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