[2] PRELIMS | REPRODUCTIVE AND GENDER RELATED DRUGS Flashcards
INDICATIONS
- Nutritional supplementation e.g. ____
- Treatment of ____
- Nutritional supplementation e.g. iron, vitamins, and minerals
- Treatment of nausea and vomiting, gastric acidity, and mild discomforts
THERAPEUTIC DRUGS AND USE OF HERBS
- ____
- ____
- ____
- Iron Supplements
- Folic Acid
- Multiple Vitamins
IRON SUPPLEMENT
- Used as ____
- ____ the normal amount of iron is needed to meet fetal and maternal daily requirements.
- RDA of Iron: ____ (non-pregnant); ____ (pregnancy)
- Supplemental: ____/ day (at risk)
- Needed only during the ____, the time when fetus begins to store iron.
- Greatest iron demand is during the ____.
- Used as hematinic
- Twice the normal amount of iron is needed to meet fetal and maternal daily requirements.
- RDA of Iron: 18 mg (non-pregnant); 27 mg (pregnancy)
- Supplemental: 60-120mg/ day (at risk)
- Needed only during the second trimester, the time when fetus begins to store iron.
- Greatest iron demand is during the third trimester.
SAMPLE OF IRON PRODUCTS
- ____ (Fer-ln-Sol, Feosol, Fero-Gradumet. MoMron, Fer-lron)
- ____ (Fergon)
- ____ (Fumasorb, Femiron, Feostat, Fumerin)
- Ferrous sulfate (Fer-ln-Sol, Feosol, Fero-Gradumet. MoMron, Fer-lron)
- Ferrous Gluconate (Fergon)
- Ferrous fumarate (Fumasorb, Femiron, Feostat, Fumerin)
IRON PHARMACOKINETICS
- Absorption ____ is ____ in intestines
- Increased absorption with ____
- Decreased absorption with ____.
- Absorption PO is 5%-30% in intestines
- Increased absorption with ascorbic acid
- Decreased absorption with eggs, milk, coffee, and tea.
IRON PHARMACODYNAMICS
- Peak ____ is ____.
- Hemoglobin values ____ in ____.
- Peak reticulocytosis is 5-10 days.
- Hemoglobin values increase in 2-4 weeks.
SIDE EFFECTS OF IRON SUPPLEMENT
- N____
- V____
- C____
- B____
- E____
- D____
- G____
- D____
- Nausea
- VomitinG
- Constipation
- Black or red tarry stools
- Epigastric pain
- Diarrhea
- GI irritation
- Discoloration of urine
IRON NURSING IMPLICATIONS
- Absorption is promoted when taken with ____.
- Administer with food if ____ occurs.
- Use ____ when taking the liquid form (e.g. elixir)
- ____ after dose to decrease reflux.
- Administer ____ with drugs like antacids, methyldopa, penicillins, quinolons and tetracyclines.
- Do not administer with ____.
- Absorption is promoted when taken with orange juice or other sources of vitamin C
- Administer with food if gastric irritation occurs.
- Use straw when taking the liquid form (e.g. elixir)
- Sit upright 30 min after dose to decrease reflux.
- Administer separately with drugs like antacids, methyldopa, penicillins, quinolons and tetracyclines.
- Do not administer with milk, cereal, tea, coffee or eggs
- Also known as Vitamin B9 or Folate
- Improves outcome of pregnancy
Folic Acid
FOLIC ACID
- Prevents ____ or ____ (e.g., neural tube defects), ____, ____, and premature separation of the placenta (____).
- RDA: ____ and must be acquired from food sources.
- Supplementation: ____ a month before pregnancy and ____ of pregnancy.
- Prevents spontaneous abortion or birth defects (e.g., neural tube defects), premature birth, low birth weight, and premature separation of the placenta (abruptio placenta).
- RDA: 180 mcg and must be acquired from food sources.
- Supplementation: 0.4-0.8 mg a month before pregnancy and 2-3 months of pregnancy.
