Hormones replacement therapy

Estrogens and progestins are diminished in menopausal or ovarectomized women. In hormone replacement therapy (HRT), these hormones are substituted to alleviate hot flushes, mood changes, sleep disorders, and osteoporosis. 

HMG CoA-Reductase HMG-CoA-Reductase Inhibitors Homologous Desensitization Homologous Proteins Homologous Recombination Homology Modeling Hormonal Contraceptives Hormone Replacement Therapy (HRT)... 

These dragp are contraindicated in patients who are hypersensitive to the bisphosphonates. Alendronate and risedronate are contraindicated in patients with hypocalcemia Alendronate is a pregnancy Category C drug and is contraindicated during pregnancy. These drugp are contraindicated in patients with renal impairment with serum creatinine less than 5 mg/dL. Concurrent use of these dm with hormone replacement therapy is not recommended. 

Thyroid hormone replacement therapy in patients with diabetes may increase the intensity of the symptoms or the diabetes. The nurse closely monitors the patient with diabetes during thyroid hormone replacement therapy for signs of hyperglycemia (see Chap. 49) and notifies the primary health care provider if this problem occurs. 

Saw palmetto (cabbage palm, fan palm, scrub palm) Serenoa repens %mptoms of benign prostatic hyperplasia Generally well-tolerated occasional gastrointestinal effects May interact with hormones such as oral contraceptive drugs and hormone replacement therapy. 

The administration of drugs to ease disease and chronic, severe pain or to provide benefits such as hormone replacement therapy is difficult because drugs taken orally may lose much of their potency in the harsh conditions of the digestive system. In addition, they are distributed throughout the entire body, not just where they are needed, and side effects can be significant. Recently, however, techniques have been developed to deliver drugs gradually over time, to the exact location in the body where they are needed, and even at the time when they are needed. 

Transdermal patches are applied to the skin. The drug is mixed with the adhesive for the patch, and so it lies next to the skin. The skin can readily absorb many chemicals and so can absorb drugs such as nitroglycerin (for heart disease), morphine derivatives (for constant, severe pain), estrogen (for hormone replacement therapy), or nicotine (for easing symptoms that result when a patient stops smoking). 

Speas C, Rushing S, Backfield M. Web based data entry in a hormone replacement therapy clinical trial for a data coordinating center. Controlled Clin Trials 2000 20 2S-91S. 

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. There are a number of established risk factors including serum cholesterol levels, smoking and family history, which are responsible for between 50 and 75% of the CVD cases, with the remainder due to factors that cause atherosclerosis. Estrogen treatment such as hormone replacement therapy is known to protect against CVD by decreasing the levels of low-density... 

There is much interest in the possible hormonal effects of phytoestrogens in both men and women. The majority of studies conducted in women have examined the ability of phytoestrogens to alleviate menopausal symptoms. Whilst hormone replacement therapy is recommended for women experiencing menopausal symptoms, there remains some uncertainty as to whether HRT can increase the risk of breast cancer. As a result of these concerns, investigations into natural alternatives such as phytoestrogens have received considerable attention. 

KOMULAINEN M, KROGER H, TUPPURAINEN M T, HEIKKINEN A M, ALHAVA E, HONKANEN R, lURVELIN I and SAARiKOSKi s (1999) Prevention of femoral and lumbar bone loss with hormone replacement therapy and vitamin D3 in early postmenopausal women a population-based 5-year randomized trial. J Clin Endocrinol Metab 84, 546-52. 

MORABITO N, CRISAFULLI A, VERGARA C, GAUDIO A, LASCO A, FRISINA N, D ANNA R, CORRADO F, PIZZOLEO M A, CINCOTTA M, ALTAVILLA d, lentile r, squadrito f (2002), Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women A randomized double-blind placebo-controlled study. J Bone Miner Res 17, 1904-1912. 

PRINCE R L, SMITH M, DICK I M, PRICE R I, WEBB P G, HENDERSON N K and HARRIS M M (1991) Prevention of postmenopausal osteoporosis. A comparative study of exercise, calciiun supplementation, and hormone-replacement therapy. N Eng J Med 325, 1189-95. 

For some conditions, a large placebo effect can be anticipated. For example, studies of hormone replacement therapies for hot flashes in postmenopausal women consistently show a 50% decline from baseline in the number of daily hot flashes in the placebo group. Therefore, in order to show significance, an active treatment must produce an effect that is substantially larger than 50%. A marked placebo response is commonly observed with any condition that has a subjective component, such as chronic pain (e.g. arthritis), episodic pain (e.g. headaches), psychological states (e.g. anxiety), and certain physiologic measurements (e.g. blood pressure). 

Simpson H, Savine R, Sonksen P, et al. Growth hormone replacement therapy for adults into the new millennium. Growth Horm IGF Res 2002 12(l) l-33. 

Smith JC. Hormone replacement therapy in hypopituitarism. Expert Opin Pharmacother 2004 5(5) 1023—1031. 

Explain how to evaluate a patient for the appropriate use of hormone-replacement therapy. 

List the adverse effects of and contraindications to hormone-replacement therapy. 

Explain the risks and benefits associated with hormone-replacement therapy. 

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