Female Reproductive Drugs Flashcards
most effective contraceptives
orals then condoms cyclebeads/sdm
then diaphrams
Oral contraceptives
hormones used to prevent pregnancy or regulate menses
most combination of estrogens & progestins
block ovulation
what reduces the effectiveness of OCPs
anticonvulsants ABX warfarin insulin some oral DM meds
Missed pills
if 1 take 2 pills next day same time
if 2 take 2 pills for the next 2 days
if 3 use alt form of contraceptive til next month
combination & progestin-only
combination contraceptives
act by providing negative feedback to pituitary (stop LH & FSH to prevent ovulation)
monophasic
biphasic
triphasic
combo contraceptives cons
mimic some symptoms of pregnanc (breast tenderness, nausea, bloating, appetite changes
monitor for s/s of thromboembolism
may increase risk of breast cancer
combination oral contraceptive examples
estrogen: ethinyl estradiol
progestin: desogestrel, norethindrone, norgestimate, progesterone
Contraceptive BBWs
if 35 y/o or older and heavy smoking (>15 cigs/day) increases risk of CV adverse effects [DON’T PRESCRIBE]
preg cat X
don’t give with st. john’s wort (bleeding)
serious complications of birth control pills (ACHES)
abdominal pain chest pain - shortness of breath headaches (sudden/persistent = CVA or ^ BP) eye problems = ^ BP severe leg pain (thromboembolic)
monphasic OCP
estrogen & progestin remain same thru month
biphasic OCP
E/P same first 21 days then E only for last 5 days
triphasic
E same 3 weeks but P changes each week
progestin-only contraceptives
no estrogen
take continuously
no week off
thick viscous mucous at cervix to discourage sperm penetration
less effective than combo
need to take at same time every day
doesn’t increase DVT or Breast cancer but increased menstrual irregularities
norethindrone
progestin only contraceptive
used for women who can’t take estrogen (usually during lactation)
SE: ectopic pregnancy, ovarian cysts, breast carcinoma, HA, irregular vaginal bleeding
contra: breast cancer, undiagnosed irregular bleeding, liver tumors
ortho-evra
transdermal patches )1 patch/week for 3 weeks 1 wk off)
combination mechanism
concern for reduced absorption in high BMI
nuvaring
vaginal ring
insert for 3 weeks 1 wk off
medroxyprogresterone (depoprovera)
injection Q3 months
inhibits effect of estrogen on uterus
SE: breakthrough bleeding, breast tenderness, weight gain, depression, HTN, n/v, dysmenorrhea
BBW: risk for thromboembolic disease, stroke, breast cancer, 65+ risk of dementia, risk of bone mineral loss
etonogesterel (nexplanon)
subdermal implant Q3 years
suppresses ovulation
increases viscosity of cervical mucus
SE: HA, vaginitis, weight increase, acne, ab pain, depression, menstrual irregularities, gallbladder disease
skyla, liletta
3 year intrauterine
mirena kyleena
5 yr intrauterine
paragard
10 yr intrauterine
conjugated estrogens
replacement for female sex hormones
mixture of different natural estrogens
TX: abnormal uterine bleeding due to hormonal imbalance, post-menopausal symptoms, hypogonadism, atrophy, increase bone density, reduce LDL
SE: nausea, fluid retention, edema, breast tenderness, ab cramps, bloating, acute pancreatitis, appetite changes, acne, depression, decreased libido, headache, fatigue, nervousness, weight gain
BBW: alone = higher risk of endometrial cancer and embolus
should not be used to prevent cardiovascular disease, or treat dementia
adding progestin can be protective
X
oxytocin
uterine stimulant
induces labor by increasing frequency & force of uterine contractions
given before partum by IV to increase frequency/force of contractions
given post partum to reduce hemorrhage
SE: fetus: dysrhthmias, intracranial hemorrhage, respiratory depression
maternal: uterine rupture (increased risk if more children)
BBW: don’t give for initiation of labor
interx: vasoconstrictors may cause severe HTN
X
magnesium sulfate
tocolytic
delays labor by 24-72 hrs
SE: comblete heart block, circulatory collapse, respiratory paralysis
hydroxyprogesterone
tocolytic
SE: thromboembolic disorders, clincal depression
nifedipine
tocolytic
SE: complete heart block
terbutaline
tocolytic
SE: bronchoconstriction
dysrhythmias
tachycardia for mom/fetus
dinoprostone
prostaglandin
cervical rippening
inserted into vagina at or near term pregnancy
SE: uterine hyperstimulation, fetal distress
BBW: uterine rupture, postpartum DIC (bleeding from everywhere)
contra: fetal distress, unexplained vaginal bleeding, previous cesarean, hx of ruptures
carboprost
labor inducer prostaglandin
causes intense smooth muscle contractions
indicated for postpartum hemorrhage
SE: hot flashes, wheezing, dypsnea, hypertension, palpitations, d
VVW: history of asthma, uterine rupture
C, only indicated after delivery
ergot alkaloid: methylergovovine
labor inducer
increases tone/rate/amplitude of contraction ions on smooth muscle of uterus
SE: shock, severe HTN, dysrhythmias
BBW: can cause uterine rupture
contra: HA, migraine, stroke, eclampsia, heart disease, renal disease, pulmonary disease
over 50 drug interx and grapefruit
only indicated after delivery
