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NU 308 Pharmacology > Exam 5 reproductive > Flashcards

Exam 5 reproductive Flashcards

1
Q

What is the action of conjugated equine estrogens?

A
  • growth and maturation of the female reproductive
    Tract
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2
Q

What are indications for conjugated equine estrogens?

A
  • Contraception with progesterone.
  • Acne in young females
  • Relief of moderate to severe postmenopausal S/S
  • Prevention of postmenopausal osteoporosis
  • Treatment of dysfunctional uterine bleeding
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3
Q

What are adverse effects of conjugated equine estrogens?

A
  • Black Box Warning: supervised use at
    the lowest dose for the shortest
    duration.
  • Increased risk of endometrial cancer
  • Increased risk of thromboembolic
    events(myocardial infarction, stroke,
    DVT, Pulmonary embolism
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4
Q

What are contraindications of equine estrogine?

A
  • Pregnancy Risk Category X
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5
Q

What do we teach patients on conjugated equine estrogens?

A

avoid all nicotine
notify provider of swelling or redness in legs, shortness of breath, or chest pain

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6
Q

What are nursing actions for conjugated equine estrogens?

A
  • Rule out estrogen-dependent breast
    cancer before starting therapy.
  • Monitor for pain, swelling, warmth, or
    erythema of lower legs(DVT)
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7
Q

What are indications for medroxyprogesterone?

A

Contraception, alone or with estrogens
Dysfunct. uterine bleeding R/T hormonal imbalance
* Amenorrhea due to hormonal imbalance
* Endometriosis
* Advanced cancer of the endometrium, breast, and
kidney
* Facilitation of in vitro fertilization

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8
Q

What are adveres effects of medroxuyprogesterone?

A

Breast cancer In post menopause when used w/estrogens
* Thromboembolic events MI, pulmonary embolism,
thrombophlebitis, stroke
* Breakthrough bleeding,
* amenorrhea,
* breast tenderness
* Edema
* Migraine

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9
Q

What are administration considerations for medroxyprogesterone?

A
  • Administer progestins through oral, IM, subcutaneous,
    intrauterine, intravaginal, or transdermal routes.
  • Vaginal inserts are administered using an applicator from
    the manufacturer
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10
Q

What are contraindications for medroxyprogesterone?

A

Pregnancy Risk Category X

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11
Q

What do we teach patients on medroxyprogesterone?

A

discourage smoking
* Report abnormal vaginal bleeding
* Notify the provider of severe headache.
* Anticipate withdrawal bleeding 3to7days after stopping
the medication

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12
Q

What do we monitor for with medroxyprogesterone?

A

Monitor for pain, swelling, warmth, or erythema of
lower legs

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13
Q

What is the action of hormonal contraceptives?

A
  • Oral contraceptives stop conception by
    preventing ovulation. They also thicken the
    cervical mucus and alter the endometrial
    lining to reduce the chance of fertilization
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14
Q

What are indications for hormonal contraceptives?

A

prevent pregnancy
Reducing menstrual cramping, which can help
with dysmenorrhea
* Protection against endometrial and ovarian
cancers

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15
Q

What are adverse effects of hormonal contraceptives?

A

Thrombolytic events: thrombophlebitis, stroke:
Unlikely with progestin-only OCs
* HTN
breast cancer

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16
Q

How do we administer hormonal contraceptives?

A

Most combination OCs are given in a cyclic
pattern, usually in a 28-day regimen
Inform the client that the injection is
repeated every 3 months.

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17
Q

What are contraindications for hormonal contraceptives?

A

pregnancy cat X
Antibiotics may ↓ the effectiveness of oral contraceptives

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18
Q

What do we teach patients on hormonal contraceptives?

A
  • Avoid smoking.
  • Report warmth, edema, tenderness, or pain in
    lower legs
  • If taking OCs, take pill every day at
    approximately the same time, and for any
    missed pills, follow provider instructions for
    catching up and use a back-up contraceptive
    method for pregnancy prevention.
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19
Q

Who do we avoid giving hormonal contraceptives to?

A

clients with breast cancer

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20
Q
A
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20
Q

What are indications for testosterone?

A
  • Hypogonadism in males
  • Delayed puberty in males
  • Androgen replacement in testicular failure or
    menopause

postmenopausal breast cancer

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21
Q

What are adverse effects of testosterone?q

A
  • Acne
  • Hair loss
  • Prostate enlargement
  • Women: deepening of the voice,
    hirsutism, and menstrual irregularities
  • Reduced sperm count
  • Liver dysfunction
  • Polycythemia- increased blood
    production
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22
Q

How do we administer testosterone?

A
  • IM, transdermal, implantable pellets, buccal
    tablets
  • Instruct clients using gel formulas to wash their
    hands after application due to the possibility of
    skin-to-skin transfer to others
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23
Q

What are contraindications for testosterone?

A

Pregnancy Risk Category X
*Preexisting liver disease
*Disorders of the prostate(may
cause additional enlargement of
the prostate or tumor growth

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24
Q

What do we teach patients about testosterone?

A

Discuss adverse effects with the provider. If
effects are undesirable, medication might need
to be stopped to prevent permanent changes

25
Q

What do we monitor for with testosterone?

A
  • Monitor for jaundice/ liver enzymes
  • Do not give to clients who have
    prostate cancer
  • Watch for possible abuse
26
Q

What are indications for finasteride?

A
  • Benign prostatic hyperplasia
  • Male pattern baldness—finasteride in
    smaller doses
27
Q

What are adverse effects of finasteride?

