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ADVANCED PHARMACOLOGY
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, How to know Terazosin (nonselective a-1 blocker) is working.
Relaxes smooth muscle, decreasing dynamic obstruction of the urethra, symptomatic
improvement and increased urinary flow develop rapidly, does not reduce prostate size.
Oral estrogen and when it would be used.
Used more than any other route. Available alone or in combination with progestins.
Transdermal estrogen and when it would be used.
The total dose of estrogen is greatly reduced (liver is bypassed), less nausea/vomiting, blood
levels fluctuate less, lower risk for DVT, PE, and stroke.
Intravaginal estrogen and when it would be used.
Used primarily to treat vulva and vaginal atrophy. Vaginal ring (femring) used for systemic
effects (control of hot flashes and night sweats) and local. Estring used only for local effects
of vulval and vaginal atrophy.
Parental estrogen and when it would be used.
IV and IM administration is used for emergency control of heavy uterine bleeding.
Uses for estrogen
menopausal hormone therapy, female hypogonadism, acne, cancer palliation (advanced
prostate cancer and metastatic breast cancer), gender affirmation therapy.
When is it safe to prescribe Progesterone
menopausal hormone therapy, dysfunctional uterine bleeding, amenorrhea, endometrial
hyperplasia, palliative in women with metastatic endometrial carcinoma, support pregnancy,
IVF.
When is it not safe to prescribe Progesterone
in presence of undiagnosed abnormal vaginal bleeding, relative contraindications (should be
used with caution): include active thrombophlebitis, or a history of thromboembolic
disorders, active liver disease and breast cancer. Do not use in pre-pubertal children, do not
use high dose therapy in 1st 4 months (birth defects), may contribute to neonatal jaundice.
Side effects of progestin-only contraceptives "mini pills".
Irregular menses, spotting, breakthrough bleeding, amenorrhea, inconsistent cycle length,
variation in volume and duration of monthly flow, decrease production of cervical mucus,
involution of the endometrial layer.
Benefits of prescribing medroxyprogesterone acetate.