Hormonal therapy hormone regimens

Unfortunately, nearly all patients with advanced prostate cancer eventually become refractory to hormone therapy. A regimen of mitoxantrone and prednisone is approved in patients with hormone-... 

Which one of the following statements about hormone replacement therapy (HRT) regimens in menopause is accurate ... 

Once a euthyroid state is achieved, tlie primary health care provider may add a thyroid hormone to tlie therapeutic regimen to prevent or treat hypothyroidism, which may develop slowly during long-term antithyroid drug therapy or after administration of 131I. 

A 50- year-old female had a radical mastectomy three years ago for hormone-dependent breast adenocarcinoma. She is now complaining of shortness of breath, and chest X-ray shows diffuse lung metastases. As part of her therapeutic regimen, she is given intramuscular hormone replacement therapy (1IRT). 

Common Combination Postmenopausal Hormone Therapy Regimens... 

The benefits of hormonal therapies for osteoporosis prevention are discussed in Chap. 3. Hormone therapy should be considered for osteoporosis prevention only in women at significant risk for osteoporosis who cannot take nonestrogen regimens. 

The goal of therapy is to provide a hormone replacement regimen that maintains sex steroid status as effectively as the normal, functioning ovary. 

Up to 30% of patients on maintenance lithium therapy develop transiently elevated serum concentrations of thyroid-stimulating hormone, and 5% to 35% of patients develop a goiter and/or hypothyroidism, which is dose-related and more likely to occur in women. This is managed by adding levothyroxine to the regimen. 

Intracellular communication often proceeds in a pulsatile, rhythmic manner [126]. Moreover, an increasing number of hormones are found to be secreted in a pulsatile manner, and the physiological efficiency of these signals appears to be closely related to their frequency [126]. Based on this understanding, a number of classes of drug therapies have been shown to require a periodic, pulsatile regimen of delivery for efficacy or optimization [131], and several delivery strategies have been proposed to respond to this need [127-131]. 

Autoimmune polyglandular syndrome-Chron c autoimmune thyroiditis may occur in association with other autoimmune disorders. Treat patients with concomitant adrenal insufficiency with replacement glucocorticoids prior to initiation of treatment. Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated. Patients with diabetes mellitus may require upward adjustments of their antidiabetic therapeutic regimens. Nontoxic diffuse goiter or nodular thyroid disease Use caution when administering levothyroxine to patients with nontoxic diffuse goiter or nodular thyroid disease in order to prevent precipitation of thyrotoxicosis. If the serum TSH is already suppressed, do not administer levothyroxine. 

Hormone replacement therapy PO 5-lOmgfor 12-14 consecutive days a month, beginning on day 1 or 16 of cycle given as parf of regimen with conjugated estrogens. Endometrial hyperplasia PO 2.5-10 mg/day for 14 days. 

Cicinelli E, de Ziegler D, Alfonso R, et al. Endometrial effects, bleeding control, and compliance with a new postmenopausal hormone therapy regimen based on transdermal estradiol gel and every-other-day vaginal progesterone in capsules a 3-year pilot study. Fertil Steril. 2005 83 1859-1863. 

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