FOLIC ACID SIDE EFFECTS
- ____
- Includes: ____, rash, ____, ____, general malaise
- May cause urine to turn ____
- Uncommon
- Includes: allergic bronchospasm, rash, pruritus, erythema, general malaise
- May cause urine to turn intense yellow
MULTIPLE VITAMINS
- ____ recommended.
- Preparations generally supply vitamins ____, ____, ____, and other minerals.
- Most effective when ____.
- Some can be ____ when taken in large amounts.
- Routinely recommended.
- Preparations generally supply vitamins A, D, E, C, B complex (B1, B2, B3, B5, B6, B12), Iron, calcium, and other minerals.
- Most effective when taken with meals.
- Some can be teratogenic or toxic when taken in large amounts.
NAUSEA AND VOMITING
- Severe occurrence: ____ (____ occurrence)
- Cause: Increased level of ____, ____, and ____
- Severe occurrence: hyperemesis gravidarum (1-3% occurrence)
- Cause: Increased level of hCG, Estrogen and progesterone
Also known as morning sickness (88% occurence).
Nausea & Vomiting
NON-PHARMACOLOGIC MEASURES FOR NVP
- Eating ____ or ____.
- Avoid ____ foods
- ____ (SFF)
- ____ in bet. meals rather than with meals
- Drinking ____ bet. meals
- Eating ____ bedtime snack
- Cessation of ____
- Taking ____ at bedtime
- Eating crackers or dry toast.
- Avoid high-fat / highly seasoned foods
- Small Frequent Feeding (SFF)
- Drinking fluids in bet. meals rather than with meals
- Drinking apple juice or flat carbonated drinks bet meals
- Eating high protein bedtime snack
- Cessation of smoking
- Taking iron supplement at bedtime
PHARMACOLOGIC TX FOR NAVP
____ (Antivert, Bonamine)
* Blocks ____ which acts on vomiting center.
* Common SE is ____
* Patients should avoid alcoholic beverages, ____, ____.
____ (Phenargan)
* Blocks ____ receptors in the brain.
* SE: ____, ____, ____
Meclizine (Antivert, Bonamine)
* Blocks CTZ which acts on vomiting center.
* Common SE is drowsiness
* Patients should avoid alcoholic beverages, tranquilizers, sedatives and narcotics.
Promethazine (Phenargan)
* Blocks post synaptic mesolimbic dopaminergic receptors in the brain.
* SE: Dizziness, drowsiness, excitation
PHARMACOLOGIC TX FOR NAVP
____ (Plasil, Nausil)
* Blocks dopamine receptor in ____ of the CNS
* AR- ____, ____, ____
____ and ____
* Safe and well-tolerated by patients
____ (severe cases)
* Administered only in patients with
Metoclopramide (Plasil, Nausil)
* Blocks dopamine receptor in CTZ of the CNS
* AR- Restlessness, drowsiness, diarrhea
Doxylamine Succinate and Pyridoxine HCl
* Safe and well-tolerated by patients
Phenothiazine (severe cases)
* Administered only in patients with hyperemesis gravidarum
NON-PHARMACOLOGUC MEASURES FOR HEARTBURN
- Limiting ____
- Avoid ____ foods
- Avoiding ____ foods
- Eating ____
- Avoiding ____
- Drinking ____ but not with meals
- Avoid ____ immediately after meal
- Limiting size of meals
- Avoid highly seasoned or greasy foods
- Avoiding gas forming foods
- Eating slowly and chewing thoroughly
- Avoiding citrus juices
- Drinking adequate fluids but not with meals
- Avoid reclining immediately after meal
Also known as pyrosis
HEARTBURN
HEARTBURN
- A burning sensation in the ____ with reflux of acidic contents.
- Common in ____.
- Causes: Increased ____; Decreased ____ time; ____ down after meal
- A burning sensation in the epigastric and sternal regions with reflux of acidic contents.
- Common in 2nd & 3rd trimester.
- Causes: Increased progesterone; Decreased gastric emptying time; Sitting or lying down after meal
PHARMACOLOGIC TX FOR HEARTBURN
____.
* Neutralization of ____.
