Term
| Sex hormones (gonads and adrenals) |
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Definition
estrogens, progestins
contraception
hormone replacement therapy |
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Term
| Adrenocorticosteroids - adrenal cortex |
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Definition
glucocorticoids
mineralcorticoids
adrenal androgens |
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Term
|
Definition
zona glomerulosa
zona fasciculata
zona reticularis |
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Term
|
Definition
mineralcorticoids
aldosterone |
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Term
|
Definition
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Term
|
Definition
adrenal androgens
dehydroepiandrosterone |
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Term
|
Definition
estrogens
selective estrogen receptor modulators (not antiestrogens)
progestins
antiprogestin |
|
|
Term
|
Definition
estradiol
ethinyl estradiol, Mestranol - synthetic steroid
diethylstilbestrol - synthetic nonsteroid |
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Term
| Selective estrogen receptor modulators |
|
Definition
clomiphene - increases ovulation
tamoxifen, toremifen - estrogen- responsive breast Ca
Raloxifene - osteoporosis |
|
|
Term
|
Definition
progesterone - corpus luteum/placenta
medroxyprogesterone - synthetic
norethindrone, norgestrel (also androgenic activity) |
|
|
Term
|
Definition
| mifepristone - 85% - abortion |
|
|
Term
| menopause occurs at about ___ of age |
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Definition
|
|
Term
| Which levels begin to drop prior to menopause and fall significantly after menopause |
|
Definition
| estrogen and progesterone production levels |
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|
Term
Menopause
The resulting estrogen deficiency results in : |
|
Definition
vasomotor symptoms (hot flushes, HA, dizzy, palpitations, N/V, night sweats)
genitourinary atrophy |
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|
Term
| The Women's health initiative study (WHI) confirmed the risk of breast cancer with use of a combination |
|
Definition
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|
Term
| There is also an association with the long term use of estrogen and ____ |
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Definition
|
|
Term
| It is now thought that HRT might increase the risk of ___ in postmenopausal women |
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Definition
|
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Term
| ERT should be used in conjuction with progestin if the woman... |
|
Definition
| still has an intact uterus |
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Term
|
Definition
| reduce risk of endometrial hyperplasia |
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Term
|
Definition
may be continuous or cyclic
incidence of endometrial hyperplasia decreases w/ continuous therapy
Continuous - will result in amenorrhea for most women after a year |
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|
Term
|
Definition
thromboembolic disorder of history of event while pregnant or using hormones
history of breast or endometrial cancer
undiagnosed genital bleeding |
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Term
| the protective effect of HRT on bone loss is only effective when the patient is ___ |
|
Definition
taking HRT
effects quickly disappear when therapy is stopped |
|
|
Term
New thinking on HRT and osteoporosis
|
|
Definition
| long term risks of HRT outweigh the benefits of osteoporosis prevention so alternative therapies should be considered |
|
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Term
| _____ are reduced by HRT and this is probably the only remaining indication for this medication |
|
Definition
menopausal symptoms
estrogen therapy |
|
|
Term
| alternative medications for osteoporosis |
|
Definition
raloxifene
biphosphonates (alendronate, risedronate)
Calcitonin (Calcimar, Miacalcin) |
|
|
Term
| _____ are the only agents proven in large randomized trails to reduce the risk of hip fracture |
|
Definition
|
|
Term
|
Definition
works as an estrogen agonist-bone & serum lipid profiles
works as estrogen antagonist - endometrial & breast tissue |
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|
Term
| only currently indicated for the tx of osteoporosis |
|
Definition
|
|
Term
| Raloxifene is approved for prevention of postmenopausal osteorosis where it prevents |
|
Definition
|
|
Term
| Raloxifene Cardiovascular |
|
Definition
probably does not reduce the overall risk of CV events in postmenopausal women
does lower LDL and total cholesterol but does not increase HDL |
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|
Term
| ___ does not induce vaginal bleeding or endometrial hyperplasia |
|
Definition
|
|
Term
| increases the risk of thromboembolic diseas and increases hot flashes |
|
Definition
|
|
Term
Estrogen prevented hot flashes
when converting a patient from estrogen to raloxifine it is advisable to |
|
Definition
| taper the conversion over a month |
|
|
Term
| Contraindications of raloxifine |
|
Definition
pregnany & lactation
thromboembolic events |
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|
Term
| Decrease bone resportion, increase bone density, and have been shown to prevent fractures |
|
Definition
biphosphonates
alendronate or risedronate |
|
|
Term
They selectively bind to the antiresorpotive surfaces of bone and may be incorporated into the bone. They have very long half lives (possibly up to 10 years) |
|
Definition
biphosphonates
alendronate or risedronate |
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|
Term
| Alternative to HRT for osteoporosis but no effect on the vasomotor symptoms or GU symptoms of menopause |
|
Definition
biphosphonates
alendronate or risedronate |
|
|
Term
Containdications and precautions of biphosphonates
(alendronate or risedronate) |
|
Definition
renal insufficiency, hypocalcemia, and upper GI problems
can cause esophageal irritation and requires that the patient sit or stand upright for 30 min after dosing and have nothing but water |
