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Pharm Test 3 > Module 14 - Reproduction > Flashcards

Module 14 - Reproduction Flashcards

1
Q

Proposed uses of uterotonics

A

To empty Uterus- labor/ terminate pregnancy

Stop Bleeding- Immediately Postpartum/ late postpartum hemorrhage

Subinvolution- reduction of uterus to its normal size after childbirth

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2
Q

Potential benefits of Oral contraceptives

A 
Avoid unwanted pregnancy 
Decrease menorrhagia
Decrease dysmenorrhea
Decrease ectopic pregnancy 
Decreased iron deficiency anemia 
Decreased PID
Decrease risk of ovarian and endometrial cancer
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3
Q

Potential Harm of Oral Contraceptives

A

Increase risk of MI/stroke/ VTE
Relative CI if woman > 35 yrs and smokes due to increased risk of VTE and cardiovascular events*
slight increased risk of breast cancer (if at all)

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4
Q

AE recommended formulation: Acne

A

higher Estrogen dose, lower androgen potency

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5
Q

AE recommended formulation: breakthrough bleeding

A

higher Estrogen and progestin potency

lower androgen potency

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6
Q

AE recommended formulation: absent/ light menstrual flow

A

higher estrogen, lower progestin dose

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7
Q

AE recommended formulation: Depression

A

lower progestin potency

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8
Q

AE recommended formulation: Moodiness or irritability

A

lower Progestin potency

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9
Q

AE recommended formulation: HA (not menstrual migraines)

A

lower estrogen and progestin potency

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10
Q

AE recommended formulation: breast soreness

A

lower estrogen and progestin potency

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11
Q

AE recommended formulation: weight gain

A

lower estrogen and progestin potency

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12
Q

AE recommended formulation: severe menstrual cramps

A

higher progestin potency

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13
Q

AE recommended formulation: endometriosis or endometriosis prevention

A

lower estrogen, higher progestin and androgen potency

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14
Q

AE recommended formulation: endometriosis or endometriosis prevention

A

lower estrogen, higher progestin and androgen potency

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15
Q

5a reductase inhibitor
competitive inhibitor
More specific for type II receptors in scalp
Inhibits conversion of testosterone to DHT

A

Finasteride

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16
Q

Med used to treat BPH and alopecia

A

Finasteride

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17
Q

5a reductase inhibitor
competitive inhibitor
Inhibits conversion of testosterone to DHT

A

Dutasteride

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18
Q

Aromatase inhibitor
competitive inhibitor
Inhibits conversion of androgen to estrogen

A

Anastrazole, Letrozole

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19
Q

Aromatase Inhibitor
Noncompetitive Inhibitor*
Inhibits conversion of androgen to estrogen

A

Exemestane, Formestane

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20
Q

SERM, Can stimulate endometrial cancer- pro-estrogenic effect on endometrium, antagonistic estrogenic effects on breast tissue

A

Tamoxifen

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21
Q

SERM, Inhibits growth of estrogen dependent (ER+) breast tumors, agonist activity in bones can delay or prevent osteoporosis, does not stimulate endometrium

A

Raloxifene (Evista)

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22
Q

SERM, ER antagonist in hypothalamus gland anterior pituitary gland = increased GnRH , Induces ovulation via partial agonism in ovaries

A

Clomiphene (clomid)

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23
Q

Pure ER receptor antagonist, competitively inhibits estrogen receptors in hormonally responsive breast cancer cells, inhibits growth of estrogen dependent (ER+) breast tumors

A

Fulvestrant

24
Q

competitively inhibits binding of endogenous androgen to androgen receptors

A

Flutamide, Bicalutaminde

25
Q

Who derives the biggest benefit of hormone replacement therapy? *

A

Pts with most severe symptoms

In mild-moderate symptoms the benefit might not outweigh the risks

26
Q

What med class stimulates receptors on osteoblasts - can lead to bone breakdown

A

SERMS- Tamoxifen, Raloxifene (Evista) , and Clomiphene (clomid)

27
Q

Synthetic form of PGE1, Pregnancy category X, Cervical ripening agent, vaginal administration*

A

Misoprostol (cytotec)

28
Q

Induces labor by promoting contractions, administered IV*, use w/ caution in cardiac/ renal disease, PIH

A

Oxytocin (pitocin)

29
Q

Cervical ripening agent, naturally occurring PGE2, vaginal administration*

A

Dinoprostone (Cervidil)

30
Q

MOA of OCPs (oral contraceptive pills)

A

Suppression of mid-cycle gonadotropin (FSH, LH) secretion = inhibiting ovulation*

31
Q

why is estrogen always administered with progesterone?