* S/E – Constipation
* AR – Dehydration
____ and ____
* Neutralization of gastric acidity and ____
* AR – constipation/diarrhea
____ is the most commonly used
Aluminum hydroxide
* Neutralization of gastric acidity.
* S/E – Constipation
* AR – Dehydration
Magnesium HCl and Aluminum hydroxide
* Neutralization of gastric acidity and antiflatulence
* AR – constipation/diarrhea
Liquid form is the most commonly used
- Frequent occurrence in pregnancy.
- Cause: hormonal changes causing decrease GI motility.
- Non-pharmacologic Mgt:
- Increased fluid intake
- Increase dietary fiber intake
- Moderate physical activity
- Pharmacologic tx: bulk-forming preparations
ex. Docusate Na
CONSTIPATION
CONSTIPATION
- Frequent occurrence in pregnancy.
- Cause: ____ causing decrease ____.
- Non-pharmacologic Mgt:
- Increased ____
- Increase ____
- Moderate ____
- Pharmacologic tx: ____ preparations
ex. ____
- Frequent occurrence in pregnancy.
- Cause: hormonal changes causing decrease GI motility.
- Non-pharmacologic Mgt:
- Increased fluid intake
- Increase dietary fiber intake
- Moderate physical activity
- Pharmacologic tx: bulk-forming preparations
ex. Docusate Na
REMINDERS FOR CONSTIPATION
Use occasionally:
- Milk of ___
- ____
- L____
- S____
- B____
- S____
Should be avoided:
- ____
Use occasionally:
- Milk of magnesia
- Magnesium citrate
- Lactulose
- Sorbitol
- Bisacodyl
- Senna
Should be avoided:
- Mineral oil
Due to headache, sinus congestion, eye strain, backache, joint pain and round ligament pain
PAIN
PAIN
- Due to headache, ____, eye strain, backache, ____.
- Non-pharmacologic tx:
- ____ techniques
- promote ____
- use of ____
- use of ____
- Pharmacologic tx: ____
- Due to headache, sinus congestion, eye strain, backache, joint pain and round ligament pain.
- Non-pharmacologic tx:
- rest and relaxation techniques
- promote calming environment
- use of ice packs or warm compress
- use of proper body mechanics
- Pharmacologic tx: Acetaminophen
Acetaminophen is the same as Paracetamol
Drug therapy to decrease uterine muscle contraction
TOCOLYTIC THERAPY
TOCOLYTIC THERAPY
- Drug therapy to ____
- Goal:
- inhibit ____
- ____ delivery
- allow ____ of patient to an appropriate facility if needed
- Includes: - ____ (terbutaline)
- ____ (magnesium sulfate)
- ____or NSAIDs (indomethacin)
- Drug therapy to decrease uterine muscle contraction
- Goal:
- inhibit uterine contraction
- delay delivery
- allow safe transport of patient to an appropriate facility if needed
- Includes: - betasympatho-mimetics (terbutaline)
- calcium antagonist (magnesium sulfate)
- non-steroidal anti-inflammatorydrugsor NSAIDs (indomethacin)
BETASYMPATHOMIMETIC DRUGS
- ____ (Brethine, Bricanyl)
- Stimulates ____ in the uterine smooth muscle to ____
- Route – ____
- AR: ____, malaise, weakness. ____, ____, increase SBP (mother)
____ and ____ (fetus) - ____ and ____. Relaxes smooth muscles of the uterus.
- Terbutaline (Brethine, Bricanyl)
- Stimulates beta2 receptors in the uterine smooth muscle to relax
- Route – SQ/PO
- AR: Tremors, malaise, weakness. Dyspnea, tachycardia, increase SBP (mother)
Tachycardia and Hypoglycemia (fetus) - Calcium antagonist and CNS depressant. Relaxes smooth muscles of the uterus.
BETASYMPATHOMIMETIC DRUGS
- ____ (Magneon, Magwell)
- Route : ____
- CI : MG, ____, MI
- AR : ____, feeling of increase ____, perspiration, dizziness, headache, ____
- AR : ____, Inc. ____,
- S/E Fetus – ____, ____ 24 – 48 hours.
