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23 Cards in this Set
- Front
- Back
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What are changes that occur during menopause?
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• decreased estrogen secretion
• decreased progesterone • increased gonadotropins • loss of ovarian function |
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How is menopause diagnosed?
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• history and physical (hot flashes is the 1st sign)
• amennorrhea for one or more years • FSH level greater than 30-40 |
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What are symptoms of estrogen deficiency?
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• vasomotor instability (hot flashes)
• genitourinary atrophy • osteoporosis • cardiovascular disease |
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What are causes of vasomotor instability (hot flashes)?
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dysregulaion of hypothalamic thermoregulation
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What is the treatment of vasomotor instability (hot flashes?
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• limit caffeine and alcohol
• estrogens • clonidine |
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What are symptoms of geitourinary atrophy caused by estrogen deficiency?
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• Vagina:
- decreased secretions - dryness - increase in vaginal pH - itching • Urinary tract: - frequency - incontinence - urgency |
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What is the treatment for genitourinary atrophy?
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• oral or vaginal estrogens
• lubricants |
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What is the effect of estrogen on the cardiovascular system?
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• CAD increases after menopause
• estrogen decreases LDL & platelet adhesion, and increases HDL |
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List examples of estrogen replacement therapy
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• conjugated estrogen (Premarin)
• esterified estrogen (Estratab) • Estropriate (Ogen or Orthoest) • Ethinyl estradiol (Estinyl) • Micronized estradiol (Estrace) |
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What is the dose for conjugated estrogen (Premarin)?
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0.3-0.625 mg QD
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What is the dosage for Ethinyl estradiol (Estinyl)?
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0.02-0.05 mg QD
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Give examples of estrogen replacement therapy that is available as a transdermal patch
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• weekly patch:
- Climara - Fempatch • 2 times a week patch: - Estraderm - Alora |
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Which estrogen replacement therapies are available as vaginal creams?
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• conjugated estrogen (Premarin)
• Estropriate (Ogen) • micronized estradiol (Estrace) |
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What are risks/adverse effects of estrogen replacement therapy?
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• breast cancer
• DVT/PE • endometrial hyperplasia • gallbladder disease (2-4 times risk of gallstones) • migraine headaches |
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Estrogen should be used with progesterone for women with an intact uterus. What are the effects of progesterone when used in combination as hormone replacement therapy?
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• reduces estrogen-induced irregular bleeding
• reduces endometrial hyperplasia • enhances estrogen activity |
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What is the most common progestin therapy?
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Medroxyprogesterone Acetate
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What is the effect of Medroxyprogesterone Acetate on lipid profile?
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has a negative effect on lipid profile (increases LDL)
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What are side effects of Medroxyprogesterone Acetate?
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• bloating
• irritability • depression |
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What drugs are incorporated into the Combipatch?
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• Estradiol/Norethindrone Acetate
• applied 2x/wk • may be used continuously |
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What are the different types of HRT regimens?
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• Cyclic:
- 5 days of Medroxyprogesterone Acetate OR - Estrogen 28 days, Progesterone 14 days • Continuous: - estrogen and progesterone everyday |
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What are adverse effects of continuous HRT?
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• irregular bleeding
• can lead to atrophy of endometrium • amennorhea |
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Prempro is a combination of what drugs?
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• Conjugated estrogen (Premarin)
• Medroxyprogesterone Acetate (Provera) |
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What should be monitored for a patient on HRT?
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• FSH levels
• breast and pelvic exams • lipid, glucose, & thyroid tests • assess need for treatment yearly |
