Term
| Estradio, Estrone and Estriol are the three endogenous oestrogen's. Which is secreted principally by the ovary and is most potent? |
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Definition
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Term
| What is the role of estrogen in regards to receptor expression? |
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Definition
| Estrogen induces the synthesis of progesterone receptors in the uterus, hypothalamus, pituitary and vagina. |
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Term
| Does progesterone increase or decrease estrogen receptors? |
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Definition
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Term
| WHat is the action of Finasteride? |
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Definition
| Finasteride is a 5a reductase inhibitor. This is the enzyme responsible for converting testosterone to the active dihydrotestosterone. Indicated in treatment of BPH. |
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Term
| How does Anastrazole work? |
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Definition
| Anastrazole is an Aromatase enzyme inhibitor. Aromatase is the enzyme responsible for converting testosterone to estradiol. |
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Term
| What are three metabolic effects of oestrogen? |
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Definition
Increase salt and water retention
Increase plasma concentration of HDL
Increase coagulability |
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Term
| 3 general functions of oestrogen |
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Definition
Replacement therapy in ovarian failure
Contraception
Prostate and breast cancer |
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Term
| 2 general uses of antioestrogens |
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Definition
Oestrogen sensitive breast cancer
To induce ovulation |
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Term
| Difference between natural and synthetic estrogen metabolism? |
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Definition
| Both are well absorbed but natural estrogens are more rapidly metabolised by the liver. |
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Term
| Group AEs of estrogen therapy? |
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Definition
| Breast tenderness, vomiting, odema, VTE |
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Term
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Definition
| Class SERM. Has an antiestrogenic effect on breasts and uterus, proestrogenic effects on bones, lipid and coagulation. Indicated in the prevention of postmenopausal osteoporosis. |
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Term
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Definition
| Is a agonist/antagonist. Proestrogenic in lipid profile, endometrium and bones and antiestrogenic effects on the mammary glands. Used in oestrogen-dependent breast cancer. |
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Term
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Definition
| Is an antiestrogenic. It inhibits estrogen binding in the anterior pituitary, deregulating GnRH production resulting in ovarian enlargement and increasing fertility. It is used in infertility due to lack of ovulation. |
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Term
| There are two types of progestogens? |
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Definition
| Progesterone (hydroxyprgesterone) and Testosterone (norethiserone) |
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Term
| Advantages and disadvantages of the newer progestogens (desogestrel)? |
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Definition
| Indicated in patients who experience acne, depression or breakthrough bleeding). Increased risk of VTE. |
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Term
| Group AEs of progesterones? |
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Definition
| Weak androgenic effects, acne, fluid retention, weight gain, depression, menstrual changes. |
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Term
| Main therapeutic indication of progesterone? |
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Definition
Contraception
Estrogen replacement (to prevent endometrial hyperplasia, because progesterone inhibits estrogen receptor synthesis)
Endometriosis |
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Term
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Definition
| is an antiprogestogen. It is a partial agonist that increases the sensitivity of the uterus to proastaglandins. Given with gemeprost (a pgl) to induce termination. |
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Term
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Definition
Short term use of HRT treats the symptoms of oestrogen reduction including hot flushes, vaginal atrophy and bone loss.