- Magnesium Sulfate (Magneon, Magwell)
- Route : IV/IM
- CI : MG, renal impairment, MI
- AR : Flushing, feeling of increase warmth, perspiration, dizziness, headache, lethargy
- AR : Heavy eyelids, Inc HR,
- S/E Fetus – hypotonia, lethargy 24 – 48 hours.
BETASYMPATHIOMIMETIC DRUGS: NURSING CONSIDERATIONS
- Monitor VS, ____ and ____
- Monitor ____.
- Assess ____ and ____ before initiation of treatment.
- Monitor ____
- Antidote: ____ (Calgonate, Kalcinate, Cal-G, Cal_Glu)- It plays a role in normal cardiac function, renal function, respiration, blood coagulation, and cell membrane and capillary permeability.
- AR – ____
Nursing Alert – always check your IVF
- Monitor VS, FHR and uterine activity
- Monitor I and O.
- Assess deep tendon reflexes and clonus before initiation of treatment.
- Monitor Respiration
- Antidote: Calcium Gluconate (Calgonate, Kalcinate, Cal-G, Cal_Glu)- It plays a role in normal cardiac function, renal function, respiration, blood coagulation, and cell membrane and capillary permeability.
- AR – Phlebitis
Nursing Alert – always check your IVF
Prevention and cessation of Pre-Term Labor (PTL)
CORTICOSTEROIDS
BIOSYMPATHOMIMETIC DRUGS
Non-steroidal anti-inflammatorydrugsor NSAIDs (forexample, ____)
* During that period, doctors can administer otherdrugsto help ensure the baby is born as healthy as possible. Nonsteroidal anti-inflammatorydrugs(NSAIDs) are a type of____ andindomethacin(Indocin).Indomethacinis the most frequently used NSAID for preterm labor.
* CI: ____,
increased risk of ____ due toclotting disorder.
AR: heart attack, stroke, skin changes
Non-steroidal anti-inflammatorydrugsor NSAIDs (forexample, indomethacin)
- During that period, doctors can administer otherdrugsto help ensure the baby is born as healthy as possible. Nonsteroidal anti-inflammatorydrugs(NSAIDs) are a type oftocolytic. NSAIDs includeibuprofen(Motrin) andindomethacin(Indocin).Indomethacinis the most frequently used NSAID for preterm labor.
- CI: systemic mastocytosis,
increased risk of bleeding due toclotting disorder.
AR: heart attack, stroke, skin changes
CORTICOSTEROIDS
- Prevention and cessation of ____.
- Client at risk for PTL (____ gestation)
- ____ maturation
- ____ development
- ____ (Decadron, Dexasone, Cordex 5, Dabrin, Decan,Dexavit, Dexicort, Doxam)
- AR – ____, ____, increased ____, headache, ____.
- Prevention and cessation of PTL.
- Client at risk for PTL (24 – 34 weeks gestation)
- Fetal lung maturation
- Surfactant development
- Dexamethasone (Decadron, Dexasone, Cordex 5, Dabrin, Decan,Dexavit, Dexicort, Doxam)
- AR – Insomia, Nervousness, increased appetite, headache, hypersensitivity reaction.
GESTATIONAL HYPERTENSION
- ____ ( Aldomet)
- MOA – stimulate ____ receptors
- Route - ____
- CI- ____
- AR- ____, NV, nasal congestion, ____
- ____(Apresoline) apparently lowers ____ by exerting a peripheral ____ effect through a direct _____.
- ____ SO4 (Magneon, Magwell)
- Methyldopa ( Aldomet)
- MOA – stimulate central alpha-adrenegic receptors
- Route - PO
- CI- MAOI’s
- AR- peripheral edema, NV, nasal congestion, dry mouth drug fever
- Hydralazine(Apresoline) apparently lowers blood pressure by exerting a peripheral vasodilating effect through a direct relaxation of vascular smooth muscle.
- Magnesium SO4 (Magneon, Magwell)
