Estrogens



Estrogens







TERMS



  • □ estradiol (Estrace, Estraderm, Alora, Climara, Menostar, Esclim, Vivelle, Vivelle-Dot)



QUICK LOOK AT THE CHAPTER AHEAD

Estrogen is primarily secreted by the ovary and produced by the cells of the developing graafian follicle. Some estrogen is secreted by the adrenal glands, corpus luteum, placenta, and testes.1 Estrogens are important in the development and maintenance of primary and secondary female sex characteristics. There are three endogenous or natural estrogens: estradiol, estrone, and estriol. They have the structure of a steroid and are synthesized by cholesterol in the ovarian follicles.2 Natural estrogens are also called steroid hormones, and most are inactivated by the liver are not effective orally. Synthetic estrogens do not have the steroid structure and can be given orally.









Table 54-1 Estrogens











































Prototype Drug

Related Drugs

Drug Classification


estradiol (Estrace, Estraderm, Alora, Climara, Menostar, Esclim, Vivelle, Vivelle-Dot)

conjugated estrogens (Premarin)

Steroidal estrogens


conjugated synthetic estrogens (Cenestin)


esterified estrogens (Menest, Estratab)


ethinyl Estradiol (Estinyl)


estradiol valerate (Delestrogen)


There is no prototype for this classification

estropipate (Ogen, Ortho-Est)

(Stabilized estrone)


There is no prototype for this classification

chlorotrianisene (TACE)

Synthetic nonsteroidal estrogen


dienestrol (DV)


diethylstilbestrol (DES, Stilphostrol)


There is no prototype for this classification

conjugated estrogens/medroxyprogesterone (Prempro, Premphase)

Estrogen-progesten combinations


estradiol/norethindrone (CombiPatch)


estradiol/norgestimate (Prefest)


ethinyl estradiol/etonogestrel (NuvaRing)


norethindrone acetate/ethinyl estradiol (Femhrt)



FEMALE REPRODUCTIVE SYSTEM DRUGS CLIENT TEACHING


All Estrogens



  • Perform monthly self-breast exams and report lumps to health care provider.


  • Continue regular follow-up care with health care provider.



  • Use sunscreen and protective clothing to prevent changes in skin pigmentation.


  • Advise other health care providers (eg, specialist, surgeon, dentist) about medication use before surgery or treatment.


  • If pregnancy is suspected, stop taking and notify health care provider.


  • Report symptoms of headache, blurred vision (stroke), chest pain, pain, swelling, tenderness in extremities, shortness of breath (thromboembolism), weight gain, edema in ankles/feet (fluid retention), depression, severe abdominal pain, jaundice (hepatic dysfunction), and changes in vaginal bleeding.


  • Bleeding occurs when estrogen is withheld.


  • Avoid smoking as smoking increases risk of serious side effects, especially in women over 35.


  • Consult with health care provider before taking herbal preparations such as St. John’s wort.


  • Diabetics should report increased glucose levels to health care provider as dosage adjustments to oral hypoglycemic or insulin may be necessary.


  • Maintain good oral hygiene and maintain preventive dental care to minimize gingival hyperplasia.


  • Read package insert carefully for directions and contact health care provider with questions.



image Perform monthly self-breast exams and report lumps to health care provider.



image Advise other health care providers (eg, specialist, surgeon, dentist) about medication use before surgery or treatment.

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Oct 21, 2016 | Posted by in NURSING | Comments Off on Estrogens

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