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16 Cards in this Set

  • Front
  • Back
What is menopause
- primary loss of ovarian function due to loss of response to FSH and LH
- Symptoms result from lack of estradiol
Why not take estrogen alone?
- can cause uterine endometrial cancer
- this can be blocked by taking estrogen with progestin
- and can cause breast cancer I believe
- womens health initiative study
- showed more breast CA, heart attacks, strokes, and lund embolism
- selective estrogen receptor modulators
- tissue specidive estrogen receptor agaonists and antagonists
- approved to prevent osteoporosis
- agonist
- increases intestinal calcium absorption
- no uterine stimulation
- will decrease risk of breast CA
- women still have hot flashes***
SERM Mechanism
- agosist= bind ER, recruidts other proteins that active DNA binding and gene expression
- antagonist= binds ER, BUT DOES NOT recruit ofther proteins necessary to activate DNA binding and gene expression
Raloxifine mechanisms
- Agonist= increase Ca++ absorption, decrease osteoclast and bone absorption
- Antagonist= decrease breast tissue growth, and uterine growth, increase hot flashes
Osteoporosis is
- a condition of skeletal fragility characterized by reduced bone mass and microarchitectural deterioration
Disease related Osteroporosis
- hypogonadism
- hyperparathyroidism
- hyperthyroidism
Drug induced osteoporosis
- corticosteroids
- thyroid replacements
- CnRH agonist suppression of gonadal steroid synthesis
- aromatase inhibitors (breast cancer)
what are bisphosphonates
- most widely prescribed osteoporosis agents
- small organic polyphosphate compounds that potently inactivate bone resorption by osteoclasts
- integrate into bone, thicken and stabilize structure
Name the bispohosphonates (3)
- Aledronate- daily
- Risedronate- weekly
- Ibandronate- monthly
= cause few bone problems and are effective for 5 years
- used for osteoporosis- both postmenopausal and glucocoritcoid induced
Bioavailablity of bisphosphonates
- oral bioavailabiltiy is low and food impairs absorption
- esophageal ulceration may occur
- must be taken with large quantities of water and pts shoudl remain upright
- strict instructions to be followed for Alendronate
What two have additive effects to increase BMD in postmenopausal wome??
- alendronate and raloxifene
Progestins to know for course
- Medroxy profesterone
- Progesterone
- Synthetic Progestins: Norethindrone, norgestrel, desogestrel, norgestimate, drospireneone
Estrogens to know for course
- conjugated estrogens
- 17B-estradiol
- ethinyl estradiol
- Raloxifene