Ch 31 Reproductive Tract Flashcards

1
Q

What meds are used to treat erectile dysfunction

A

Phosphodiesterase type 5 ( PDE5)inhibitors

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2
Q

Name Estrogen drugs

A

Conjugated equine estrogens ( Premarin)

Estradiol ( estrace, vagifem), estradiol hemihydrate ( estrasorb)

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3
Q

What is the pharmacological action of estrogens

A

They are hormones needed for growth and maturation of the female reproductive tract and secondary sex characteristics.
Estrogens block bone reabsorption and reduce low density lipoprotein LDL levels.
At high levels estrogens suppress the release of a follicle stimulating hormone needed for conception

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4
Q

What are therapeutic uses for estrogens

A

Contraception
Relief of moderate to severe postmenopausal symptoms, such as hot flashes, mood changes
Prevention of post menopausal osteoporosis
Treatment of dysfunctional uterine bleeding
Treatment of prostate cancer, symptoms of vulvar atrophy

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5
Q

What is the route of administration for estrogen

A

PO, transdermal, intravaginal, IM, IV

IV and IM use is rare

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6
Q

What are adverse effects of estrogen

A

1.Endometrial and ovarian cancers when prolonged estrogen is the only post, menopausal therapy. ( administer progestins along with estrogen
Instruct to report persistent vaginal bleeding if they have a intact uterus, advise to have an endometrial biopsy q2 yrs and yearly pelvic exam.
2. Risk for estrogen dependent breast cancer
3.embolic events such as MI, PE, DVT, stroke ( woman over 60 have increased risk of myocardial infarction and coronary heart disease (CHD)( avoid all nicotine products

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7
Q

Estrogens is what category drug

A

X
Contraindicated in abnormal undiagnosed vaginal bleeding, breast or estrogen dependent cancer, history or risk of thromboembolic disease
Use cautiously in prepubescent girls, monitor bone growth and check periodically for early epiphyseal plate closure

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8
Q

What are med interactions of estrogens

A

Estrogens can reduce the effectiveness of warfarin ( monitor INR & PT)
phenytoin use can decrease the effectiveness of estrogens
Corticocosteroids may increase the effects of estrogen
Smoking increases the risk for thrombophlebitis

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9
Q

When should estrogens be taken

A

At the same time each day preferably at bedtime

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10
Q

What is the prototype progesterone and other drugs

A

Medroxyprogesterone (provera)
Norethindrone ( micronor)
Meg estriol acetate ( megace)

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11
Q

What is the pharmalogical action of progesterone

A

It induces favorable conditions for fetal growth and development and maintain pregnancy
A drop in progesterone levels leads to menstruation

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12
Q

Therapeutic uses for progesterones

A

Use progesterones alone or with estrogens for contraception
Progesterones counter adverse effects of estrogen
Can also use in woman who are undergoing in vitro fertilization and in some clients to prevent premature birth

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13
Q

What are routes of progesterone

A

PO, IM, SC, transdermal, and intravaginal

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14
Q

What are adverse effects of progesterone

A

Breast cancer
Thrombolytic events ( MI, PE,thrombophlebitis, stroke,)
Bleeding, amenorrhea, and breast tenderness
Edema
Jaundice
Migraine headaches

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15
Q

What are contraindications and precautions of progesterones

A

x
Undiagnosed vaginal bleeding
History of thromboembolic disease, cardiovascular or cerebrovascular disease
History of breast or genital cancers
Smoking increases risk for thrombophlebitis
Use cautiously in diabetes mellitus,,seizure disorders, and migraine headaches

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16
Q

What is be advised to the pt regarding progesterone therapy

A

Anticipate withdrawal bleeding 3-7 days after stopping the med
Stop taking immediately if pregnancy is suspected

17
Q

Concurrent use of bromocriptine ( Parlodel) and progesterone causes what

A

Amenorrhea

18
Q

The use of carbamazepine, Phenobarbitol, phenytoin, and rifampin does what

A

Decreases contraceptive effectiveness

19
Q

Smoking concurrently while on progesterone theory does what

A

Increases the risk for thrombophlebitis

20
Q

What meds are used to treat BPH

A

5 alpha reductase inhibitors

Alpha adrenergic antagonists