Hormone replacement therapy (HRT)
Not recommended for women with histories of endometrial cancer
conjugated estrogens(Premarin)
MOST COMMON
Estrogen: contraindications
undiagnosed abnormal vaginal bleeding
- anything with estrogen always chose answer with bleeding and blood clots
Amenorrhea
absence of period
estrogen: interactions
decrease the activity of the oral anticoagulants
- smoking should be avoided-decrease effects of the estrogen and increase risk of thrombosis (blood clots)
contraceptive drugs: MOA
Prevent ovulation by inhibiting the release of gonadotropins and increasing uterine mucus viscosity resulting in decreased sperm movement and possible inhibition of implantation of fertilized egg
oral contraceptive's
prior to starting; pregnancy test needs to be preformed and negative
minipill
contains ONLY progestion
minipill-
what to teach your patient regarding this medication
if you miss a dose, take medication as soon as you notice
contraceptive drugs - pregnancy
known high risk for thromboembolic events
progestin's indication
- hormonal imbalance, fibroids, uterine cancer.
- prevention of threatened miscarriage
adverse effects of progestions
liver dysfunction, thrombophlebitis, thromboembolic disorders, such as PE
Megestrol - megace
can cause appetite stimulation and weight Gain
osteoporosis
the most common bone disease
female, postmenopausal women, hypogonadism, low body weight (slender body build), history of parental hip fracture, ethnic background (European or asian descent) have higher risk for osteoporosis
(T/F)
true
bisphosphonate
builders, can reverse lost bone mass and reduce fracture risk
alendronate (fosamax)
given once a week and has to sit up for at least 30 minutes and has to drink 8oz of water after
calcitonin (calcinar)
if patient has a salmon allergy; should NOT take
teriparatid (forteo)
stimulates bone formation
denosumab (prolia)
prevents bone resorption
raloxifene
decreases the effects of warfarin (anti-coagulant)
bisphosphonates
drug allergy, hypocalcemia, esophageal dysfunction, and the inability to sit or stand upright for at least 30 minutes after taking the medication
SERMS-
adverse effects
hot flashes, leg cramps
fertility drug: clomiphene
maturation of ovarian follicles is stimulated, leading to ovulation and increased chance of conception
menotropins
may also be given to men to stimulate spermatogenesis
diplopia
doubled vision
uterine stimulate
given to promote labor
- postpartum use: reduce the risk of postpartum hemorrhage, induction of therapeutic abortion
oxytocin (synthetic form)
used to induce labor or near full term gestation and to enhance labor when contractions are weak or ineffective
prostaglandins
used to induce labor by softening the cervix and enhancing uterine muscle tone
cytotec
think cervix
ergot alkaloids
increase force and frequency of uterine contractions
uterine stimulants (oxytocin)
- dont leave patient unattended, use IV pump
- monitor uterine contractions, fetal heart rate and rhythm, observe for fetal distress.
- overdose may cause hyper stimulation of the uterus
oral contraceptives
birth control
uterine stimulants- contraindications
cannot be given if baby is breached
(T/F)
combing Durga with uterine stimulants that produce vasoconstriction, such as sympathomimetics, with the oxytocin drugs can result in severe hypertension
true
uterine relaxants- TOCOLYTICS
used to stop labor that begins before term to prevent premature birth
magnesium sulfate
works on smooth muscle and stop contractions.
-used to control seizure activity, inhibits preterm labor
magnesium sulfate- serious adverse effect
everything in the body becomes to relax, reduced urine output
early signs of magnesium toxicity
feeling hot all over, thirst, flushed skin, diaphoresis
late signs of magnesium toxicity
CNS depression, anxiety, confusion, lethargy
very late sign of magnesium toxicity
cardiac depression , respiratory paralysis
testosterone
helps keep electrolytes
anabolic steroids
helps grow tissue; overly abused by athletes
approved indications for anabolic steroids
promote weight gain, trauma, and metastatic breast cancer
serious consequences
sterility, can cause liver failure
androgens
help with building of RBC'S
flomax
helps to maximize urine flow and BPH
- also used to treat hypertension
finasteride
treatment of male pattern baldness
-women must wears gloves when giving if pregnant or plan to become pregnant
erectile dysfunction
inability to achieve or maintain an erection
phosphodiesterase inhibitors - uses
treatment for pulmonary arterial hypertension
adverse effect of phosphodiesterase inhibitors
color vison impairment
serious effect of phosphidesterase inhibitors
sustained erection
sildenafil (viagra)
relaxes smooth muscle
tadalafil (cialis)
used to treat pulmonary hypertension
angina
concurrent use with nitrates may cause severe hypertension
priapism
abnormally prolonged erection
-medical emergency that warrants urgent medical attention
finasteride
use in women of any age (pregnant or not) is not recommended
leuprolide (lupron)
given for prostate cancer
SAW palemetto
used to treat BPH& alopecia
-can interact with NSAIDS