CHAPTER 40 – DRUGS AFFECTING FERTILITY OR SEXUAL FUNCTIONING Flashcards
Jane is an 18 year old woman who takes Carbamazepine and Valporate for the treatment of partial seizures. She has consulted her GP regarding contraception. The GP advised Jane that a copper intrauterine Device may be more suitable for her than combined oral contraceptive ‘pill’.
Jane is an 18 year old woman who takes Carbamazepine and Valporate for the treatment of partial seizures. She has consulted her GP regarding contraception. The GP advised Jane that a copper intrauterine Device may be more suitable for her than combined oral contraceptive ‘pill’.
- Explain the most likely reason why Jane’s GP has recommended a copper IUD rather than the pill.
.-long lasting=long term effect (10 years-depending on type used)
- no need to remember to take it orally each day
- very effective form of contraception
- does not contain hormones which could be beneficial to those who can’t use hormones
- immediate reversible
- -highly cost effective
- What other contraceptive options could be considered in Jane’s case?
- depo (hormonal) injection
- implant (Implanon)
- vaginal ring
Phosphodiesterase-5 inhibitors are contraindicated in patients taking nitrates. If a nitrate is required, at least 24 hours should be allowed after the last dose of Sildenafil or Vardenafil, and 48 hours after Tadalafil before the nitrate is given.
Phosphodiesterase-5 inhibitors are contraindicated in patients taking nitrates. If a nitrate is required, at least 24 hours should be allowed after the last dose of Sildenafil or Vardenafil, and 48 hours after Tadalafil before the nitrate is given.
- Explain the mechanism and clinical basis for not using nitrates and phosphodiesterase-5 inhibitors together.
- they both can cause vasodilation of the blood vessels.
- PDE5 inhibitors interact with nitrates by decreasing the metabolism of nitric oxide induced activation of cGMP, thereby allowing more cGMP mediated smooth muscle relaxation or vasodilation.
- Why is it necessary for a longer period between treatment with Tadalafil and a nitrate?
It requires a longer period of time due Tadalafil has a longer half-life thereby needing a longer time before introducing a nitrate into the patients system.
