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Pre-pharmacology > Chapter 16 (OB-GYN and GU drugs) > Flashcards

Chapter 16 (OB-GYN and GU drugs) Flashcards

1
Q

abortion

A

any loss of fetus after contraception

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2
Q

OC

A

oral contraceptives; composed of estrogens and/or progestins.
Taken daily to suppress release of luteinizing hormone (LH) and follicle stimulating hormone (FSH) produced by pituitary; without LH and FSH spike, ovulation does not occur and also messes up hormonal situation necessary for uterine lining build up for implantation to occur)
Two types are COCPs or mini pill

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3
Q

COCPs

A

combined oral contraceptives; use both synthetic estrogen and synthetic progestin in combo
Most popular OC

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4
Q

mini pill

A

only progestin OC; prevent ovulation if taken for more than 1 cycle, plus they thicken cervical mucus, and prevent uterine lining from maturing to the point it can accept a fertilized ovum
less effective for preventing pregnancy compared to COCPs, but safer with women that have CV or cancer risks

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5
Q

birth control pills prevent ovulation, and also…

A

thicken cervical mucus; impedes sperm passage into uterus and fallopian tubes
thin lining of uterus; prevents pregnancy by interfering with implantation of fertilized egg (and lightens period)
prevents shedding of endometrium; potentially prevents menstruation

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6
Q

oral contraceptive health issues

A

may slightly increase risk of breast cancer, but for sure increases risk of thromboembolic events (DVTs, PE, and stroke)

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7
Q

OC dosing schedule

A

21 tablets of either fixed or variable dose, then week of placebo or iron tablets (in this gap of drug is where withdrawal bleeding occurs)

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8
Q

monophasic pills

A

COCPs with fixed dose of estrogen (very high dose) and progestin; very effective, but had common bad side e’s like nausea and blood clots

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9
Q

biphasic pills

A

COCPs with fixed dose of estrogen and two different amounts of progestin

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10
Q

triphasic pills

A

COCPs with fixed dose of estrogen (usually) and three different amounts of progestin that varies throughout the cycle

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11
Q

progestin in high levels is used for…

A

“restarting” woman’s menstrual cycle if she is irregular or has spotted, intermittent bleeding

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12
Q

Lunelle

A

contraceptive injection

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13
Q

Ortho Evra

A

contraceptive transdermal patch; only one in US

As effective as COCP with perfect use

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14
Q

NuvaRing

A

flexible plastic vaginal ring contraceptive; 3 week vaginal insert that slowly leaks estrogen progestin combination

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15
Q

non-oral contraceptives

A

use same drugs as OC, but pts. don’t have to remember to take pill at same time every day
Injection, patches, vaginal rings, intrauterine devices, subcutaneous implants)

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16
Q

Depo-Provera

A

medroxyprogesterone; progestin-only injectable contraceptive; very convenient b/c only need 4/year, so great for irresponsible patients
Not as effective as COCPs, but people do not have to be responsible and take pill every day

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17
Q

Norplant II

A

implantable contraceptives; consist of 1-2 small silicone rods implanted under skin every 3 years or so that leach a progestin
Very popular b/c ease of use, low rate of adverse effects, and reliable

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18
Q

barrier contraceptives

A

condoms, diaphragms, and cervical caps

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19
Q

IUDs

A

intrauterine device; temporary devices that disrupt implantation by virtue of presence in uterine cavity
Store progestin drug that prevents ovulation as slow release

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20
Q

Lybrel

A

only OC approved to totally eliminate periods

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21
Q

abortifacient properties of OCs

A

all OCs can act as abortifacients b/c suppressing ovulation and preventing implantation are both silent events

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22
Q

EC

A

emergency contraceptive; using abortifacient properties of COCPs as morning after pill; usually large dose progestin
Can reduce risk of pregnancy by up to 89%

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23
Q

Plan B

A

high dose progestin levonorgestrel (2nd gen progestin); “morning after pill”; EC taken in two doses within 3 days of intercourse to make uterus inhospitable to implantation
*sooner it is taken after intercourse the better b/c like all OCs, once ovum implants in uterus then the drug will not stop a pregnancy

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24
Q

abortifacients

A

drugs that terminate an already established pregnancy (usually in first trimester); called a medical abortion
Drugs bind to progesterone rc’s in uterine lining to cause a dramatic withdraw of calming progestin effects on uterine lining so severe contractions occur to abort fetus
*can cause severe side effects b/c of severe contraction that may lead to death so follow up and pt. education is key

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25
Q

Mifeprex

A

mifepristone; RU-486; anti-progesterone abortifacient drug that can be used after implantation b/c it causes vigorous contractions of uterus and will terminate pregnancy

