Module 2: Chapter 52 Drugs Affecting Women's Health and Sexuality Flashcards

1
Q

what are the female sex hormones responsible for

A

producing female sex characteristics
developing the female reproductive systme
maintaining pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two types of female sex hormones

A

estrogen

progestin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

true or false: both female sex hormones are not steroidal compounds

A

false: they are steroidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when are female sex hormones produced and where

A

ovaries begin to secrete at puberty and the placenta secretes during pregnancy
adrenal cortex also secretes estrogen and progestin but in much smaller amounts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does the menstral cycle work

A

low estrogen and progesterone levels cause stimulation
GnRH is produced
release of FSH and LH
ovulation
development of corpus luteum
estrogen and progesterone levels rise to high levels
fertilization or non fertilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the three options that occur in the menstral cycle when their are high estrogen and progesterone levels

A

fertilization
no fertilization
suppression and indirect shutoff of FSH and LH (negative feedback)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what happens if fertilization occurs

A

production of progesterone and estrogen by placenta
high levels of estrogen and progesterone maintained
suppression and indirect shutoff of FSH and LH (negative feedback)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens if no fertillization occurs

A

disintigration of corpus luteum
drop in levels of progesterone and estorgen
low levels cause stimulation and cycle repeats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

will a women who is deficient in endogenous sex hormones can she still experience normal sexual development

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what happens to a womans estrogen levels during menopause

A

estrogen levels drop and woman experiences several changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

in postmenopausal women the loss of estrogen contribute to the development of what

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is osteoporosis characterized by

A

low bone mineral density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the leading cause of osteoporosis

A

deficiency of sex hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

is there many different types of exogenous estrogen that differ in terms of indications, route of administration and pharmacokinetics

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the different routes of administration for exogenous estrogens

A

oral
IM
transdermal
topcial (vaginal creams)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are most of these estrogens used for

A

correction of low endogenous estrogen or in birth control products combined with progestins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the prototype drug for estrogen

A

conjugated estrogen (premarin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

conjugated estrogen is primarily used in what

A

hormone replacement therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where is conjugated estrogen metabolised

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

where is conjugated estrogen excreted

A

kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does conjugated estrogen do

A

stimulates the development of the female sex organs and secondary female sexual characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the contraindications for conjugated estrogen

A

black box warning for increase of risk of cardiovascular events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some adverse effects for conjugated estrogen?

A
incr. risk for stroke and heart disease
breakthrough bleeding
headache
N/V
bloating
abdominal cramps
chloasma (brown patches on the skin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what should be assessed for when giving conjugated estrogen

A

assess BP and breast fr any masses

check pts age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

why is the environment important when giving conjugated estrogen

A

causes photosensitiviity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how can the therapeutic effects of conjugated estrogen be maximized

A

administer conjugated estrogen cyclically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how can adverse effects of conjugated estrogen be minimized

A

monitor for signs of thrmobophlebitis and thromboembolus

monitor uterus for risk of endometrial cancer with the combination of estrogen and progestin

28
Q

True or False: The women’s health initiative (WHI) found that menopausal women who had moderate-to-severe vasomotor symptoms had benefirt from estrogen therapy

A

True: small benefit in sleep quality with 3 years of estrogen-progestin therapy

29
Q

What do progestins consist of

A

progesterone and its derivatives

30
Q

how do progestins work

A

through stimulation or inhibition
regulate secretion of pituitary gonadotropins
inhibit spontaneous uterine contractions

31
Q

what is the prototype drug for progestins

A

progesterone (prometrium, crinone)

32
Q

what is the desired therapeutic effect of progesterone

A

help produce normal menstrual cycle

33
Q

how is progesterone administered

A

oral or IM

34
Q

where is progesterone metabolized

A

liver

35
Q

where is progesterone excreted

A

kidneys

36
Q

does exogenous progesterone affect the body in ways similar to endogenous progesterone

A

yes

37
Q

are there any contraindications or precautions for progesterone

A

hypersensitivity

38
Q

what are some adverse effects of progesterone

A

may increase the risk of breast and ovarian cancer when given in combination with estrogen in postmenopausal women

39
Q

are there any known drug interactions with progesterone

A

no

40
Q

what pregnancy category is progesterone

A

B

41
Q

what is important about environment regarding progesterone

A

caution pts about exposure to UV light

42
Q

how can you maximize therapeutic effects for progesterone

A

dosing schedule dependent n the clinical indication for using progesterone

43
Q

how can you minimize adverese effects for progesterone therapy

A

don’t give to pts with contraindications to therapy

44
Q

what do you need to educate patients on that are receiving progesterone therapy

A

teach patients how to perform breast self-examination

45
Q

what patients should you monitor closely during progesterone therapy

A

premenopausal women taking progesterone for return of normal menstral flow and cessation of abnormal bleeding

46
Q

why is progesterone also added to postmenopausal HRT (hormone replacement therapy)

A

decrease the risk of endometrial cancer

47
Q

what hormones do oral contraceptives contain

A

estrogen and progesterone or just progesterone

48
Q

what is the purpose of oral contraceptives

A

to prevent pregnancy

49
Q

hwo do oral contraceptives work

A

inhibit ovulation by suppressing the gonadotropins FSH and LH

50
Q

oral contraceptives should be prescribed with the ______ effective dose of estrogen possible

A

smallest

51
Q

oral contracetpives are known to interact with what two classes of drugs

A

penicillins and tetracyclines

52
Q

what class of drugs affects normal and abnormal bone reabsorption

A

bisphosphonates

53
Q

what is the prototype drug for bisphosphonates

A

alendronate (fosamax)

54
Q

what is alendronate used for

A

to treat and prevent osteoporosis

55
Q

how is alendronate administered

A

orally

56
Q

how is alendronate excreted

A

kidneys

57
Q

how does alendronate work

A

inhibits both normal and abnormal bone resorption

58
Q

what are the contraindications and precautions for alendronate

A

hypocalcemic or hypersensitivity

59
Q

what are the adverse effects of alendronate

A
musculoskeletal pain
flatulence
acid regurgitation
esophageal ulcer
gastritis
headache 
erythema
60
Q

are there any known drug interactions for alendronate

A

recommended to wait at least 30 minutes after taking alendronate before taking any other drug

61
Q

what pregnancy category is alendronate

A

category C

62
Q

what race of women are at risk for ostoporosis

A

asian and white

63
Q

how can you minimize adverse effects for alendronate

A

take measures to correct preexisting hypocalcemia before treatment
monitor electrolytes during therapy

64
Q

what are two key pieces of patient teaching you should do when teaching about alendronate therapy

A

take alendroante at least 30 mins before eating

patients should swallow the medicine with 6-8ox (180-240mL) of plain water

65
Q

what ongoing assessment should you monitor when a patient is taking alendronate

A

make sure patient is not experiencing hypocalcemia or other adverese effects