, medroxyprogesterone

MOA: in women, promotes the endometrium. Continues to increase if conception occurs decreasing uterine contractions and further supporting the endometrium. IF no conception occurs progesterone stops causing menstruation

Uses: Contraception, tx hormone dificiency, dysmenorrhea, endometriosis management, and infertility

Pharmacokinetics: