Meds for Women's Health Flashcards
Define estradiol
main endogenous estrogen from the inside the body
Explain how estradiol and progesterone levels fluctuate during the menstrual cycle
estrogen is higher in the follicular phase and drop at ovulation
progesterone becomes higher in the luteal phase
Recite the reproductive roles of estrogen in women
development of secondary sex characteristics (breast, endometrium, etc.)
Describe the non-reproductive actions of estrogen in women
- strong bones (blocks bone resorption)
- Decreased vascular constriction (–> low BP, better tissue perfusion)
- lower LDL
List the routes of estrogen administration
- Oral
- Transdermal
- Intravaginal
Recall where one would apply an estrogen emulsion
Top of thighs & back of calves
Recall where one would apply an estrogen spray
Inner forearm
Recall where one would apply an estrogen gel
one arm from shoulder to wrist
Recall where one should apply an estrogen patch
intact skin (except breasts & waistline)
What are common indications for estrogen (estradiol)
sed for symptoms of menopause like vaginal dryness, itching and increased or painful urination, etc.!
List some of 3 adverse effects of estrogen therapy
- nausea
- increased risk of endometrial carcinoma (if used without progesterone)
- testicles fail to develop in male fetus
What are the risks of estrogen for women >65 years
- dementia
- DVT or stroke
Describe why constipation is more common in pregnant women
The answer is progesterone!
Progesterone suppresses uterine contraction & GI smooth muscle contraction
Recall the role of progesterone in pregnancy
In the event of conception, progesterone is the fundamental hormone facilitating pregnancy.
It maintains thickness of endometrium, prevent other eggs fertilization, relax uterine muscle, prevent lactation until birth, etc.
What are 4 therapeutic indications for progesterone
- Menopause
- Heavy uterine bleeding caused by imbalance of endogenous progestin
- Amenorrhea
- Support early pregnancy with IVF & if corpus luteum deficient
What are some adverse effects of progestin
- breast tenderness, headache, depression, abdominal discomfort, arthralgias
- for older people: risk of dementia, DVT, stroke, etc.
List 2 types of oral contraceptives (OCs)
- combination OC (progestin + estrogen)
- mini-pills (progestin only)
List contraindications to oral contraceptive use
- Cardiovascular problems (PE, DVT, heart disease)
- Diabetes, heavy smoking
- Seizures
- Postpartum
- Migraine with aura
What is the generic name of combination OC?
Ethinyl estradiol/norethindrone
Describe the mechanism by which estrogen and progestin prevent pregnancy in those taking combination oral contraceptives (OCs)
Estrogen: suppresses FSH release from AP (follicles do not mature)
Progestin: suppresses hormone LH release (ovulation does not occur)
Top 3 adverse effects of combination OC
- risk of developing clots
- Abnormal uterine bleeding
- risk of stroke
Recite the patient populations that should not take OCs
- history of thrombosis
- breast cancer
- known or possible pregnancy
- abnormal liver function
- Abnormal vaginal bleeding
- smoker over 35
Explain how antibiotics affect birth control (according to current research)?
Only rifampin has been proven to decrease effectiveness of birth control
Recall which medications can also lower the effect of birth control
- griseofulvin (anti-fungal)
- carbamazepine, phenytoin, primidone, phenobarbital
- some HIV meds
Review how taking oral contraceptives interacts with blood thinners
OCs can reduce the effect (increased levels of clotting factors), so the increased dosage may be required
Review how taking oral contraceptives interacts with hypoglycemic drugs
OCs can reduce the effect (increased level of glu), so the increased dosage may be required
List drugs that may lead to toxicity when taken with an oral contraceptive
- theophylline (bronchodilator; asthma, emphysema, chronic bronchitis)
- TCAs
- diazepam
- chlordiazepoxide (long-acting sedative; alcohol detox)
