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NURS 305 - Final > GU > Flashcards

GU Flashcards

1
Q

What is the drug class of ethinyl estradiol (Estinyl)?

A

Synthetic estrogen

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2
Q

ethinyl estradiol (Estinyl) is most commonly found in ______

A

Oral contraceptives

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3
Q

Describe ethinyl estradiol (Estinyl)

A
  • Combined with a progestin (norethindrone or drospirenone)
  • Monophasic, biphasic, triphasic, or quadriphasic
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4
Q

Describe monophasic

A

Estrogen / progestin dose same throughout cycle

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5
Q

Describe biphasic / triphasic / quadriphasic

A

Estrogen / progestin doses change to mimic typical menstrual cycle

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6
Q

Describe the MOA of ethinyl estradiol (Estinyl)

A

Suppresses ovulation, thicken cervical mucus & alter endometrial lining to prevent implantation

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7
Q

What is the goal of ethinyl estradiol (Estinyl)?

A

Prevent pregnancy / regulate menstruation

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8
Q

What is the primary drug interaction associated with oral contraceptives?

A

SERMs - already contain estrogen

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9
Q

What are the side effects of oral contraceptives?

A
  • Thromboembolic events
  • Hypertension
  • Depression
  • Breakthrough / irregular bleeding
  • Breast cancer
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10
Q

What are the side effects of estrogen?

A
  • Thromboembolism
  • Hypertension
  • Edema
  • Diarrhea / constipation
  • Facial skin discoloration
  • Tender breasts
  • Fluid retention
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11
Q

What are the side effects of progestin?

A
  • Thromboembolism
  • Liver dysfunction
  • Nausea / vomiting
  • Amenorrhea / spotting
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12
Q

What are the black box warnings associated with estrogen / progestin?

A
  • Endometrial cancer
  • CV disorders
  • Breast cancer
  • Dementia
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13
Q

What are the contraindications of oral contraceptives?

A
  • Pregnancy
  • Postpartum < 6 weeks
  • History of thromboembolism
  • Family history of breast cancer / estrogen-dependent cancer
  • CV events
  • Liver disease
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14
Q

Describe the education associated with oral contraceptives

A
  • Avoid smoking
  • Monitor BP
  • Report severe headaches
  • Record breakthrough bleeding
  • > 2 missed periods
  • Routine breast cancer screenings
  • Monitor glucose in diabetics
  • Check for pregnancy prior to testing
  • Take at same time every day
  • Begin sequence on first Sunday after onset of menstruation
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15
Q

Describe menopause

A
  • Permanent end of spontaneous menstruation
  • Cessation of ovary function
  • Can be natural or surgical
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16
Q

Describe post-menopause

A
  • Ovaries continue to secrete androgens
  • Increased levels of luteinizing hormone
  • Period of intense heat, tachycardia, and sleep disruption
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17
Q

What are the estrogens for menopause?

A
  • Conjugated Equine Estrogen
  • Estradiol
  • Estradiol Transdermal (Estraderm)
  • Estradiol Vaginal (Vagifem)
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18
Q

What are the estrogens / progestins for menopause?

A
  • Conjugated estrogen / medroxyprogesterone acetate (Prempro)
  • Estradiol / norethindrone acetate (Activella)
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19
Q

What is the function of estrogen / progestin for menopause?

A

Vasomotor symptom control

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20
Q

What causes the increased risk of hypertension associated with estrogens / progestins for menopause?

A

Arteriosclerosis / atherosclerosis

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21
Q

Describe endometrial hyperplasia / endometriosis

A

Excess growth of endometrium

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22
Q

All estrogen containing contraceptives must also contain ______ to prevent endometrial hyperplasia

A

Progestin

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23
Q

What is the drug class of leuprolide (Lupron)?

A

Gonadotropin-releasing hormone (Gn-RH) analogue

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24
Q

What are the indications of leuprolide (Lupron)?

A
  • Endometrial hyperplasia
  • Endometriosis
  • Prostate cancer
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25
Q

Describe the MOA of leuprolide (Lupron)

A

Inhibits gonadotropin release which suppresses estrogen production in women / testosterone production in men

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26
Q

What are the contraindications of leuprolide (Lupron)?

A
  • Pregnancy
  • Breastfeeding
  • Undiagnosed vaginal bleeding
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27
Q

What conditions require cautious use of leuprolide (Lupron)?

