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NR 566 Final Study Guide
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Endocrinology - Thyroid LAB EXAM 1 Comprehensive Fitness and
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Terms in this set (240)
Week 1
Ch 50 estrogen and progestins
Menopause 1. at approximately age 51 to 52 years, with 95% of women entering
1. is the associated loss of estrogen menopause between the ages of 45 and 55 years.
which typically begins 2. irregular, anovulatory cycles may occur, and periods of amenorrhea
2. During the initial phase, the may alternate with menses
menstrual cycle becomes 3. cease entirely
3. Eventually, ovulation and
menstruation
,Physiologic Alterations 1. 70% of postmenopausal women. Episodes are characterized by
Accompanying Menopause sudden skin flushing, sweating, and a sensation of uncomfortable
1. Vasomotor Symptoms; hot flashes warmth. These episodes can occur at night, resulting in drenching
and night sweats) develop in sweats
approximately 2. concentrations of ERs; when estrogen levels decline during
2. Genitourinary Syndrome of menopause, these structures begin to atrophy resulting in urge
Menopause; the urethra and vagina incontinence and urinary frequency; Urethritis and UTIs can also occur
have the highest 3. cognitive changes such as difficulty in problem solving and short-
3. Mental Changes; Many women term memory loss. Others experience depression or an increase in
report anxiety
4. Bone Loss; In the absence of 4. to a 12% loss of bone density leading to Osteoporosis which can
estrogen, bone resorption cause compression fractures of the vertebrae causing a decrease in
accelerates, leading height and produce a hump. In osteoporotic women, fractures of the
5. Altered Lipid Metabolism; studies hip and wrist can result from minimal trauma
have shown increases in 5. LDL cholesterol & decreases in HDL cholesterol. which play a role in
6. Female Sexual Interest-Arousal the increase in CV disease after menopause.
Disorder 6. more common during this stage of life
1. it is usually accompanied by the use of progestins
Estrogen
2. pubertal transformation will not take place. (variety of causes see pg
Therapeutic Uses:
428) This treatment promotes breast development, maturation of the
1. Menopausal hormone therapy-
reproductive organs, and pubic and axillary hair. This tx regimen
When estrogen is used for this
consists of continuous low-dose therapy (for approx a year) followed
purpose,
by cyclic administration of estrogen in higher doses
2. Female hypogonadism-In the
3. oral contraceptives, can help control acne. Tx is limited to patients at
absence of ovarian estrogens,
least 14-15 years old who want contraception
3. Acne-Estrogens, in the form of
4. in management of advanced prostate CA in men and in a select type
4. Cancer palliation-sometimes
of metastatic breast CA in men& women
used for palliative therapy
5. transgender women; not approved by the FDA) but prescribed off-
5. Gender-affirmation therapy-for
label
,Forms of Estrogen 1. are plant based; conjugated estrogens are natural preparations
1. Estrogen is available in derived from the urine of pregnant horses.
conjugated and esterified forms. 2. the manufacturer has withdrawn them from the market
Esterified estrogens 3. "natural" way to manage symptoms associated with menopause
2. Until mid-2016, synthetic 4. Women should not use phytoestrogens if they have a history of
conjugated estrogens A (Cenestin) thromboembolic events or a personal or family history of breast,
and B (Enjuvia) were available; uterine, or ovarian cancer.
however, 5. to provide the benefits of estrogen (e.g., protection against
3. Phytoestrogens (plant-based osteoporosis, maintenance of the urogenital tract, reduction of LDL
compounds)-commonly used by cholesterol) while avoiding its drawbacks (e.g., promotion of breast
women as a cancer, uterine cancer, and thromboembolism)
4. Phytoestrogens are not as potent
as estradiol, but they carry some of
the same risks.
5. Selective estrogen receptor
modulators (SERMs) are drugs that
activate ERs in some tissues and
block them in others. These drugs
were developed in an effort
Estrogen-Adverse Effects 1. endometrial hyperplasia, endometrial cancer, breast cancer, and
1. principal concerns with estrogen cardiovascular thromboembolic events
therapy are the potential for 2. by prescribing a progestin
2. endometrial hyperplasia and 3. Fluid retention with edema, gallbladder disease, jaundice, and
endometrial cancer can be headache; especially migraine headache
resolved 4. gallbladder disease. Jaundice may develop in women with
3. Estrogens have been associated preexisting liver dysfunction, especially those who experienced
with what common SE cholestatic jaundice of pregnancy
4. menopause may produce or 5. frequent undesired response to the estrogens
uncover 6. Chloasma,
5. Nausea is the most
6. (blank) a patchy brown facial
discoloration, though not
dangerous, may cause significant
distress
Contraindications of Estrogen 1. DVT, pulmonary embolus, or conditions such as stroke or MI that
1. Estrogens should not be taken by occurred secondary to a thromboembolic event.
patients with a history of 2. are pregnant or who have vaginal bleeding without a known cause.
