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DictionarySeeestradiolSandra Day O'Connor
O'Connor, Sandra Day, 1930–, U.S. lawyer and associate justice of the U.S. Supreme Court (1981–2006), b. El Paso, Tex. Graduating from Stanford law school (1952), she returned to practice in her home state of Arizona. There she was a state assistant attorney general (1965–69) and a Republican state senator (1969–74). Appointed a state judge in 1974, she was in 1979 named to the Arizona Court of Appeals. In 1981, President Reagan nominated her to the U.S. Supreme Court, where she became the first woman justice. Except in cases of sexual discrimination and states' powers under the federal system, she generally resisted judicial activism, emerging in the 1990s as a frequent swing vote between more and less conservative blocs. After leaving the Court, she served (2006) as a member of the Iraq Study Group. Bibliography See her Lazy B: Growing Up on a Cattle Ranch in the American Southwest (with her brother, H. A. Day; 2001), The Majesty of the Law: Reflections of a Supreme Court Justice (2003), and Out of Order: Stories from the History of the Supreme Court (2013); study by J. Biskupic (2005); L. Hirshman, Sisters In Law: How Sandra Day O'Connor and Ruth Bader Ginsburg Went to the Supreme Court and Changed the World (2015). O'Connor, Sandra Day(1930– ) Supreme Court justice; born in El Paso, Texas. After taking her law degree from Stanford (1952), she had a private practice in Arizona; serving in the Arizona Senate (1969–74), she was the first woman in America to be elected majority leader of a state senate (1972–74). She was elected to a county superior court (1974–79) and was then appointed to the Arizona Court of Appeals (1979–81). When President Ronald Reagan selected her, she became the first woman to serve on the U.S. Supreme Court (1981). Generally conservative in her legal views, she occasionally took independent positions and for long held the "swing vote" on the issue of abortion.Sandrena
estradiol Bedol (UK), Elestrin, Elleste (UK), Elleste-Solo (UK), Estrace, Estring, Estrogel, Gynodiol, Innofem, Oestrogel (UK), Progynova (UK), Sandrena (UK), Vagifem, Zumenon (UK) estradiol acetate Femring, Femtrace estradiol cypionate Depo-Estradiol estradiol hemihydrate Estrasorb estradiol transdermal system Alora, Climara, Estraderm, Estradot (UK), Evorel (UK), Fematrix (UK), Femseven (UK), Menostar, Vivelle estradiol valerate Climaval (UK), Delestrogen, Femogex (CA) Pharmacologic class: Estrogen Therapeutic class: Hormone Pregnancy risk category X Action Binds to nuclear receptors in responsive tissues (such as female genital organs, breasts, and pituitary gland), enhancing DNA, RNA, and protein synthesis. In androgen-dependent prostate cancer, competes for androgen receptor sites, inhibiting androgen activity. Also decreases pituitary release of follicle-stimulating hormone and luteinizing hormone. Availability Injection (cypionate in oil): 5 mg/ml Injection (valerate in oil): 10 mg/ml, 20 mg/ml, 40 mg/ml Tablets: 0.5 mg, 1 mg, 1.5 mg, 2 mg Tablets (film-coated): 25.8 mcg estradiol hemidrate (equivalent to 25 mcg estradiol) Transdermal system: 25 mcg/24-hour release rate, 37.5 mcg/24-hour release rate, 50 mcg/24-hour release rate, 75 mcg/24-hour release rate, 100 mcg/24-hour release rate Vaginal cream: 100 mcg/g Vaginal ring: 2 mg released over 90 days Vaginal tablets: 10 mcg Indications and dosages ➣ Symptoms of menopause, atrophic vaginitis, female hypogonadism, ovarian failure, and osteoporosis Adults: 0.5 to 2 mg (estradiol) P.O. daily continuously or cyclically. Or 1 to 5 mg (cypionate) or 10 to 20 mg (valerate) I.M. monthly. Or 50- or 100-mcg/24-hour transdermal patch applied twice weekly (Alora, Estraderm) or weekly (Climara). Or 25-mcg/24-hour patch applied q 7 days (FemPatch) or 37.5- to 100-mcg transdermal patch applied twice weekly (Vivelle). Or 2 to 4 g (0.2 to 0.4 mg) vaginal cream (estradiol) applied daily for 1 to 2 weeks, then decreased to 1 to 2 g/day for 1 to 2 weeks, then a maintenance dose of 1 g one to three times weekly for 3 weeks, then off for 1 week; repeat cycle once vaginal mucosa has been restored. Or 2-mg vaginal ring q 3 months or 10-mcg vaginal tablet once daily for 2 weeks, then twice weekly. ➣ Postmenopausal breast cancer Adults: 10 mg P.O. t.i.d. (estradiol) ➣ Prostate cancer Adults: 1 to 2 mg P.O. t.i.d. (estradiol) or 30 mg I.M. q 1 to 2 weeks (valerate) Contraindications • Hypersensitivity to drug or its components • Thromboembolic disease (current or previous) • Undiagnosed vaginal bleeding • Breast or reproductive system cancer (except in metastatic disease) • Estrogen-dependent neoplasms • Pregnancy Precautions Use cautiously in: • cardiovascular, hepatic, or renal disease • breastfeeding patients. Administration • Inject I.M. dose deep into large muscle mass; rotate injection sites. • If switching from oral to transdermal estrogen, apply patch 1 week after withdrawal of oral therapy.  Adverse reactions CNS: headache, dizziness, lethargy, depression CV: hypertension, myocardial infarction (MI), thromboembolism EENT: contact lens intolerance, worsening of myopia or astigmatism GI: nausea, vomiting, bowel obstruction with vaginal ring (rare) GU: amenorrhea, dysmenorrhea, breakthrough bleeding, cervical erosions, decreased libido, vaginal candidiasis, erectile dysfunction, testicular atrophy, gynecomastia, breast pain or tenderness Hepatic: jaundice Metabolic: sodium and fluid retention, hypercalcemia, hyperglycemia Musculoskeletal: leg cramps Skin: oily skin, acne, pigmentation changes, urticaria Other: weight loss or gain, edema, increased appetite, toxic shock syndrome with vaginal ring (rare) Interactions Drug-drug. Insulin, oral hypoglycemics, warfarin: altered requirements for these drugs Drug-diagnostic tests. Antithrombin III, folate, low-density lipoproteins, pyridoxine, total cholesterol, urine pregnanediol: decreased levels Cortisol; factors VII, VIII, IX, and X; glucose; high-density lipoproteins; phospholipids; prolactin; prothrombin; sodium; triglycerides: increased levels Metyrapone test: false decrease Thyroid function tests: false interpretation Drug-behaviors. Smoking: increased risk of adverse CV reactions Patient monitoring See Monitor vital signs and cardiovascular status, especially for hypertension, thromboembolism, and MI. • Be aware that a few cases of ring adherence to the vaginal wall have occurred, which may require evaluation of wall ulceration and erosion. • Assess vision. • In diabetic patient, monitor blood glucose level and watch for signs and symptoms of hyperglycemia. Patient teaching • Instruct patient to place transdermal patch on clean, dry skin area. • Teach proper technique for use of vaginal tablet, ring, or cream, as appropriate. • Tell patient drug may cause loss of libido (in women) or erectile dysfunction (in men). Encourage patient to discuss these issues with prescriber. See Teach patient to recognize and immediately report signs and symptoms of thromboembolism. See Caution patient not to take drug if she is or plans to become pregnant. • Advise patient that drug may worsen nearsightedness or astigmatism and make contact lenses uncomfortable. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above. Sandrena A brand name for OESTRADIOL (estradiol). |