ANSWERS COMPLETE CHAMBERLAIN COLLEGE.
1. When and when combined estrogen-progestin therapy for women with an
not to use prog- intact uterus. Estrogen-only HRT can be given to some-
estin for hor- one with a hysterectomy. Progestin is required to prevent
mone replace- estrogen-associated endometrial hyperplasia.
ment therapy and
why?
2. Local vs. sys- intravaginal preparations are most helpful in treating
temic estrogen symptoms associated with local estrogen deficiency, such
options and why as vaginal and vulvar atrophy; these preparations are as-
one would be sociated with a lower risk of systemic effects
chosen over the progesterone is contraindicated in women who have un-
other dergone a hysterectomy but required in women with an
intact uterus who have undergone hormone replacement
therapy
IV administration is generally limited to acute, emergency
control of heavy uterine bleeding.
One of the two available vaginal rings (Estring) are used
only for local effects, primarily treatment of vulval and
vaginal atrophy associated with menopause.
The other vaginal ring (Femring) is used for systemic
effects (e.g., control of hot flashes and night sweats) as
well as local effects (e.g., treatment of vulval and vaginal
atrophy).
3. Peri-menopausal remains the most effective treatment option for relieving
estrogen therapy perimenopausal and menopausal hot flashes and night
(ET) sweats.
taken to compensate for the loss of estrogen that occurs
during menopause.
There are two basic regimens for HT: estrogen alone (ET)
and estrogen plus a progestin (estrogen/progestin therapy
[EPT]).
The purpose of estrogen in both regimens is to control
menopausal symptoms by replacing estrogen that was
lost owing to menopause.
4. Transdermal es- The total dose of estrogen is greatly reduced (because the
trogen therapy liver is bypassed).
, NR 568 ADVANCED PHARMACOLOGY WEEK 5 QUESTIONS AND
ANSWERS COMPLETE CHAMBERLAIN COLLEGE.
has fewer ad- There is less nausea and vomiting.
verse effects Blood levels of estrogen fluctuate less.
There is a lower risk for DVT, pulmonary embolism, and
stroke.
Types:
Emulsion (Estrasorb)
Spray (Evamist)
Gels (EstroGel, Elestrin, Divigel)
Patches (Alora, Climara, Estraderm, Menostar, Viv-
elle-Dot, Oesclim )
5. Selective es- Are drugs that activate ERs in some tissues and block
trogen recep- them in others.
tor modulator These drugs were developed in an effort to provide the
(SERM) benefits of estrogen (e.g., protection against osteoporo-
sis, maintenance of the urogenital tract, reduction of LDL
cholesterol) while avoiding its drawbacks (e.g., promotion
of breast cancer, uterine cancer, and thromboembolism)
6. Bazedoxifene Duavee (conjugated estrogens/bazedoxifene) for preven-
tion of vasomotor symptoms and osteoporosis in post-
menopausal women with a uterus.
Duavee is the first drug to combine estrogen with an
estrogen agonist/antagonist (bazedoxifene).
The bazedoxifene component of Duavee reduces the risk
for excessive growth of the lining of the uterus that can
occur with the estrogen component.
Contraindications to taking Duavee are the same as for
other estrogen-containing products.
7. Prevention of os- HT reduces postmenopausal bone loss and thereby de-
teoporosis with creases the risk for osteoporosis and related fractures.
hormone re- Unfortunately, when HT is stopped, bone mass rapidly
placement thera- decreases by approximately 12%. ****Hence to maintain
py bone health, HT must continue lifelong.***
HT should be considered only for women with significant
risk for osteoporosis, and only when that risk outweighs
the risks of HT.
A person on HT and pts, in general, should practice prima-