2. They should not be prescribed to 3. liver disease, estrogen-dependent tumors, or breast cancer (except
women who when indicated for management) also should not take estrogens.
3. Patients with a hx of
Estrogen-Interactions 1. CYP1A2 and CYP3A4; inducers/inhibitors of these isoenzymes may
1. Estrogens are major substrates of raise/lower estrogen levels
2. In addition, they may decrease 2. antidiabetic drugs and thyroid preparations.
the effectiveness of some 3. anticoagulants and other drugs that affect clotting.
3. Estrogens can also interact with
, Local vs. systemic estrogen options 1. more than any other. estradiol—is available alone and in combination
and why one would be chosen with progestin
over the other 2. Emulsion (Estrasorb), Spray, Gels & Patches
1. Oral-Owing to convenience, the 3a. The total dose of estrogen is greatly reduced
oral route is used 3b. There is less nausea and vomiting.
2. Transdermal estradiol is available 3c. Blood levels of estrogen fluctuate less.
in four formulations: 3d. There is a lower risk for DVT, pulmonary embolism, and stroke.
3. Compared with oral formulations, 4. are used only for local effects, primarily treatment of vulval and
transdermal formulations have four vaginal atrophy associated with menopause.
advantages: 5. control of hot flashes and night sweats as well as local effects-Tx of
4. Intravaginal options come as vulval and vaginal atrophy
inserts, creams, and vaginal rings & 6. acute, emergency control of heavy uterine bleeding
5. The other vaginal ring (Femring)
is used for systemic effects to
6. Parenteral; is used only for
emergencies d/t
Clinical Practice Guidelines for 1. with local estrogen deficiency such as vaginal and vulvar atrophy;
menopause these preparations are assoc with a lower risk of systemic effects
Not all women who experience 2. less fluctuation of estrogen levels than do oral preparations
distressing symptoms of 3. hysterectomy but required in women with an intact uterus who
menopause should be treated with undergone hormone replacement therapy
oral estrogen or combination
estrogen/progestin therapy. Key
points include:
1. intravaginal preparations are most
useful for treating sx associated
2. transdermal estrogen
preparations have fewer adverse
effects, use lower doses of
estrogen, and have
3. progesterone is contraindicated
in women who have undergone a
NR 566 Final Study Guide
5.0 (1 review)
Save
Students also studied
Endocrinology - Thyroid LAB EXAM 1 Comprehensive Fitness and
120 terms 105 terms 36 terms
sarahcb18 Preview lizbethbo0302 Preview Zach_Pedro6
Terms in this set (240)
Week 1
Ch 50 estrogen and progestins
Menopause 1. at approximately age 51 to 52 years, with 95% of women entering
1. is the associated loss of estrogen menopause between the ages of 45 and 55 years.
which typically begins 2. irregular, anovulatory cycles may occur, and periods of amenorrhea
2. During the initial phase, the may alternate with menses
menstrual cycle becomes 3. cease entirely
3. Eventually, ovulation and
menstruation
,Physiologic Alterations 1. 70% of postmenopausal women. Episodes are characterized by
Accompanying Menopause sudden skin flushing, sweating, and a sensation of uncomfortable
1. Vasomotor Symptoms; hot flashes warmth. These episodes can occur at night, resulting in drenching
and night sweats) develop in sweats
approximately 2. concentrations of ERs; when estrogen levels decline during
2. Genitourinary Syndrome of menopause, these structures begin to atrophy resulting in urge
Menopause; the urethra and vagina incontinence and urinary frequency; Urethritis and UTIs can also occur
have the highest 3. cognitive changes such as difficulty in problem solving and short-
3. Mental Changes; Many women term memory loss. Others experience depression or an increase in
report anxiety
4. Bone Loss; In the absence of 4. to a 12% loss of bone density leading to Osteoporosis which can
estrogen, bone resorption cause compression fractures of the vertebrae causing a decrease in
accelerates, leading height and produce a hump. In osteoporotic women, fractures of the
5. Altered Lipid Metabolism; studies hip and wrist can result from minimal trauma
have shown increases in 5. LDL cholesterol & decreases in HDL cholesterol. which play a role in
