medication therapy for women's health and infertility Flashcards
(37 cards)
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
Premarin, estrace, Estraderm
estrogens
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
Premarin, estrace, Estraderm
estrogens 2
Contraindications:
•Any estrogen dependent cancer
•Undiagnosed abnormal vaginal bleeding
•Active thromboembolic disorder or history
Premarin, estrace, Estraderm
estrogens 3
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.
Premarin, estrace, Estraderm
estrogens 4
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
Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone
Benefits:
• No effect on lactation
• No increased risk of venous thromboembolism
• Mild anticonvulsant – consider as contraception in seizure disorder
Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 2
Adverse Effects: • Blood clots • Edema • Liver Dysfunction • Nausea and Vomiting • Weight Gain or Loss • Amenorrhea • Increase Breast Cancer
Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 3
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
Depot-Medroxyprogesterone (Depo-Provera) and
Megace
Progesterone 4
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
Contraceptives
Forms of Medications:
• Oral –most estrogen-progestin combinations
• Injection: Medroxyprogesterone acetate (Depro-Provera)
• Transdermal Patch
• Vaginal Ring (NuvaRing)
• Progestin IUD (Mirena, Skyla)
contraceptives 2
Adverse effects: • Hypertension • Thromboembolism • Alterations in lipid and carb metabolism • Increases in serum hormone concentrations • Edema • Headache • Weight gain • Breast changes • Nausea and vomiting
contraceptives 3
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
contraceptives 4
Stimulates Ovulation Adverse Effects • Common • Decreased cervical mucus • Hot flashes • Less common • Pelvic Pain • Nausea • Mastalgia • May exacerbate premenstrual symptoms
Clominphene citrate (clomid) infertility medications
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
Clominphene citrate (clomid) infertility medications 2
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.
Progesterone oral or injections
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
Progesterone oral or injections 2
GnRH antagonists (Leuprolide & Gonadorelin)
• Binds to gonadotropin-releasing hormone
receptors and decrease the effect of gonadotropinreleasing
hormone.
Indications:
• uterine fibroids
• endometriosis
GnRH antagonists (Leuprolide & Gonadorelin) Gonadotropin-Releasing Hormone Antagonists
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
GnRH antagonists (Leuprolide & Gonadorelin) Gonadotropin-Releasing Hormone Antagonists 2
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
Nafarelin acetate (synarel) Gonadotropin-Releasing Hormone Antagonists
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
Nafarelin acetate (synarel) Gonadotropin-Releasing Hormone Antagonists 2
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
Metronidazole (Flagyl) (first line medication)
Bacterial vaginosis
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
Metronidazole (Flagyl) (first line medication)
Bacterial vaginosis 2
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
Clindamycin (Cleocin HCl)
Bacterial vaginosis
Adverse Effects:
• Pseudomembranous colitis (severe diarrhea)
• GI distress
Patient Teaching: Take entire dose to prevent development of antibiotic
resistance.
Clindamycin (Cleocin HCl)
Bacterial vaginosis 2
