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OB pharm > medication therapy for women's health and infertility > Flashcards

medication therapy for women's health and infertility Flashcards

1
Q 
Required for:
•Development and maintenance of female reproductive system
Indications:
•Premature ovarian failure
•Atrophic vaginitis
•Hypogonadism
•Oral contraception
•Dysmenorrhea
•Hot flashes of menopause
•Osteoporosis treatment
•Dysfunctional uterine bleeding
A

Premarin, estrace, Estraderm

estrogens

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2
Q 
Adverse Effects:
•Thrombolytic events –most serious
•Nausea & Vomiting
•Hypertension, Edema, Thrombophlebitis
•Constipation, Abdominal Pain
•May cause photosensitivity, choloasma
•Breast tenderness
•Headaches
•Fluid retention
•Breast, Endometrial and Ovarian Cancer
A

Premarin, estrace, Estraderm

estrogens 2

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3
Q

Contraindications:
•Any estrogen dependent cancer
•Undiagnosed abnormal vaginal bleeding
•Active thromboembolic disorder or history

A

Premarin, estrace, Estraderm

estrogens 3

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4
Q

Patient Teaching:
•Do not take if pregnant
• Grapefruit and grapefruit juice may interact with
estradiol and lead to unwanted side effects
•Notify HCP if signs of heart disease, blot clots,
abnormal vaginal bleeding or other s/s of cancer
especially breast, endometrial or ovarian.

A

Premarin, estrace, Estraderm

estrogens 4

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5
Q

mportant for the regulation of ovulation and menstruation.
• Indications:
• Functional uterine bleeding
• Primary and secondary amenorrhea
• Leiomyoma (fibroids)
• Palliative treatment of some cancers and endometriosis
• Used with estrogen replacement after menopause
• Used for weight gain for patients with cancer or AIDS

A

Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone

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6
Q

Benefits:
• No effect on lactation
• No increased risk of venous thromboembolism
• Mild anticonvulsant – consider as contraception in seizure disorder

A

Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 2

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7
Q 
Adverse Effects:
• Blood clots
• Edema
• Liver Dysfunction
• Nausea and Vomiting
• Weight Gain or Loss
• Amenorrhea
• Increase Breast Cancer
A

Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 3

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8
Q

Patient Teaching:
• Do not take if pregnant or peanut allergy
• May develop break through bleeding
• Do not take if there is a history of heart disease or bleeding disorders

A

Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 4

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9
Q 
Actions:
• Prevents ovulation by inhibiting release of gonadotropins
• Increase uterine mucous viscosity
Metabolism: Renally
Indications:
• Treatment of acne
• Relieve the symptoms of premenstrual dysphoric disorder
• Treatment of abnormal uterine bleeding
• Family planning
A

Contraceptives

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10
Q

Forms of Medications:
• Oral –most estrogen-progestin combinations
• Injection: Medroxyprogesterone acetate (Depro-Provera)
• Transdermal Patch
• Vaginal Ring (NuvaRing)
• Progestin IUD (Mirena, Skyla)

A

contraceptives 2

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11
Q 
Adverse effects:
• Hypertension
• Thromboembolism
• Alterations in lipid and carb metabolism
• Increases in serum hormone concentrations
• Edema
• Headache
• Weight gain
• Breast changes
• Nausea and vomiting
A

contraceptives 3

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12
Q

Patient teaching:
• Take medications at same time daily
• Do not skip a dose
• Follow instructions if missed dose
• Avoid smoking
• Notify HCP if any s/s of adverse effects appear
• Antibiotics can cause decrease in effectiveness