|
|
Term
gonadotropin-releasing hormone agonists
(AKA luteinizing hormone releasing factor LH-RH agonists) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Reduces testosterone to castrate levels |
|
Definition
|
|
Term
| linked to the maintence of bone mass and it is now recognized that men treated w/ GnRH agonists have a high rate of developing osteoporosis |
|
Definition
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|
Term
| approved for the primary osteoporosis in men |
|
Definition
|
|
Term
| exhibits antagonist effects on breast tissue |
|
Definition
|
|
Term
| compenetes with estrogen for binding sites in target tissue such as the breast |
|
Definition
|
|
Term
| works as an estrogen agonist on bone, serum lipid profiles and endometrial tissue |
|
Definition
|
|
Term
|
Definition
|
|
Term
| adverse reactions - hot flashes, N/V |
|
Definition
|
|
Term
| mediates ovulation through increased output of pituitary gonadotropins |
|
Definition
|
|
Term
| Indication - treatment of ovulatory failure to women desiring pregnancy |
|
Definition
|
|
Term
| Ophthalmic effects - blurring spots or flashes, vasomotor flushes, andominal symptoms and @ high doses possible ovarian enlargement |
|
Definition
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|
Term
| Unlabeled use - used to treat male infertility |
|
Definition
|
|
Term
inhibit ovulation by suppressing hypothalamic release of FSH-RF and LHRF
(ovulation is suppressed 95-98%) |
|
Definition
| estrogens as contraceptives |
|
|
Term
| ___ also inhibit ovum implantation, decrease time available for fertilization and break down the corpus luteum |
|
Definition
|
|
Term
| Progestins - work by multiple methods |
|
Definition
1. hamper the transport of sperm through cervical canal by thickening cervical mucus
2. disturbing crital time sequence required for fertilzation in the fallopian tube by slowing ovum transport
3. inhibit implantation by altering FSH and LH peaks, and fertilization and ovulation |
|
|
Term
| Precautions for oral contraceptives |
|
Definition
any thromboembolic event - DVT, PE stroke, ischemic heart disease
breast Ca
pregnancy
HTN, liver problems |
|
|
Term
anabolic and/or masculinizing effects
|
|
Definition
|
|
Term
| Androgens (Testosterone) therapeutic uses |
|
Definition
androgenic effects in males w/ inadequate androgen secretions (hypogonadism)
anabolic effects - in senile osteoporosis and severe burns
growth
unapproved use - increase lean body mass & muscle strength |
|
|
Term
| this produce can't be used inmen with GnRH agonist induced osteoporosis |
|
Definition
|
|
Term
| inactive orally due to first pass effect |
|
Definition
|
|
Term
|
Definition
| masculinization, acne, growth of facial hair, deeping of voice, male pattern baldness, excessive muscle development |
|
|
Term
|
Definition
| priapism, impotence, decreased spermatogenesis, gynecomastia |
|
|
Term
|
Definition
| growth disturbances and abnormal sexual maturation |
|
|
Term
| Increase LDL relative to HDL thereby increasing the risk of heart disease, they also cause fluid retention |
|
Definition
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|
Term
In females the treatment of some metastatic breast cancer
androgen products
injections |
|
Definition
short acting - testosterone aqueous & tesosterone propionate (three times a week)
long acting - testosterone enanthate & testosterone cypionate (allows for once a month dosing)
|
|
|
Term
In females the treatment of some metastatic breast cancer
androgen products
pellets |
|
Definition
| SC every 3-6 months and testosterone transdermal system (patches) are other dosing systems |
|
|
Term
| oral testosterone products for hypogonadism and inoperable breast carcinomas and postpartum breast pain and engorgement |
|
Definition
| methyltestosterone and fluoxymesterone |
|
|
Term
| synthetic androgen that suppresses the pituitary ovarian axis by inhibiting the output of pituitary gonadotropins |
|
Definition
|
|
Term
|
Definition
| endometriosis and fibrocystic breast diseases |
|
|
Term
|
Definition
benign prostatic hyperplasia
inhibits 5 alpha reductase the enzyme that converts testosterone into the androgen 5 alpha dihydrotestosterine, principle androgen responsible for prostatic growth |
|
|
Term
|
Definition
| decreased libido and ejaculation dysfunction |
|
|
Term
|
Definition
halts BPH progression unlike alpha blockers (ie terazosin) that only improve obstructive symptoms
may be used together (w/ proscar) |
|
|
Term
| Finasteride (Propecia) is only indicated for... |
|
Definition
androgenetic alopecia (male pattern baldness)
same med as proscar only @ lower dose |
|
|
Term
| AE reactions of Finasteride (propecia) |
|
Definition
same except Proscar has a greater %
|
|
|
Term
| Actions of adrenal corticosteroids |
|
Definition
1. intermediary metabolism (gluconeogenesis, protein catabolism, lipolysis)
resistance to stress
2. anti-inflammatory - blocks arachidonic acid release
3. inhibits glucocorticoids & TSH synthesis
4. stimulate egastric acid/pepsin production (gastric ulceration possibly)
5. osteoporosis |
|
|
Term
| Replace deficiences of endogenous hormone (cortisol) in Addison's disease and other adrenocortical insufficiences |
|
Definition
|
|
Term
| diagnosis of cushings disease - Dexamethasone supression test |
|
Definition
|
|
Term
| Supportive therapy for a variety of anti-inflammatory and immunosuppresive effects |
|
Definition
|
|
Term
| treatmet of allergies - Beclametasone, Triamclicolone |
|
Definition
|
|
Term
|
Definition
|
|
Term
AE of systemic corticosteroids
short term, high dose |
|
Definition
Cerebral edema, diabetes mellitus, GI bleed, Glaucoma, Hypertension, Hypokalemic alkalosis, mood disorder, Increase in BUN, pancreatitis, proximal myopathy, and sodium and water retention |
|
|
Term
AE of systemic corticosteroids
long term use |
|
Definition
Amenorrhea, aseptic necrosis of bone, cataracts, centripetal obesity, growth failure, hyperlipidemia, hypertension, immunosuppression, mood disorders, muscle weakness, osteoporosis, seizures |
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