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26
Q

Yaz

A

formulated with drospirenone (a synthetic hormone that mimics progesterone; 4th gen progestin); first OC approved for treating PMDD
Approved for contraception, moderate acne, and PMDD
*has serious risks like 7x risk of blood clots and stroke

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27
Q

PMS cause

A

from withdrawal of estrogen and progesterone

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28
Q

PMDD

A

premenstrual dysphoric disorder; most severe form of PMS that affects 5% of women
Markedly depressed mood, anger, irritability, anxiety, headaches, and muscle aches

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29
Q

PMDD treatment

A

SSRI and SNRI antidepressants, antianxiety medications like benzodiazepines (Xanax, alprazolam), and OCs like Yaz

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30
Q

HRT

A

hormone replacement therapy; aka MHT (menopausal hormone therapy); either estrogen is used by itself or with progestin to replace loss of natural hormones

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31
Q

E2

A

estradiol; predominant estrogen in women who are not pregnant and not menopausal

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32
Q

Premarin

A

conjugated estrogens from equine sources; used to treat HRT/MHT
Improved vascular instability (hot flashes), irritability, insomnia, weight gain, and bone loss

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33
Q

WHI

A

women’s health initiative; 20 year study of HRT on women and found that it increased risk of MI, stroke, Venous thromboembolic events (VTEs), and breast cancer; but decreased risk of colorectal cancer and osteoporosis

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34
Q

why do women get osteoporosis more than men

A

b/c men weigh more (which is a protective factor against it) and have thicker bones to start with

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35
Q

osteoporosis from menopause drug therapies

A

estrogen supplements, calcium supplements, biphosphonate drugs, and estrogen receptor agonists (SERMs)

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36
Q

calcium supplements

A

easiest drugs to taken to prevent osteoporosis; often combined with vitamin D; recommended to everyone starting in their 20s

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37
Q

osteoporosis with age

A

bone production decreases with age and osteoclastic activity increases; both processes favor decreasing bone density

38
Q

biphosphonates

A

treat osteoporosis; suppress specialized white blood cells that eat away bone (osteoclasts); but make stomach upset, GI inflammation, leads to esophogitis, and even esophageal erosion

39
Q

Fosamax

A

alendronate; biphosphonate used to prevent osteoporosis

40
Q

SERMs

A

selective estrogen receptor modulators; prevent osteoporosis; have same desirable effects of natural estrogens like improving lipid profile, reducing hot flashes, and stabilizing bone mass; but do not risk increasing breast cancer

41
Q

Evista

A

raloxifene; SERM (selective estrogen receptor modulator) used to prevent osteoporosis and help with lipid profile and hot flashes related to menopause

42
Q

calcitonin drugs

A

drugs used to actually treat osteoporosis after it is diagnosed, not just prevent it

43
Q

vaginitis

A

inflammation of the vagina often caused by imbalances of normal flora of vagina; perturbations in normal milieu (changes in pH, hormone fluctuations, and sexual activity) can lead to specific organism overgrowth

44
Q

vaginitis microbial causes

A

yeast (fungal) infection, vaginal trichomoniasis, or bacterial vaginosis

45
Q

vaginitis yeast infection

A

second most common cause of vaginitis; normally caused by C. albicans (also causes thrush) and treated with topical antifungals
Treat like all other topical fungal infections

46
Q

Monistat

A

miconazole; topical antifungal for vaginitis, OTC

47
Q

Gyne-Lotrimin

A

clotrimazole; topical antifungal for vaginitis, OTC

48
Q

nystatin

A

topical antifungal for vaginitis, OTC

49
Q

terbinafine

A

topical antifungal for vaginitis, OTC

50
Q

BV

A

bacterial vaginosis; most common cause of vaginitis and accompanied by bad smell normally
More common in women who are sexually active, but unlikely to be actually caught from partner, smokers, or those who douche

51
Q

Flagyl

A

oral metronidazole; good for anaerobic infections, Rx to treat bacterial vaginosis (BV) or trichomoniasis

52
Q

MetroGel

A

vaginal metronidazole; good for anaerobic infections, Rx to treat bacterial vaginosis (BV)

53
Q

Cleocin

A

oral or vaginal clindamycin; good for anaerobic infections, Rx to treat bacterial vaginosis (BV) or trichomoniasis

54
Q

trichomoniasis

A

protozoan T. vaginalis infection (can be just overgrowth of natural microbe or actual STI); different from BV b/c of frothy and greenish discharge
Least likely cause of vaginitis

55
Q

cystitis

A

bladder infection; more common in women
Not a big deal and easy to treat, but big problem if recurrent or if infection ascends into kidneys
*not normally cultured unless it ascends or is recurrent