A

contraceptives 4

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13
Q 
Stimulates Ovulation
Adverse Effects
• Common
• Decreased cervical mucus
• Hot flashes
• Less common
• Pelvic Pain
• Nausea
• Mastalgia
• May exacerbate premenstrual symptoms
A 
Clominphene citrate (clomid)
infertility medications
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14
Q 
Complications:
• Multiple pregnancy (twins most common)
• Mild ovarian hyper-stimulation
• Venous Thromboembolism
• Increased ovarian cancer risk
Patient Teaching:
• Important to report visual changes, ascites abdominal pain, weight gain,
shortness of breath
• Common side effects include:
• Flushing, GI distress, mastalgia, headache, abnormal vaginal bleeding
A 
Clominphene citrate (clomid)
infertility medications 2
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15
Q

Indicated for luteal phase deficiency (LPD)
• Fertilization takes place and fertilized egg is released but does not implant into the
lining of the uterus.
• Ovarian follicle that released the egg does not turn into a corpus luteum.

A

Progesterone oral or injections

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16
Q

Treatment: IVF patients prescribed progesterone (oral or injection) during the
second half of the menstrual cycle up to first/second trimester
• No scientific studies have found definitive evidence that progesterone
supplements prevent miscarriage in women who are not using artificial
reproduction methods

A

Progesterone oral or injections 2

17
Q

GnRH antagonists (Leuprolide & Gonadorelin)
• Binds to gonadotropin-releasing hormone
receptors and decrease the effect of gonadotropinreleasing
hormone.
Indications:
• uterine fibroids
• endometriosis

A 
GnRH antagonists (Leuprolide & Gonadorelin)
Gonadotropin-Releasing Hormone
Antagonists
18
Q 
Adverse Effects:
• Hot flashes
• Headaches
• N&V
• Constipation
• Emotional lability
• Vaginititis & Decreased libido
• Severe Reactions: cardiac complications including heart failure and
arrhythmias
Patient Teaching:
• Do not use if pregnant or lactating
• Monitor for dehydration closely due to N&V
A 
GnRH antagonists (Leuprolide & Gonadorelin)
Gonadotropin-Releasing Hormone
Antagonists 2
19
Q

Initially causes synthesis and release of luteinizing hormone (LH) and
follicle-stimulating hormone (FSH). With continued use (more than 4
wk) suppresses secretion of LH and FSH
Indications:
• Endometriosis symptoms such as pelvic pain, menstrual cramps and
dyspareunia
• Central precocious puberty in male and females

A 
Nafarelin acetate (synarel)
Gonadotropin-Releasing Hormone
Antagonists
20
Q

Adverse Effects:
• Headaches; insomnia; depression.
• Acne; seborrhea.
• Nasal irritation.
• Vaginal dryness.
• Hot flushes; decreased libido; emotional lability; myalgia; reduced breast
size; edema; weight gain; hirsutism; decreased bone density
Patient Teaching: Do not use if pregnant or lactating

A 
Nafarelin acetate (synarel)
Gonadotropin-Releasing Hormone
Antagonists 2
21
Q

Indications:
• Anaerobic bacterial infection (BV, C-diff, bacteroides fragilis)
• Protozoal infections (Trichomoniasis, amebiasis & giardiasis)
• An antibiotic. Covalently binds to DNA resulting in disruption of its helical
structure, inhibiting bacterial nucleic acid synthesis and resulting in bacterial
cell death
• Metabolism: Hepatic

A

Metronidazole (Flagyl) (first line medication)

Bacterial vaginosis

22
Q

Adverse Effects:
• Antabuse like effects (Never use with alcohol)
• GI intolerance
• Neurotoxicity (stop immediately with s/s of seizures, encephalopathy,
cerebellar dysfunction or peripheral neuropathy)
Patient Teaching: Do not use in first trimester

A

Metronidazole (Flagyl) (first line medication)

Bacterial vaginosis 2

23
Q

Indications:
• Anaerobic bacterial infection (BV, C-diff, bacteroides fragilis)
• topically to treat acne
• intra-abdominal or pelvic infections, osteomyelitis, diabetic foot ulcers,
aspiration pneumonia and dental infections
An antibiotic. Inhibits bacterial protein synthesis by binding to bacterial
ribosomal subunits
• Metabolism: Hepatic

A

Clindamycin (Cleocin HCl)

Bacterial vaginosis

24
Q

Adverse Effects:
• Pseudomembranous colitis (severe diarrhea)
• GI distress
Patient Teaching: Take entire dose to prevent development of antibiotic
resistance.

