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Pharm Final > Drugs for Reproductive Health > Flashcards

Drugs for Reproductive Health Flashcards

1
Q

what positive effects does estrogen have?

A

positive effect on bone mass and cholesterol levels

- increase skin vascularity

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2
Q

estrogen increases the risk of what?

A

thromboses

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3
Q

when is estrogen used?

A
  • birth control
  • menopause - hormone replacement
  • reproductive deficiency
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4
Q

what is the action of conjugated estrogen (Premarin)?

A

stimulates estrogen production

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5
Q

what form does conjugated estrogen (Premarin) come in?

A

PO, transdermal patch, IM, topical gel

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6
Q

what is hormone replacement therapy? what types are there?

A

the replacement of estrogen when ovaries no longer producing it

  • can be estrogen only
  • can be estrogen + progestin
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7
Q

what are the benefits of hormone replacement therapy?

A
  • relief of vasomotor symptoms
  • management of urogenital atrophy
  • prevention of osteoporosis and fractures
  • prevention of colon cancer
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8
Q

what are the risks of hormone replacement therapy?

A
  • nausea and fluid retention
  • thromboembolic events
  • endometrial cancer
  • breast cancer
  • ovarian cancer
  • dementia
  • gallbladder disease
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9
Q

when should hormone replacement therapy be used?

A
  • when benefits outway risks
  • should be shorter (less than 4 years)
  • use specifically for symptoms and adverse effects of menopause
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10
Q

what is the action of oral contraceptives?

A
  • inhibit ovulation

- thicken cervical mucous

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11
Q

what are the different types of oral contraceptives?

A
  • combination of estrogen and progestin

- progestin only

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12
Q

what are the different types of combination oral contraceptives?

A
  • monophasic
  • biphasic
  • triphasic
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13
Q

what is unique about monophasic combination oral contraceptives?

A
  • estrogen and progestin levels are constant

- more side effects

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14
Q

what is unique about biphasic combination oral contraceptives?

A
  • progestin dose increases second-half
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15
Q

what is unique about triphasic combination oral contraceptives?

A
  • progestin dose changes for each phase of the cycle

- most tolerated

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16
Q

what are the uses for oral contraceptives?

A
  • pregnancy prevention
  • decrease menstrual cramps (endometriosis)
  • acne
  • reduce symptoms of PMS
  • ovarian cysts
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17
Q

what are dosing regimens like for oral contraceptives?

A
  • 28 day cycle (21 days on, 7 days off)

- extended cycle (84 days of active pills, 7 days of low dose estrogen - better for endometriosis)

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18
Q

what are the adverse effects of oral contraceptives?

A
  • thromboembolism
  • hypertension
  • abnormal uterine bleeding
  • nausea
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19
Q

what are drugs that decrease the effectiveness of oral contraceptives?

A
  • barbiturates
  • benzodiazepines
  • rifampin
  • st. john’s wort
  • some seizure medications (carbamazepine. phenytoin)
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20
Q

what symptoms increase as progestin increases?

A
  • fatigue
  • weight gain
  • depression
21
Q

estrogen decreases the effectiveness of what drugs?

A
  • tamoxifen - breast cancer
  • sulfonylureas - diabetes
  • anticoagulants
22
Q

what are other forms of birth control?

A
  • transdermal patch (ethinyl estradiol + progestin)
  • NuvaRing (ethinyl estradiol + progestin)
  • subdermal implants
  • depot IM injections (progesterone)
23
Q

what drugs are used for BPH?

A
  • 5-alpha-reductase inhibitors (-teride)

- alpha 1 blockers

24
Q

what is the action of 5-alpha-reductase inhibitors (-teride)?

A

inhibits metabolism of testosterone, which decreases proliferation of prostate cells

25
Q

what does finasteride (proscar) do?

A

decreases the size of the prostate by blocking the active form of testosterone in prostate
- 5-alpha-reductase inhibitors (-teride)

26
Q

how long does it take for 5-alpha-reductase inhibitors (finasteride) to produce results?

A

6-12 months

27
Q

how long does it take for 5-alpha-reductase inhibitors (finasteride) to produce results?

A

6-12 months

28
Q

what is the normal dose for 5-alpha-reductase inhibitors (finasteride)?

A

5mg PO daily

29
Q

what are the adverse effects of 5-alpha-reductase inhibitors (finasteride)?

A
  • decreased libido

- gynecomastia

30
Q

true or false: 5-alpha-reductase inhibitors (finasteride) are only helpful if the prostate is very enlarged

A

true

31
Q

what is the action of alpha 1 blockers?

A

relax the smooth muscle of the prostate through alpha 1 blockage

32
Q

what are examples of alpha 1 blockers used for BPH?

A

doxazosin (cardura) and tamsulosin (flomax)

- osin

33
Q

what are the adverse effects of alpha 1 blockers (-osin)?

A
  • hypotension - second line treatment for HTN
  • dizziness
  • nasal congestion
  • blurred vision
  • abnormal ejaculation
34
Q

what 2 medications don’t mix for men?

A

viagra and nitroglycerin

35
Q

what type of drugs can treat erectile dysfunction?

A

phosphodiesterase type 5 inhibitors (-afil)

  • sildenafil (Viagra)
  • tadalafil (Cialis)
36
Q

what is the action of phosphodiesterase type 5 inhibitors (-afil)?

A

enhances effects of nitric oxide to enhance blood flow to the corpus cavernosum

37
Q

what are adverse effects of phosphodiesterase type 5 inhibitors (-afil) ?

A
  • headache
  • MI, sudden death
  • dyspepsia (indegestion)
  • flushing
38
Q

what are female causes of infertility?

A
  • anovulation
  • follicular immaturity
  • abnormal cervical mucus
  • increased prolactin levels
  • endometriosis
  • PCOS
39
Q

what are male causes of infertility?

A
  • decreased sperm motility

- erectile dysfunction

40
Q

what is the action of clomiphene citrate (Clomid)?

A

used for infertility

  • promotes follicular maturation and ovulation by blocking estrogen receptors
  • produces more follicles
41
Q

what should be monitored with the use of clomiphene citrate (Clomid)?

A

the risk of multiples

42
Q

what are the risks of clomiphene citrate (Clomid)?

A
  • nausea, bloating, breast enlargement
  • visual disturbances
  • multiple births (8-10%)
  • ovarian hyperstimulation syndrome
43
Q

what is the action of menotropins and follitropins?

A

used for infertility - IM

  • promote follicular development directly in ovaries
  • can be used with IVF
44
Q

what are the adverse effects of menotropins and follitropins?

A
  • ovarian hyperstimulation syndrome

- multiple births (15-20%)

45
Q

what is the difference between menotropins and follitropins?

A

menotropins - equal amounts of LH and HSG

follitropins - FSH

46
Q

what is the action of leuprolide (Lupron)?

A

prevents premature ovulation to improve the number of quality eggs

47
Q

what are the other uses of leuprolide (Lupron) besides infertility?

A
  • precocious puberty
  • endometriosis
  • advanced prostate cancer
48
Q

what are the adverse effects of leuprolide (Lupron)?

A

like menopause

  • hot flashes
  • mood swings
  • insomnia
  • vaginal dryness/painful intercourse

Pharm Final (5 decks)

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