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Hormone Therapy
Hormone Therapy
29
Pharmacology
Professional
09/26/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
What is hormone therapy (HT) used for?
Definition
women who are in menopause
Term
When does perimenopause occur?
Definition
Normally between the ages of 45 and 55
Term
How does hot flashes occur?
Definition

Decrease in estrogen causes an increase in luteinizing hormone (LH), which can result in hot flashes and night sweats

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Term
Decreased estrogen may lead to what?
Definition

decrease in the vaginal mucosa; vaginal dryness; burning and painful intercourse

 

These are vasomoter symptoms

 

 

Term
The most effective thearpy for vasomotor symptoms is ____?
Definition

estrogen, which causes a decrease in LH and more stable temperature control. Estrogen improves bone density and has historically been used to prevent postmenopausal osteoporosis

Term
Natural products used to treat vasomotor symptoms?
Definition

black cohosh

red clover

evening primrose

Term
Should estrogen be given alone in women with a uterus?
Definition

NO! In women with a uterus, estrogen should not be given alone!

 

To do so will increase the risk of endometrial cancer

Term
What is Premarin?
Definition
conjugated equine estrogens, or CEE
Term
What is Prempro?
Definition

CEE plus a synthetic progesterone (medroxyprosterone acetate, or MPA)

Term
What is Vivelle Dot?
Definition

A patch.

 

It is a combo of estradiol and MPA (which is used in women with uterus)

Term
Some prescribers believe estradiol is safer, why?
Definition

it is produced naturally in (pre-menopausal) women and it was the hormoe from pregnant mares urine that was used in the WH trials

Term
Estrogens increase the risk of?
Definition
endometrial cancer
Term
Estrogen in any form has what contraindications?
Definition

Undiagnosed abnormal genital bleeding

 

Active or past breast cancer

 

Known or suspected estrogen-dependednt cancer

 

Active or past deep vein thrombosis or pulmonary embolism

 

Active or recent arterial thromboembolic disease (e.g. stroke, myocardial infarction)

 

Liver dysfunction or disease

 

Known or suspected pregnancy

 

Term
Benefits of topical formulations, given as a patch, gel or emulsion?
Definition

bypass first dose metabolism, and lower doses can be used. Topical formulatioins usually causes less nausea and may expose the woman to lower systemic estrogen.

 

 

Term
Benefits of Vaginal products?
Definition

most usefull for patients who have vaginal symptoms (dryness, painful intercourse) only, since these do not expose the woman to risks from systemic estrogen.

 

These include estrogen vaginal cream or the vaginal ring (Femring)

 

Due to bypassing the liver, topical formulations do not affect cholesterol levels. Estrogen typically increase TG and increase HDL.

Term
Brand name for estradiol transdermal system
Definition
Vivelle, Vivelle Dot
Term
Brand name for conjugated estrogens tablet
Definition
Premarin
Term
Brand name for conjugated estrogens cream
Definition
Premarin vaginal cream
Term
Brand name for conjugated estrogens/medroxyprogesterone acetate tablet
Definition
Prempro
Term
[image]
Definition
Statement. Not a question.
Term
Estrogen Counseling
Definition
[image]
Term
How often should Vivelle-Dot patch be applied?
Definition
twice - a - week application
Term
Vivelle Dot counseling
Definition
[image]
Term

Increasingly, older males are requesting testosterone therapy for puported health claims, including increased muscle mass and bone density, improved sexual interest (increased libido), sharpened memory and concentration, and increased energy. The use of testosterone replacement is controversial in what whay?

 

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Definition

primay risk is whether the use of testosterone increases prostat cancer risk. Testosterone can also increase cholesterol levels and cause liver damage

 

Term
Appropriate indications for testosterone use?
Definition

men with low prostate cancer risk who have a low testosterone level and a related condition, such as low muscle mass. It should not be used routinely for normal aging until the health risk are better quantified.

 

Another reason for the increase in testosterone prescriptions has been due to the restriction on PDE5 I in the medicare formulary - which led men and their physicians to consider other options

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Term
Should men at high risk for prostate cancer use testosterone products?
Definition

NO!

 

So, I assume this includes black men. Also, if one is on a 5-α-reducatase inhibitor for BPH that blocks the conversion of testosterone to its active form it would not make much sense to give another drug that provides testosterone directly

Term
Name some testosterone products
Definition

[image]

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Term
Does the androgel pump need priming?
Definition

Yes. To prime AndroGel, fully push down ont he pump 3 times.

 

Term
Androgel Patient Counseling
Definition
[image]
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