Increases risk of breast and uterine cancer, increase VTE. |
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Term
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Definition
| used for the short term treatment of oestrogen deficiency. Has estrogenic, progesterogenic and weak androgenic effects. |
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Term
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Definition
| Gametogenesis, as regulated by the sertoli cells. |
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Term
| LH in males is responsible for? |
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Definition
| Stimulating testosterone production by the Leydig (or interstitial cells) |
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Term
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Definition
Development of secondary sexual characteristics
Increase in muscular strength
Development of the reproductive organs |
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Term
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Definition
| Down regulation of GnRH production, infertility, oedema, acne, growth impairment in children. |
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Term
| Indications for androgens? |
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Definition
Hypogonadism
Hyposexuality following ovariectomy |
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Term
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Definition
| is a partial agonist of androgen receptors. It depresses GnRH and therefore gonadotrophin concentration indicated in precocious puberty, masculinity in women and sex offenders, as well as an adjunct in prostate cancer. |
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Term
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Definition
| is a a1 adrenoreceptor anatagonist, which relaxes the smooth muscle in the prostate capsule to treat BPH. |
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Term
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Definition
| is a potent synthetic GnRH. With continuous use initially they increase the concentration of sex hormones, but quickly desensitisation occurs. Indicated for treatment of hormone sensitive cancers of the prostate, breast and endometriosis. |
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Term
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Definition
| is a GnRH inhibitor used in sex hormone dependent conditions like gynecomastia. Adverse effects include fluid retention, GI disturbances and headache. Used as a virilising agent. |
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Term
| The two main types of contraception pills |
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Definition
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Term
| Which estrogen and progestogen are used in the COCP? |
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Definition
Ethinylestradiol
Levenorgesterel, Norethiserone
(Third gen --> desogestrel)
We choose the lowest dose that gives good cyclical control and is well tolerated. |
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Term
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Definition
| Third have less androgenergic effect but have increased risk of VTE |
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Term
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Definition
Estrogen inhibits FSH production
Progestogen inhibits LH production + cervical thickening
Combine to alter endometrium
21 of 28 days |
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Term
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Definition
| Weight gain, nausea, depression, dizziness, skin changes, amenorrhea. |
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Term
| MoA of progestogen only, advantages disadvantages? |
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Definition
Cervical mucus thickening and some effects of implantation. No estrogenic effects, more sensitive to mistake in missing pill.
28 of 28 days |
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Term
| Interactions to consider with contraceptive pills? |
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Definition
| Affected by enzyme inducers (phenytoin, carbemazepine), action can be inhibited by antibiotics. |
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Term
| High dose oral levonorgestrel |
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Definition
| Emergency contraception up to 72 hours. Needs to be taken with an antiemetic. |
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Term
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Definition
| IM contraception, effective and safe but increase chance of menstrual irregularities and long time return to fertility. |
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Term
| Implanon (levonorgestrel) |
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Definition
| Slow release sub cut capsule, 3 years of contraception. Unpredicatable menstruation + headaches. |
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Term
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Definition
| IUD 3-5 years contraception. |
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Term
| Uterine myometrial pacemakers are controlled by... |
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Definition
| sex hormones, hence the activity during menstruation. |
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Term
| In the uterus there are B2 and alpha adrenoreceptors, which inhibits and which induces contraction. |
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Definition
B2 inhibits
Alpha induces. |
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Term
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Definition
Release is stimulated by cervical dilation and suckling.
Ostrogen induces oxytocin receptors
Oxytocin induces contraction
Indicated in the induction of labour and let down. |
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Term
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Definition
| indicated in post partum hemorrhage (after oxytocin) Given incombination before third stage of labour. Induces strong contraction in a lax uterus. Rapid onset last 3-6 hours. Causes vasoconstriction. |
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Term
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Definition
| indicated in late therapeutic abortion |
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Term
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Definition
| Given in combination with Mifepristone to medically induce abortion. |
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Term
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Definition
| Is a B2 agonist in the uterus and inhibits preterm labour |
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Term
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Definition
| Water retention and rebound tachycardia |
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Term
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Definition
| is an oxytocin antagonist, to delay preterm labour, can cause vomiting, vasodilation and hyperglycemia. |
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Term
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Definition
| increase cGMP resulting in a vasodilatory effect and filling of the penile vascular bed. 30 minute onset. COntraindicatng with nicorandil. AEs include hypotension, flushing, headache. |
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Term
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Definition
| has a longer half life the Sildenafil so can be taken longer before the required time. |
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Term
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Definition
| Estrogen receptor antagonist indicated in treatment of estrogen receptor positive breast cancer. |
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Term
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Definition
| is a MAb use to treat HER2 positive breast cancer |
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