A

unopposed estrogen promotes endometrial growth = increased risk of endometrial cancer

32
Q

Progestin AEs

A

breast tenderness, weight gain, depression, moodiness, irritability, headaches

33
Q

what component is largely responsible for the androgenic effect of a combination pill? for pt w/ acne

A

Progestin (precursor to androgen and estrogen synthesis)

34
Q

What formulation might work better for a pt with acne that has no androgenic activity? Possible AEs?

A

Drospirenone (Yaz)
monitor for hyperkalemia*
may decrease h20 retention, breast tenderness, and acne

35
Q

what would be some good options for a 35 yr old pt, mom of 3, who does not want more kids, and IUD, or OCP

A

Ortho Evra (transdermal patch)
- find out her weight?
- less effective in pts weighing 90kg (198 lbs)
Nuva Ring

36
Q

In what forms of BC are hormone drug levels less variable? Why?

A

Transdermal patch and vaginal ring because of relatively continuous absorption

37
Q

what is best form of BC for pt with hx of DVT?

A

Transdermal patch

38
Q

What do you need to consider when prescribing corticosteroids to pt on OCP?

A

OCPs potentiate corticosteroids, may be related to steroid metabolism or the ability of the steroid to bind to serum protein
may need lower steroid dose

39
Q

What happens when drugs induce metabolism of contraceptives? Examples? *
what to do?

A

Dilantin/ Rifampin/ Griseofulvin/ Tegretol = decrease effectiveness of the contraceptive … use back up method

40
Q

What kind of hormonal contraceptives would be useful for breastfeeding mother? Route of admin, AE, CI

Who else could benefit?

A

Progestin Only- Oral/ IM/ Intrauterine
must take at same time everyday, more breakthrough bleeding, less effective than combo pills

anyone who would benefit from avoiding estrogen- lupus sickle cell, cardiovascular disease, VTW, migraines

41
Q

AEs of Plan B

How to get this med?

A

Nausea and vomiting

OTC w/out prescription regardless of age

42
Q

What are some other med options for terminating early pregnancy?

A

Mifepristone

Misoprostol (cytotec)- off label use

43
Q

Ideal candidate for HRT and general recommendations

A

only in women with severe menopausal symptoms for the shortest time possible

44
Q

What to say to pt about natural estrogen supplements?

A

make sure there are no interactions with other meds they are on

45
Q

TX of vasomotor sxs of menopause, SIgnificant 1st pass metabolism-> increased binding of globulins, TGs, HDL, clotting factors

A

Oral Estrogen

46
Q

TX of vasomotor sxs of menopause, as effective as oral estrogen for menopause and bone density but less AEs

A

Transdermal Estrogen

47
Q

TX of vasomotor sxs of menopause, caution w/ transfer to children/ pets

A

Topical Estrogen

48
Q

TX of vasomotor sxs of menopause, Tx vaginal atrophy, GU sxs of menopause

A

Vaginal Estrogen

49
Q

What to counsel pts taking topical testosterone gel/ patch?

A

caution w/ transfer to children or pets - kids can develop premature pubic hair, increased libido, aggressive behavior

50
Q

Tx of hypogonadism, perimenopause transgender, can be fluctuations in hormone levels

A

IM Testosterone

51
Q

What are PDE 5 inhibitors contraindicated to take with?

A

Nitrates (will have too much smooth muscle relaxation)

52
Q

Examples of PGE 5 inhibitors

A

Sildenafil, Vardenafil

53
Q

What should you do in a pt develops breakthrough bleeding on OC?

A

estrogen dose should be increased

54
Q

A pt with acne would benefit from OC with _____ estrogen content and ______ androgenic progesterone

A
  1. High

2. Low

55
Q

A SERM that can stimulate endometrial growth?

A

Tamoxifen

56
Q

What happens when SERMS activate receptors on osteoblasts ?

A

leads to bone anabolism

Pharm Test 3 (7 decks)

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