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Chapter 34: Women's Health Drugs

Terms in this set (45)

Indicated for the treatment of many clinical conditions, particularly those that occur around menopause. A study from the Women's Health Initiative demonstrated the possible detrimental effects of estrogen and estrogen-progestin therapy. Results of women who took an estrogen-progestin combo product were found to have an increased risk of breast cancer, heart disease, stroke, and blood clots, although their risk of hip factures and colon cancer was reduced. The women in the study also identified adverse cognitive effects, they showed an increased risk of developing dementia and demonstrated reduced performance on test of cognitive function.
A second study of hormone replacement therapy where women who had undergone hysterectomy received estrogen (alone) and the women were advised to stop taking their assigned medication b/c the therapy appeared to be associated w/increased risk of stroke. Also there was no effect on rates of coronary heart disease or breast cancer but it was associated w/a reduced rate of hip facture. Now understood that HRT is more beneficial for women who are just beginning menopause b/c it can treat menopause related symptoms and reduce the risk of osteoporosis or factures. HRT not recommended for women w/hx of endometrial cancer. Estrogen therapy has not proven safe in women w/breast cancer. When hormone therapy is discontinued after several years of use, assess bone-mineral density and begin treatment if indicated. Effects of all estrogens are similar b/c there are only slight difference in chemical structures and these difference yield drugs of different potencies which make for a variety of indications and routes of administration (highly customizable doses)
Estrogen-progestin combo products are commonly referred to as continuous combined hormone replacement therapy. Use of estrogen alone has been associated w/increased risk of endometrial hyperplasia, a possible precursor of endometrial cancer. Addition of continuously administered protestin w/estrogen regimen reduces incidence of endometrial hyperplasia.
Examples of combo products: conjugated estrogens w/medroxyprogesterone, norethindrone acetate w/ ethinyl estradiol, and estradiol w/norethindrone