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Pharmacology II > Menstrual Related Disorders > Flashcards

Menstrual Related Disorders Flashcards

1
Q

PCOS

A

-can present with amenorrhea, menorrhagia or anovulatory bleeding
-Androgen disorder
Tx: Metformin

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2
Q

Amenorrhea due to hyperprolactinemia: Tx

A

dopamine agonist

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3
Q

Anovulation due to PCOS: Tx

A

If trying to get pregnant: clomiphene citrate +/- Metformin

If not trying to get pregnant: Metformin +/- oral contraceptive with progesterone with reduced antiandrogenic effects

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4
Q

Dopamine agonist: ADE

A
  • hypotension
  • nausea
  • constipation
  • anorexia
  • Raynaud’s
  • fatigue
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5
Q

What is important to know about using dopamine agonist to treat amenorrhea with St. John’s Wort?

A

St. John’s Wort induces CP3A4 so coadministration can lead to treatment failure

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6
Q

Combination oral contraceptives, how long do you need to take these before seeing benefit with amenorrhea, dysmenorrhea, or menorrhagia?

A

1-2 months

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7
Q

Which drugs should you be mindful about coadministering with combination oral contraception?

A
  • St. John’s Wort - contributes to altered menstrual bleeding
  • Rifampin induces estrogen metabolism (so may reduce or nullify benefit with OCP)
  • Sulfa-containing drugs may contribue to photosensitivity
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8
Q

What difference is there between oral contraceptives and the ethnyl estradiol transdermal patch?

A

transdermal pass has less effect on cholesterol since it avoids first pass effect

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9
Q

What is first line nonpharmacologic treatment for dysmenorrhea?

A

topical heat

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10
Q

1st line pharmacologic treatment for dysmenorrhea?

A

NSAIDs

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11
Q

2nd line pharmacologic treatment for dysmenorrhea?

A

hormonal contraception for 2-3 cycles

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12
Q

3rd line pharmacologic treatment for dysmenorrhea?

A

depo MPA (IM) or LNG- IUD

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13
Q

What is the sequence of drugs for menorrhagia for a woman who doesn’t want contraception?

A
  1. NSAIDs
  2. Tranexamic acid OR proesterone during the luteal phase
  3. LNG-IUD
  4. Conservative Endometrial ablation
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14
Q

What is the sequence of drugs for menorrhagia in a patient who wants contraception?

A
  1. LNG-IUD
  2. Oral contraception
  3. Conservative endometrial ablation
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15
Q

Tranexamic Acid: pearls

A
  • antifibrinolytic by reversibly blocking lysine binding sites
  • reduction in blood loss seen in 1st month
  • Hemoglobin/hematocrit improvement in 3 months
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16
Q

PCOS: what is important to know about metformin

A

using IV contrast with metformin can increase risk of lactic acidosis. (affects renal function)

17
Q

How does metformin help in PCOS?

A

Metformin lowers androgens and improves insulin sensitivity

18
Q

What are some adverse drug events if using a SSRI for PMDD?

A
  • sexual dysfunction
  • insomnia
  • sedation
  • hypersomnia

Pharmacology II (31 decks)

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