6. Female Sexual Interest-Arousal the increase in CV disease after menopause.
Disorder 6. more common during this stage of life
1. it is usually accompanied by the use of progestins
Estrogen
2. pubertal transformation will not take place. (variety of causes see pg
Therapeutic Uses:
428) This treatment promotes breast development, maturation of the
1. Menopausal hormone therapy-
reproductive organs, and pubic and axillary hair. This tx regimen
When estrogen is used for this
consists of continuous low-dose therapy (for approx a year) followed
purpose,
by cyclic administration of estrogen in higher doses
2. Female hypogonadism-In the
3. oral contraceptives, can help control acne. Tx is limited to patients at
absence of ovarian estrogens,
least 14-15 years old who want contraception
3. Acne-Estrogens, in the form of
4. in management of advanced prostate CA in men and in a select type
4. Cancer palliation-sometimes
of metastatic breast CA in men& women
used for palliative therapy
5. transgender women; not approved by the FDA) but prescribed off-
5. Gender-affirmation therapy-for
label
,Forms of Estrogen 1. are plant based; conjugated estrogens are natural preparations
1. Estrogen is available in derived from the urine of pregnant horses.
conjugated and esterified forms. 2. the manufacturer has withdrawn them from the market
Esterified estrogens 3. "natural" way to manage symptoms associated with menopause
2. Until mid-2016, synthetic 4. Women should not use phytoestrogens if they have a history of
conjugated estrogens A (Cenestin) thromboembolic events or a personal or family history of breast,
and B (Enjuvia) were available; uterine, or ovarian cancer.
however, 5. to provide the benefits of estrogen (e.g., protection against
3. Phytoestrogens (plant-based osteoporosis, maintenance of the urogenital tract, reduction of LDL
compounds)-commonly used by cholesterol) while avoiding its drawbacks (e.g., promotion of breast
women as a cancer, uterine cancer, and thromboembolism)
4. Phytoestrogens are not as potent
as estradiol, but they carry some of
the same risks.
5. Selective estrogen receptor
modulators (SERMs) are drugs that
activate ERs in some tissues and
block them in others. These drugs
were developed in an effort
Estrogen-Adverse Effects 1. endometrial hyperplasia, endometrial cancer, breast cancer, and
1. principal concerns with estrogen cardiovascular thromboembolic events
therapy are the potential for 2. by prescribing a progestin
2. endometrial hyperplasia and 3. Fluid retention with edema, gallbladder disease, jaundice, and
endometrial cancer can be headache; especially migraine headache
resolved 4. gallbladder disease. Jaundice may develop in women with
3. Estrogens have been associated preexisting liver dysfunction, especially those who experienced
with what common SE cholestatic jaundice of pregnancy
4. menopause may produce or 5. frequent undesired response to the estrogens
uncover 6. Chloasma,
5. Nausea is the most
6. (blank) a patchy brown facial
discoloration, though not
dangerous, may cause significant
distress
Contraindications of Estrogen 1. DVT, pulmonary embolus, or conditions such as stroke or MI that
1. Estrogens should not be taken by occurred secondary to a thromboembolic event.
patients with a history of 2. are pregnant or who have vaginal bleeding without a known cause.
2. They should not be prescribed to 3. liver disease, estrogen-dependent tumors, or breast cancer (except
women who when indicated for management) also should not take estrogens.
3. Patients with a hx of
Estrogen-Interactions 1. CYP1A2 and CYP3A4; inducers/inhibitors of these isoenzymes may
1. Estrogens are major substrates of raise/lower estrogen levels
2. In addition, they may decrease 2. antidiabetic drugs and thyroid preparations.
the effectiveness of some 3. anticoagulants and other drugs that affect clotting.
3. Estrogens can also interact with
, Local vs. systemic estrogen options 1. more than any other. estradiol—is available alone and in combination
and why one would be chosen with progestin
over the other 2. Emulsion (Estrasorb), Spray, Gels & Patches
1. Oral-Owing to convenience, the 3a. The total dose of estrogen is greatly reduced
oral route is used 3b. There is less nausea and vomiting.
2. Transdermal estradiol is available 3c. Blood levels of estrogen fluctuate less.
in four formulations: 3d. There is a lower risk for DVT, pulmonary embolism, and stroke.
3. Compared with oral formulations, 4. are used only for local effects, primarily treatment of vulval and
transdermal formulations have four vaginal atrophy associated with menopause.
advantages: 5. control of hot flashes and night sweats as well as local effects-Tx of
4. Intravaginal options come as vulval and vaginal atrophy
inserts, creams, and vaginal rings & 6. acute, emergency control of heavy uterine bleeding
5. The other vaginal ring (Femring)
is used for systemic effects to
6. Parenteral; is used only for
emergencies d/t
Clinical Practice Guidelines for 1. with local estrogen deficiency such as vaginal and vulvar atrophy;
menopause these preparations are assoc with a lower risk of systemic effects
Not all women who experience 2. less fluctuation of estrogen levels than do oral preparations
distressing symptoms of 3. hysterectomy but required in women with an intact uterus who
menopause should be treated with undergone hormone replacement therapy
oral estrogen or combination
estrogen/progestin therapy. Key
points include:
1. intravaginal preparations are most
useful for treating sx associated
2. transdermal estrogen
preparations have fewer adverse
effects, use lower doses of
estrogen, and have
3. progesterone is contraindicated
in women who have undergone a