A
  • Electrolyte imbalances
  • QT prolongation
  • Bradycardia
  • Recent MI
  • CHF
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28
Q

What are the side effects of leuprolide (Lupron)?

A
  • Hot flashes / diaphoresis
  • Headache
  • Vaginitis
  • Depression
  • Edema
  • Insomnia
  • Seizures
  • Hepatotoxicity
  • QT prolongation
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29
Q

What are the drug interactions associated with leuprolide (Lupron)?

A
  • Lowers seizure threshold
  • Prolongs QT interval (amiodarone, quinolones, ondansetron)
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30
Q

Describe the monitoring associated with leuprolide (Lupron)

A
  • Glucose/A1C
  • Electrolytes - calcium, magnesium
  • EKG initially / with any concerns
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31
Q

What are the indications of medroxyprogesterone acetate (provera)?

A

Functional uterine bleeding caused by hormonal imbalance, endometriosis, and endometrial hyperplasia

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32
Q

Describe the MOA of medroxyprogesterone acetate (provera)

A

Inhibits pituitary gonadotropin release

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33
Q

medroxyprogesterone acetate (provera) is used in ______

A

Oral contraceptives

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34
Q

What are the contradictions of medroxyprogesterone acetate (provera)?

A
  • Undiagnosed vaginal bleeding
  • Liver disease
  • Breast cancer
  • Blood clotting issues
  • Recent MI / CVA recently
  • Current pregnancy
35
Q

What is the dosage of medroxyprogesterone acetate (provera)?

A

2.5 – 10 mg/day PO for a set number of days

36
Q

What are the side effects of medroxyprogesterone acetate (provera)?

A
  • Headache
  • Dizziness
  • Breast tenderness
  • Abdominal pain
  • Hypertension
  • Decreased bone density
37
Q

What are the adverse effects of medroxyprogesterone acetate (provera)?

A
  • Thromboembolic events
  • Pancreatitis
  • Intracranial meningiomas
38
Q

Describe the monitoring associated with medroxyprogesterone acetate (provera)

A
  • Amylase
  • Lipase

** For pancreatitis

39
Q

Testosterone (androderm) is a ______

A

Controlled substance - misused as bulking agent

40
Q

What is the primary indication of testosterone (androderm)?

A

Hypogonadism (inadequate levels of testosterone) due to disorders of the testes (primary) & disorders of the pituitary or hypothalamus (secondary)

41
Q

Describe testosterone (androderm)

A
  • Responsible for normal development & maintenance of primary & secondary male sex characteristics
  • Development of bone and muscle tissue
  • Inhibition of protein catabolism (metabolic breakdown)
  • Retention of various electrolytes
  • Stimulates the production of blood cells
42
Q

Describe the MOA of testosterone (androderm)

A

Binds to androgen receptors, producing multiple anabolic and androgenic effects

43
Q

What are the contraindications of testosterone (androderm)?

A
  • Prostate cancer
  • Male breast cancer
44
Q

What conditions require cautious use of testosterone (androderm)?

A
  • BPH
  • Elderly
  • Hepatic / renal impairment
  • CV disease
45
Q

What is the primary side effect of testosterone (androderm)?

A

Local skin irritation

46
Q

What are the adverse effects of testosterone (androderm)?

A
  • Thromboembolic events
  • Edema
  • BPH
  • Priapism
  • Prostate cancer
  • Hematuria
  • Dependency
  • Hepatitis
  • Respiratory distress
47
Q

What are the interactions associated with testosterone (androderm)?

A
  • Hypertension
  • Hypoglycemia
48
Q

What is the drug class of finasteride (propecia, proscar)?

A

5-alpha reductase inhibitor

49
Q

What is the primary indication of finasteride (propecia, proscar)?

A

BPH

50
Q

Describe the MOA of finasteride (propecia, proscar)

A

Decreases testosterone to decrease prostate size (BPH)

51
Q

What are the side effects of finasteride (propecia, proscar)?

A
  • Decreased libido
  • Gynecomastia
  • Increases hair growth (male pattern baldness)
52
Q

What are the contraindications of finasteride (propecia, proscar)?

A
  • Pregnancy
  • Liver disease
53
Q

Describe the education associated with finasteride (propecia, proscar)

A
  • Teach patient therapeutic effects may take 6 months or longer
  • Not to be handled by pregnant women – women to wear gloves when handling
54
Q

What is the drug class of tamsulosin (Flomax)?

A

Alpha 1 adrenergic antagonist – selective for prostate alph-1a receptors

55
Q

What is the primary indication of Tamsulosin (Flomax)?

