Medications affecting Reproduction Flashcards
CEE
conjugated equine estrogen
*estrogen replacement
drug names
- CEE
- Estradiol
- Ethyl Estradiol
- Drospirenone
CEE, estradiol, ethyl estradiol, + drospirenone MOA/route
- HRT (horm therapy)
- prevent ovulation
-often PO or patch
CEE, estradiol, ethyl estradiol, + drospirenone Tx
- contraception along w progestin
- acne
- relief of severe postmeno s/s
- prevention of postmeno OSTEOPOROSIS
- prostate cancer
CEE, estradiol, ethyl estradiol, + drospirenone
CI
- *cigarette/nicotine + <35yr+
- Cat X
- fam Hx of hrt disease
- atypical vaginal bleeding
- breast or estrogen-dependent CA
- Hx of thromboembolic disease
*CEE, estradiol, ethyl estradiol, + drospirenone
AE
- endometrial, breast, ovarian cancer
- hypercoagulability
____, is administered along with estrogen to decrease the risk of endometrial, breast, + ovarian cancer
progestins
CEE, estradiol, ethyl estradiol, + drospirenone causes hypercoagulability which can lead to…
- DVT
- stroke
- MI
**CEE, estradiol, ethyl estradiol, + drospirenone
RN/teach
- endometrial biopsy Q2yrs
- breast exam Qyr
- avoid cig/nicotine esp 35+
- monitor for DVT
- DO NOT place patch near breast + waistline
- admin same time each day
progesterones vs progestins
progestines are synthetic
*progesterone replacement
drug names
medroxyprogesterone + norethindrone
medroxyprogesterone + norethindrone
Tx
- contraception
- lowers A/E of estrogen in hormonal therapy
- protects fr endometrial cancer
medroxyprogesterone + norethindrone
A/E
-breast cancer
-thromboembolic events
-breakthrough bleeding
-amenorrhea
migraines
medroxyprogesterone + norethindrone
CI
- cat X
- Hx of DVT or CVD
*medroxyprogesterone + norethindrone
RN/teach
- *anticipate withdrawal bleeding 3-7 days after stopping the medication
- —–if the A/E is amenorrhea, it makes sense that bleeding would recommence
- smoking incr risk for thrombophlebitis
- IM injections 4x/yr
why would we administer ethinyl estradiol + norethindrone as a combination?
combo med has fewer side effects
-reduces blood loss + muscle cramping
combo med: ethinyl estradiol + norethindrone
MOA/routes
- blocks FSH/LH
- via transdermal patch, contraceptive ring, parenteral depot, etonogestral implants
combo med: ethinyl estradiol + norethindrone
Tx
- contraception
- protects against endometrial + ovarian cancer
combo med: ethinyl estradiol + norethindrone
A/E
- hyperglycemia
- hyper-K
- thromboembolic events
- breakthru bleeding
- breast cancer
nursing safety w all hormone therapy?
careful w handling
depot injections
-injection formulation of a med which RELEASES SLOWLY OVER TIME
- IM or subQ
- —not IV! that is literally the opposite of slowly over time
what is the longest-acting contraception?
IUD-10 yrs
androgen replacement
drug names
testosterone HRT + oxandrolone
*testosterone HRT + oxandrolone
Tx
- cachexia
- longevity + quality of life
testosterone HRT + oxandrolone
A/E
- virilization effects
- epiphyseal closure (in kids)
- hepatitis
- hyper-cholesterol
- polycythemia
- hyper-Ca
- hypoglycemia
testosterone HRT + oxandrolone
CI
- cat X
- prostate/breast cancer
testosterone HRT + oxandrolone
RN teaching
w gel formula, wash hands after every application to reduce risk of SKIN TO SKIN TRANSFER
-cover application w clothing after gel has dried + wash off before skin to skin contact
BPH drugs
5-alpha: finasteride + dutasteride
alpha 1: tamsulosin + doxazosin
finasteride + dutasteride
MOA
blocks conversion of TESTOSTERONE
finasteride + dutasteride
A/E
- decr libido
- gynecomastia
- decr PSA levels
finasteride + dutasteride
onset
lifelong therapy
long lonely ride
finasteride + dutasteride
RN teaching
female clients shouldnt handle medication
–wear gloves
–avoid semen
onset takes 6 mos or more
tamsulosin + doxazosin
Tx
- BPH
- HTN
- helps w urination (relax bladder neck + prostate muscle)
tamsulosin + doxazosin
A/E
- hypotension
- dizzy
- retro ejac
- floppy iris syndrome
tamsulosin + doxazosin
CI
clints using sildenafil or NTG
- Hx of syncope
- cataract surgery
tamsulosin + doxazosin
RN/teaching
lifelong
- 30 min after meals
- onset 48hr