56
Q

Septra

A

trimethoprim and sulfamethoxazole combination anitbiotic for UTIs

57
Q

UTI treatment for those allergic to sulfa

A

penicillins are used, like amoxicillin

58
Q

b/c of resistance in bacteria for UTIs, often other drugs must be used…

A

fluoroquinolones like Cipro (ciproflaxacin) and Levaquin (levoflaxacin)

59
Q

severe kidneys infections that ascended from cystitis need…

A

gentamicin (aminoglycoside)

60
Q

cranberries for UTIs

A

tannin chemicals have been shown to interfere with bacterial adhesion and growth, plus anything that causes someone to pee more helps with the infection

61
Q

Pyridium

A

phenazopyridine; urinary analgesic OTC that relives pain, burning, urgency, and frequency that accompany UTIs
*but does not cure UTI and should not be used for more than 2 days or else it masks symptoms that may require more advanced treatment

62
Q

bladder antispasmodics

A

anticholinergic drugs that relax smooth muscle of urinary tract

63
Q

Ditropan

A

anticholinergic drug used to treat urge incontinence or overactive bladder; blocks all three muscarinic receptors

64
Q

Vesicare

A

solifenacin; selectively blocks M3 muscarinic receptor; anticholinergic drug used to treat urge incontinence or overactive bladder

65
Q

interstitial cystitis

A

disease of bladder spasm, frequency and urgency without any underlying bladder infection

66
Q

bacterial STIs

A

syphilis, gonorrhea, and chlamydia

67
Q

viral STIs

A

HSV (mostly type 2) and human papilloma viruses (genital warts)

68
Q

syphilis

A

bacterial STI caused by T. pallidin spirochete; treat with penicillin G and procaine penicillin (Bicillin)

69
Q

gonorrhea

A

bacterial STI caused by gram negative diplococcus N. gonorrhea; many strains are resistant to penicillin drugs so 3rd gen cephalosporins like Rocephin (ceftriaxone) or fluoroquinolone like ciproflaxacin is used
*discharge is big giveaway for diagnosis in males

70
Q

Chlamydia

A

bacterial STI caused by C. trachomatis; treat with amoxicillin, Cipro (ciproflaxacin), and/or Zithromax (azithromycin; macrolide)

71
Q

prevention of neonatal eye infections during transvaginal delivery

A

caused by chlamydia and gonorrhea organisms that cause STI; originally silver nitrate drops were used in eyes, but now erythromycin or ciproflaxacin drops are used b/c of less side e’s

72
Q

genital herpes

A

viral STI; most common STI with 1/5 active adults having it. Treat withi acyclovir-type drugs like Zovirax (acyclovir) or Valtrex (valacyclovir) or Famvir (famciclovir); val/fam is better because 1-2 pills a day instead of 5

73
Q

genital warts

A

viral STI; caused by strains of HPV (human papilloma virus) that is known to cause cervical cancer
Gardasil HPV vaccine can prevent warts and cervical cancer

74
Q

ED

A

erectile dysfunction; drugs to treat it are PDE-5 (phosphodiesterase-5) inhibitors that increase nitric oxide (NO) locally in penile vasculature and in lungs to cause vasodilation (so used for pulmonary hypertension too)

75
Q

Viagra

A

sildenafil; PDE-5 inhibitor for ED or pulm. HTN

76
Q

Cialis

A

tadalafil; PDE-5 inhibitor for ED or pulm. HTN

77
Q

Ortho tri-cycline

A

triphasic OC pill approved for treating acne

78
Q

Enovid

A

first oral contraceptive marketed in US in 1960s, was a progestin only drug

79
Q

main female progestogen

A

progesterone

80
Q

Provera

A

medroxyprogesterone; synthetic progestin

81
Q

Megace

A

megestrol; progestin used for cachexia

82
Q

sulfanilamide

A

one of first drugs we had to treat syphilis; three day regime combined with trimethoprim is still used with Bactrim and Septra DS for uncomplicated, non-recurrent UTIs

83
Q

penicillins for STIs

A

ampicillin, amoxicillin, penicllin G, procaine penicillin (Bicillin)

84
Q

cephalosporins for STIs

A

Keflex (cephalexin) and Rocephin (ceftriaxone)

85
Q

fluoroquinolones for STIs

A

Cipro (ciproflaxacin) and Levaquin (levoflaxacin)

86
Q

macrolide antibiotics for STIs

A

EES (erythromycin) and Zithromax (azithromycin)

87
Q

tetracycline antibiotics for STIs

A

Minocin (minocycline)

88
Q

Macrodantin

A

nitrofurantoin; nitrofuran antibiotic that interferes with protein synthesis; for prophylaxis of UTIs

89
Q

Levitra

A

vardenafil; PDE-5 inhibitor for ED or pulm. HTN

90
Q

PDE-5 inhibitors for BPH

A

decrease size of prostate gland in benign prostatic hypertrophy

Pre-pharmacology (27 decks)

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