A
  • Sexual Dysfunction- ED
  • Gynecomastia
28
Q

What administration consideration regarding pregnant people and finasteride should we teach?

A

Pregnant clients should not handle crushed
or broken medication

29
Q

What are the contraindications for finasteride?

A

pregnancy risk X

30
Q

What do we teach patients on finasteride?

A
  • Therapeutic effects can take 6 months or
    longer.
  • Do not donate blood unless medication
    has been discontinued for at least 1
    month
31
Q

What are indications for tamsulosin?

A
  • BPH, thus increasing urinary flow
  • Off-label use for females for treatment
    of urinary hesitancy or urinary retention
32
Q

What are adverse effects of tamulosin

A
  • Hypotension, dizziness, nasal
    congestion, sleepiness, faintness
  • Problems with ejaculation
33
Q

How do we administer tamsulosin?

A

monitor BP
30 min after a meal same time every day

34
Q

What do we teach patients on tamsulosin?

A

Rise slowly from sitting or lying
position
Do not take with Sildenafil

35
Q

What is the action of sildenafil?

A

Augments the effects of nitric oxide released
during sexual stimulation, resulting in enhanced
blood flow to the corpus cavernosum and penile
erection

36
Q

what are indications for sildenafil?

A

erectile dysfunction

37
Q

what are adverse effects of sildenafil?

A
  • MI, sudden death
  • Priapism (erection > 4 hours)
  • Sudden hearing los
38
Q

What are administration considerations for sildenafil?

A

if using sildenafil to treat pulmonary artery HTN,
administer TID at least 4 hr apart
If taking these meds for erectile dysfunction, do
not exceed one dose in 24 hr

39
Q

What are contrainidcations for sildanefil?

A

Contraindicated in clients taking any meds in the
nitrate family (nitroglycerin- NTG)
grapefruit juice inhibit metabolism of
sildenafil, thereby increasing plasma levels of
medication.
* Organic nitrates, such as nitroglycerin and
isosorbide dinitrate, can lead to fatal
hypotension

40
Q

What do we teach pts on sildenafil?

A

Notify provider if a erection lasts > 4
hr

41
Q

What do we monitor for with sildenafil

A

Monitor risk factors and history
regarding CV health

42
Q

What is the action of oxytocin?

A

Uterine stimulants increase the strength,
frequency, and length of uterine contractions

43
Q

What are indications for oxytocin?

A

Induction of labor
* Augmentation of labor
* Delivery of placenta (postpartum,
miscarriage)
* Management of postpartum hemorrhage

44
Q

What are adverse effects of oxytocin?

A

Uterine rupture, uterine
tachysystole, placental abruption

45
Q

What are adverse effects of misoprostol?

A

Uterine tachysystole, non-
reassuring fetal heart rate

46
Q

What are adverse effects of methylregonovine?

A

hypertensive crisis

47
Q

What are contraindications/precautions for oxytocin?

A

active genital herpes
Immature lungs,
cephalopelvic-disproportion, fetal
malpresentation, prolapsed umbilical
cord, fetal distress

48
Q

What are contraindications for oxytocin?

A

HTN &
preeclampsia

49
Q

How do we administer oxytocin?

A

Use an IV pump for oxytocin. Gradually
increase rate as prescribed
*Monitor VS q30 to 60 min and with
every dosage change

50
Q

What is the goal with oxytocin?

A

Goal is contractions that last 45 to 60
seconds or less q2 to 3 min.

51
Q

What is the action of terbutaline?

A

Selectively activates beta2-
adrenergic receptors resulting in
uterine smooth muscle relaxation.

52
Q

What are indications for terbutaline?

A

Subcutaneous terbutaline can be used for up to
48 hours to delay but not prevent preterm labor

Calcium gluconate should be available to
administer as an antidote for magnesium sulfate
toxicity

53
Q

What are adverse effects of terbutaline?

A

Maternal: Tachycardia, palpitations, chest pain,
hypotension, hypokalemia, hyperglycemia
*Fetal: Tachycardia

54
Q

What are adverse effects of magnesium sulfate?

A

Maternal: Hypocalcemia, hot flashes, dyspnea,
transient hypotension
*Intolerable: Respirations less than 12/min, pulmonary
edema, altered LOC, severe hypotension, urine output
less than 25 mL/hr, blood magnesium level 10mEq/L
or greater (norm 1.3-2.1mEq/L)

55
Q

How do we administer terbutaline?

A

Terbutaline is administered subcutaneously.
Monitor injection site for infection.
* Assess maternal heart rate before and after
administering terbutaline.
* Withhold terbutaline and contact the
provider for reports of chest pain, maternal
heart rate greater than 120/min, or
presence of cardiac arrhythmias

56
Q

What do we teach patients on terbutaline?

A

Avoid green tea and Beta
Blockers

57
Q

What do we monitor for with magnesium sulfate?

A

Monitor for toxicity (thirst,
confusion, decreased or absent
reflexes)

58
Q

What are the actions of glucocorticoids?

A

Releases enzymes that produce and
release lung surfactant to
stimulate lung maturity in a fetus
Other Meds

59
Q

What are indications for glucocorticoids?

A

Reduce neonatal respiratory distress
syndrome, intraventricular
hemorrhage, necrotizing
enterocolitis and death

60
Q

What do we teach pts on glucocorticoids?

A

Patient to return in 24 hours for
second dose of Betamethasone

NU 308 Pharmacology (23 decks)

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