Exam 2- lecture 4 Flashcards Preview

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Flashcards in Exam 2- lecture 4 Deck (28)
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1
Q

DA agonist treatment for amenorrhea

A
bromocriptine BID-TID
cabergoline 2x/wk
- suppress prolactin release from pituitary-> >FSH/LH
- take 3-6 months
- take with food
- CYP3A4
2
Q

treatment for PCOS

A
  • insulin resistance: metformin or TDZ +/- OC
3
Q

metformin MOA

A

inhibits glucose production & increases insulin sensitivity; redcues insulin resistance

4
Q

thiazolidinediones MOA

A

increase insulin sensitivity; reduce resistance

5
Q

menorrhagia treatment options

A

NSAIDS, OCs, mirena, progesterone,, tranexamic acid, surgery- endometiral ablation->hysterectomy

6
Q

menorrhagia first line treatment

A

mirena & NSAIDs

7
Q

progesterone for menorrhagia treatment

A
  • during luteal phase or for 21 days starting on day 5 after onset of mendes
8
Q

tranexamic acid for menorrhadga treatment

A

tid

  • antifibrinolytic
  • blocks lysine binding sites on plasminogen & prevents fibrin degradation
9
Q

OC for menorrhagia treatment

A

> 35mcg estradiol

10
Q

follow up with menorrhagia

A

after 1 cycle

- measure hemoglobin/hematocrit- dont want anemia

11
Q

most common cause of anovulatory bleeding

A

PCOS

12
Q

perimenopausal symptoms

A

hot flashes, night sweats, vaginal dryness

- anovulatory bleeding

13
Q

PCOS symptoms

A

acne, hirsutism, obesity

- anovulatory bleeding

14
Q

if acute, severe bleeding episodes

A

estrogen is beneficial

15
Q

anovulatory OC treatment

A

estradiol dose <35mcg

16
Q

what increases sex hormone- binding globulin (SHBG)

A

OCs, metformine & TZDs

- binds & reduces androgens

17
Q

clomiphene citrate (Clomid)

A

50mg/day for 5 days between menstrual cycle days 3 & 5
- increase if no ovulation
anovulatory bleeding

18
Q

anovulatory follow up

A

with in 1 week

  • bleeding should decline within 10 days
  • ovulation should return w/in 3-6 months (metformin)
19
Q

dysmenorrhea nonpharmacologic treatment

A

topical heat therapy, exercise, low-fat vegetarian diet

20
Q

dysmenorrhea first line treatment

A

NSAIDs- improve w/in 1 hour

21
Q

dysmenorrhea follow-up

A

1-2 cycles

improved QOL within 1-3 cycles

22
Q

therapeutic lifestyle changes for PMS.PMDD

A

reduce caffeine, sugar, & Na, increase exercise, Vitamin B6(50-100mg/day), calcium carbonate (1200mg/day)

23
Q

first line PMS/PMDD treatment

A

SSRIs (fluoxetine, citalopram, paroxetine) & SSNRI(venlafaxine)
- other options- monophasic OCs 20mcg EE & 3 mg drospirenone, TCAs, GnRH agonists

24
Q

endometriosis treatment options

A

combined OCs, GnRH agonists, andogen analogs, surgery

25
Q

pharmacological treatment for endometiosis=

A

inducing a pseudopregnancy or pseudomenopausal state

26
Q

first line endometriosis treatment

A

combined hormonal contraceptives or progestins

- at least 3 month trial

27
Q

alternative treatments for endometriosis

A
  • GnRH- functional oophorectomy via inhibitoing FSH/LH secretion->hypoestrogenic state
  • danazol- testosterone analogue- supress LH/FSH->anovulation, amenorrhea, endometrial atrophy (do not use in hyperlipidemia or liver disease)-prego X
28
Q

last line alternative treatments for endometriosis

A

aromtase inhibitors (anastrazole, letrozole)- direct inhibition of estrogen production