A

Clindamycin (Cleocin HCl)

Bacterial vaginosis 2

25
Q

Indications:
-Treats vaginal yeast infections
-relieves external itching and irritation
• Anti-fungal medication.
• Prevents fungal organisms from producing vital substances required for growth
and function

A

Miconazole (Gyn-Lotrimin, Mycelex G, Monistat)

yeast - candida albicans

26
Q 
Adverse Effects:
• Headache
• Vaginal/urethral burning/itching/pain may occur
 Patient Teaching:
• Vaginal use only
A

Miconazole (Gyn-Lotrimin, Mycelex G, Monistat)

yeast - candida albicans 2

27
Q

an antioxidant
• Plays a role in the immune system and metabolic
processes
• Fat soluble
• GYN indication: Fibrocystic breast
• Patient teaching: good sources of vitamin E include vegetable oils,
margarine, nuts and seeds, leafy greens. Also added to certain foods
like cereal.
• May be harmful if taking blood thinners

A

Vitamin E

28
Q

Aids the body with utilization of energy from foods
•Water soluble
• GYN indication: Premenstrual Dysphoric Disorder
• Patient teaching: good sources of vitamin B6 include fish, poultry,
meat, eggs and dairy products. Leafy green vegetable, beans and
peas. Many cereals and breads have added B vitamins

A

Vitamin B6 (pyridoxine)

29
Q

Key role in bone health, maintains heart rhythm and
muscle function
• GYN indication: Premenstrual Dysphoric Disorder
• Patient teaching:
• Constipation and GI upset is common side effect
• Foods rich calcium include dairy products, dark-green
leafy vegetables and calcium-fortified foods (e.g., orange
juice)
• Vitamin D helps with absorption of calcium

A

calcium

30
Q

Immunostimulant for preventing and treating infection
• Adverse Effects: Opportunistic infections, Impaired Wound Healing &
Hepatotoxicity with prolonged use
• No Evidence Based Research (EBR) it improves cold symptoms

A

Echinacea

31
Q

moderate lipid lowering & antihypertensive effect,
improves milk production with breastfeeding
Adverse Effects:
-Halitosis & altered body odor, GI upset & Flatulence

A

Garlic

32
Q

psychological benefit & improved immune function
• Adverse Effects: Hypoglycemia, HTN, GI distress, Insomnia &
Headaches

A

Ginseng

33
Q

a remedy for skin conditions including burns, sunburn, frostbite,
psoriasis, and cold sores, used on areola and nipples after
breastfeeding
• Adverse Effects: aloe gel contains latex
• Wash off prior to breastfeeding to minimize diarrhea in infant

A

aloe

34
Q

improves insomnia
• Adverse Effects: Sleepiness on awakening, Headache, GI distress,
Withdrawal symptoms when stopped (similar to benzodiazepine
withdrawal)

A

valerian

35
Q
  • Avoid Vitamin A in excess of 3000 IU per day

* Avoid Vitamin D in excess of 400 IU per day

A

vitamins

36
Q
  • Devil’s claw root - decrease inflammation , swelling & resulting pain.
  • Barberry – improves heart rate and decrease inflammation
  • Dong Quai - menstrual cramps, PMS and menopausal symptoms
  • High concentrations of Oregano - helps reduce cough and spasms
A

herbals associated with miscarriage

37
Q

Ginkgo - improves blood circulation
• Ephedra – stimulates the heart but is banned in the USA
• Ginseng - used for stress, to boost the immune system & stimulant.
• Goldenseal- treatment of urinary tract infections, upset stomach irregular,
menstrual periods, chronic fatigue syndrome

A

Other herbal teratogens

OB pharm (7 decks)

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