A

BPH

56
Q

Describe the MOA of tamsulosin (Flomax)

A

Relaxes smooth muscle of bladder neck / prostate - improved urine flow/stream

57
Q

What are the side effects of tamsulosin (Flomax)?

A
  • Hypotension
  • Dizziness
  • Nasal congestion
58
Q

What is the primary contraindication of tamsulosin (Flomax)?

A

Hepatic / renal impairment

59
Q

What are the interactions associated with tamsulosin (Flomax)?

A
  • Antihypertensives,
  • Viagra
  • Nitroglycerin

** Increased / severe hypotension

60
Q

Describe the monitoring associated with tamsulosin (Flomax)

A

Monitor BP

61
Q

What is the drug class of sildenafil (Viagra)

A

Phosphodiesterase type 5 inhibitor

62
Q

What is the primary indication of sildenafil (Viagra)?

A

Erectile dysfunction

63
Q

Describe the MOA of sildenafil (Viagra)

A

Augments nitric oxide release with sexual stimulation to increase blood flow to corpus cavernosum / penis erection

64
Q

What are the adverse effects of sildenafil (Viagra)?

A
  • MI
  • Sudden death
  • Priapism
  • Sudden hearing loss
65
Q

What is the primary contraindication of sildenafil (Viagra)?

A

Nitrate use

66
Q

Describe the black box warning associated with sildenafil (Viagra)

A

Fatal hypotension can occur when used with nitrates

67
Q

Describe the education associated with sildenafil (Viagra)

A

Take 30 minutes to 4 hours before planned sexual activity

68
Q

What is the drug class of oxybutynin (Ditropan)?

A

Anticholinergic

69
Q

What are the indications of oxybutynin (Ditropan)?

A
  • Overactive bladder
  • Antispasmodic for neurogenic bladder with spinal cord injuries
70
Q

Describe the MOA of oxybutynin (Ditropan)

A

Relaxes detrusor muscle, increases constriction of internal sphincter (this may cause urinary retention)

71
Q

What are the contraindications of oxybutynin (Ditropan)?

A
  • Urinary / gastric retention
  • Uncontrolled angle-closure glaucoma
72
Q

What are the side effects of oxybutynin (Ditropan)?

A
  • Urinary retention
  • Tachycardia
  • Palpitations
  • Drowsiness
  • Confusion
  • Dilated pupils
  • Dry eyes
  • Dry mouth
  • Decreased GI secretions / motility (constipation)
  • Respiratory depression
73
Q

What is the dosage of oxybutynin (Ditropan)?

A

5 mg BID-QID; ER 5-30 mg/day in single or divided doses

74
Q

Describe the education associated with oxybutynin (Ditropan)

A

Transdermal patch available OTC - 1 patch twice weekly

75
Q

What is the drug class of bethanechol (Urecholine)?

A

Direct-acting cholinergic agonist

76
Q

What are the indications of bethanechol (Urecholine)?

A
  • Acute nonobstructive urinary retention
  • Management of urinary retention d/c neurogenic atony of bladder
77
Q

Describe the MOA of bethanechol (Urecholine)

A
  • Increases bladder (detrusor muscle) & GI tract tone & motility and Relaxes GU & GI sphincters
  • Stimulates the bladder to produce urinary frequency
78
Q

What are the contraindications of bethanechol (Urecholine)?

A
  • Hyperthyroidism
  • PUD
  • Asthma
  • CV disease
  • CAD
  • Epilepsy
  • PD
79
Q

What are the side effects of bethanechol (Urecholine)?

A
  • Syncope
  • Hypotension with reflex tachycardia
  • Seizures
  • GI upset
  • Asthma attack
80
Q

What is the dosage of bethanechol (Urecholine)?

A

10-50 mg TID-QID

81
Q

What is the drug class of phenazopyridine (Azo urinary pain relief)?

A

Local anesthetic on mucosa of urinary tract

82
Q

What is the primary indication of phenazopyridine (Azo urinary pain relief)?

A

Relieves burning with urination, pain, frequency, and urgency associated with UTI

83
Q

What are the contraindications of phenazopyridine (Azo urinary pain relief)?

A
  • AKI
  • CKD
84
Q

Describe the education associated with phenazopyridine (Azo urinary pain relief)

A
  • Urine will change to an orange-red color & may stain clothing and contacts
  • Advise patients to take with or after meals to minimize GI effects

NURS 305 - Final (1 decks)

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