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NURS 572 - 60
Ch. 60 Est/Progest non-contraceptive
| Question | Answer |
|---|---|
| General fx of estrogen/progesterone | *sexual organs/menstruation *bone/prevent resorption, maint density, *cholesterol favorable effects |
| Estrogen given without progesterone can cause what adverse effects (first four) | *endometrial hyperplasia *ovarian ca *breast ca *stimulates existing ca using estrogen receptors |
| Estrogen/progestin adverse effects (second four) | *CV increase MI, DVT, CVA, VTE *GI A, N, V *GB cholelithiasis |
| Minor s/e of both est/progest | jaundice, HA, depr, Na/H20 retent |
| Major non-contraceptive uses | *HRT *female hypogonadism *acne *prostate ca |
| Routes of est/progest | po, transdermal, vag, parenteral |
| SERMs definition | selective estrogen receptor modulator |
| MOA of SERMs | mixed action - agonist and antagonist |
| 2 SERM drugs | *tamoxifen *raloxifene |
| positive effects of both SERMs | *tx breast ca *prevent osteoporosis *positive lipid effects |
| negative effects SERMs tamoxifen | *hot flashes *endometrial ca *VTE |
| negative effect of SERM raloxifene | *hot flashes *VTE *DOES NOT cause endometrial hyperplasia |
| General fx of endogenous progesterone | *prepare/maintain uterine lining (secretory changes in leutal phase) *cervical secretions - inc. visc, dec amt *maint pg, inhibit uterine contractions *some estrogenic, adrogenic, anabolic effects |
| What might be given to prevent pre-term labor | progestins to inhibit uterine contractions |
| first 4 ADRs of progestins | *teratogenic fetus masculinization *menstrual irreg (BTB, amenorr) *cervical secretions dec amt, inc visc *if used with estrogen-->breast ca |
| second 3 ADRS of progestins | *breast tenderness *depression *same misc as estrogen (and phto sens, wt gain, dec app) |
| Noncontraceptive tx uses of progestin | *HRT *uterine dx (bleed, amenorr, endometriosis, endometrial ca) *PMS |
| how does progest effect uterine lining? | it makes endometrium thinner to prevent ca |
| benefits of HRT | *dec vasomotor menop effects *dec uroginital dysfx, atrophy *dec bone loss *dec colon cancer *maybe QOL |
| Is HRT established to provide a CV benefit? | No, HRT has NOT been established to provide a CV benefit |
| Risks of HRT | *CV events *if ET only, not EPT: ovarian, uterine ca *breast ca *cholecystitis, lithiasis |
| What do we give for HRT with in tact uterus | pempro given for this uterine status |
| What do we give for HRT s/p hysterectomy? | premarin given for this uterine status |
| Example of EPT drug | pempro representative of this class |
| Example of ET drug | premarin representative of this class |
| WHI, HERs study concenus | *HRT NOT advised >4 yrs (long term) *IS advised < 4 years |
| WHI, HERs study short term uses | *vasomotor menop sxs *osteoporosis *vulvar/vaginal menop atrophy |
Created by:
lorrelaws
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