Prescribing Sex Hormones and Antiestrogens

Flashcards about prescribing sex hormones and antiestrogens.

What are some pronounced symptoms women experience during menopause?

Waves of feeling hot and cold, irritability, depression, vegetative instability.

What are the beneficial consequences of hormone substitution in menopause?

Decreased risk of osteoporosis and colon cancer.

What are the side effects of sex hormone substitution?

Increased risk of developing breast cancer, endometrial cancer, ovary and stroke.

What are the requirements for substitution of sex hormones in menopause?

Women under 60, and less than 10 years elapsed since the cessation of menstrual cycles.

In which women sex hormone substitution should not be done?

Women who have already had breast, endometrial or ovarian cancer, who have already had venous thrombosis, myocardial infarction or stroke, as well as in those who have not regulated their hypertension or have liver disease.

If a woman's uterus is surgically removed, what hormone is substituted?

Only estrogen is substituted, i.e., such a person takes preparations containing some of the synthetic estrogens.

Why preparations containing both estrogen analogues and progesterone analogues are used in women with preserved internal sex organs during hormone substitution?

Reduce the risk of cancer of the endometrium, which estrogens themselves increase.

When estrogen can be used, why are transdermal preparations more favorable?

Because they contain a lower total dose of estrogen, and successfully control menopausal symptoms.

In what forms preparations for hormone substitution can be applied?

Vaginal cream, tablets, vaginal tablets, trans dermally or in the form of implants.

Why after 5-10 years of use, preparations for the substitution of hormones during the menopause are gradually discontinued?

To prevent the reappearance of menopause symptoms.

What women are recommended to use during the menopause?

Vaginal creams without hormones, bisphosphonates or denosumab.

What is the polypeptide secreted in the hypothalamus that leads to the release of gonadotropic hormones in the pituitary gland called?

Gonadotropin-releasing hormone (GRH).

What is GRH used for?

To induce ovulation in people suffering from infertility.

What is the preparation of FSH and LH can be obtained in larger quantities from the urine of women in postmenopause called?

Human menopausal gonadotropin (HMG) or urofollitropin.

What can be used instead of LH?

Human chorionic gonadotropin (hHG).

What are the side effects of the use of gonadotropins?

Ectopic pregnancy (about 8%), multiple pregnancy (about 30%), spontaneous abortion (about 20%), rupture and torsion of the ovary, and ovarian hyperstimulation syndrome (up to 30%).

How Hyperstimulation syndrome ovary is characterized?

Enlargement of the ovary, accumulation of fluid in the interstitial space and peritoneal cavity (ascites and the like), hemoconcentration, hyponatremia and hyperkalemia.

How Hyperstimulation syndrome is treated?

The infusion of an isotonic saline solution, the infusion of a 25% albumin solution and the use of prophylactic doses of heparin.

Which drug blocks estrogen receptors in the pituitary gland and hypothalamus, interfering with the negative feedback loop of estrogen on the release of gonadotropins?

Clomiphene

What are the adverse effects of clomiphene?

Thickening of cervical mucus, hot flashes, vaginal dryness, and ovarial hyperstimulation syndrome.

Which oral antidiabetic drug that increases the sensitivity of peripheral tissues to the action of insulin, is also used to stimulate ovulation, although this indication is not officially approved?

Metformin

Which drugs can be used if the production of gonadotropin and testosterone is not within normal limits in men infertility?

Clomiphene or human menopausal gonadotropin.

What are the two types of intracellular estrogen receptors?

Alpha and beta.

Which selective modulators of estrogen receptors block alpha estrogen receptors in breast tissue, and act as agonists of these receptors in bones, liver and blood vessels?

Tamoxifen and raloxifene

Some of selective aromatase inhibitors drugs

Letrozole, anastrozole and exemestane.

Which drugs are inhibitors of cyclin-dependent kinase 4 and 6 (CDK 4/6 inhibitors) combined with aromatase inhibitors?

Palbociclib, ribociclib and abemaciclib.

Which drug is used when a metastatic breast tumor becomes resistant to tamoxifen, raloxifene or aromatase inhibitors?

Fulvestrant

Which gonadotropin-releasing hormone analog is used to prevents the release of FSH and LH from the pituitary gland?

Leuprolide