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Clinical Medication: HEENT > Pharm 1: Menstruation-Related Disorders > Flashcards

Pharm 1: Menstruation-Related Disorders Flashcards

1
Q

Amenorrhea
Primary amenorrhea:

Secondary amenorrhea:

A

Primary amenorrhea: Absence of menses

Secondary amenorrhea: absence of menses for three cycles or for 6 months

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2
Q

What are the goals of Amenorrhea therapy?

A

Bone density preservation
Bone loss prevention
Ovulation restoration
Improving fertility

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3
Q

Treatment: Normal Amenorrhea treatment:

A

Normal Amenorrhea treatment:

  • Vitamin D with Calcium
  • Estrogen: Decreases osteoporosis risk and improved quality of life
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4
Q

Treatment of: hyperprolactinemia and Amenorrhea

A

-Dopamine agonists, including bromocriptine and cabergoline if hyperprolactinemia is the cause of amenorrhea

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5
Q

Treatment of PCOS and Amenorrhea

A

Metformin and thiazolidinedione if amenorrhea associated with PCOS

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6
Q

Questions

A

Questions

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7
Q

what is an advantage of estrogen?

A

Decreases osteoporosis risk and improved quality of life

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8
Q

If a patient is experiencing hyperprolactemia what can you use for treatment?

A

Dopamine agonists, including bromocriptine and cabergoline if hyperprolactinemia is the cause of amenorrhea

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9
Q

what is first line treatment for amenorrhea and PCOS?

A

Metformin or thiazolidinedione

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10
Q

What do you need to look at before you perscrive metformin?

A

Creative clearance

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11
Q

Management of pain associated with Menorrhea

A

Management of pain associated with Menorrhea

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12
Q

-

A
  • NSAIDS: the nonsteroidal antiinflammatory drugs (NSAIDs) have the advantage of administration only during menses. NSAID use is associated with a 20% to 50% reduction in blood loss in 75% of treated women.
  • OC use is beneficial for menorrhagia and should be considered or women desiring to avoid pregnancy. Alternative choice levonorgestrel-releasing IUD
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13
Q

Management of pain associated with Menorrhea :If someone is bleeding don’t give NSAIDs why?

A

Increased risk of miscarriage

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14
Q

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

A

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD)

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15
Q

Define PMS:

A

Constellation of symptoms including mild mood disturbances and physical symptoms occurring prior to menses and resolving with menses initiation

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16
Q

Define PMDD

A

Severe depression symptoms, irritability, and tension before menstruation

17
Q

Treatment of PMS and PMDD:

A

o OTC options: Vitamin and mineral supplements, such as vitamin B6 and calcium carbonate, may help reduce the physical symptoms associated with PMS

oDrug of Choice: SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline)

18
Q

•What is the issue with giving SSRIs for the treatment of PMS and PMDD?

A

oSSRIs take up to four weeks to work so it may or may-not be helpful

19
Q

• When will an SSRI be helpful for PMS?

A

oIf the individual is depressed before the PMS issues

20
Q

Contraception

A

Contraception

21
Q

•Spermicides

A

most of which contain nonoxynol-9, are chemical surfactants that destroy sperm cell walls and act as barriers that prevent sperm from entering the cervical os to the fallopian tubes in women.

22
Q

•Progestins:

A

It provide most of the contraceptive effect, by thickening cervical mucus to prevent sperm penetration, slowing tubal motility and delaying sperm transport, and inducing endometrial atrophy. Progestins block the LH surge, therefore inhibiting ovulation

23
Q

Questions

A

Questions

24
Q

What do spermicides usually contain?

A

most of which contain nonoxynol-9

25
Q

what is the function of Spermicides?

A

are chemical surfactants that destroy sperm cell walls and act as barriers that prevent sperm from entering the cervical os to the fallopian tubes in women.

26
Q

How does progestins effect contraception?

A

by thickening cervical mucus to prevent sperm penetration, slowing tubal motility and delaying sperm transport, and inducing endometrial atrophy. Progestins block the LH surge, therefore inhibiting ovulation

27
Q

What is the estrogen part of the combo oral contraceptives?

A

Ethinyl estradiol (EE)

28
Q

What is the progesterone part of the combo oral contraceptives?

A

mestranol

29
Q

Ethinyl estradiol (EE) and mestranol. Mestranol, must be converted

A

by the liver to EE before it is pharmacologically active and is 50% less potent than EE

30
Q

What are some advantages of condoms?

A

Cheap, protection from stds

31
Q

What are some disadvantages of condoms?

A

Failure rate is high

32
Q

If a patient is experiencing neausa, breast tenderness, HA ,cyclic weight gain what are you thinking?

A

The patient is experiencing Estrogen excess

33
Q

What would you give to this patient experiencing Estrogen excess?

A
  • A combination durg with more progesterone than estrogen
  • Progesterone only drug
  • IUDs
34
Q
  • If you have a patients experiencing break through bleeding days 1-9 (early in the cycle) or the absence of withdrawal bleeding what are you thinking?
  • What would you give to this patient?
A

o Estrogen deficiency

•Give an OC that has a higher estrogen content

35
Q
  • If a patient is experiencing acne, oily skin and histuism, increased weight gain and increased appetite what are you thinking?
  • What would you want to do for this paitent?
A

oProgestin excess

Decreased the progesting content

36
Q

If you have a patient with break through bleeding from days 10-21 (late cycle) what are you thinking?

What would you do for this patient?

A

Progestin deficiency

Increase progestin content

37
Q

WHO recommended Precautions

A

WHO recommended Precautions

38
Q 
•Notes on the use of CHC combinded hormonal contraceptives 
Women > 35 : 
Smoking
Hypertension
Dyslipidemia
A
  • Women > 35 : Increased risk of cardiovascular disease and VTE
  • Smoking- increased risk of VTE
  • Hypertension: Increased levels of potassium if they are also using an OC containing drospirenone, which has antialdosterone properties (Avoid in patient on potassium sparing BP meds)
  • Dyslipidemia: Estrogens tend to have more beneficial effects by enhancing removal of LDL, increased HDL levels and moderately increase triglycerides. Low estrogens containing CHC may not provide such benefit
39
Q
  • Diabetes
  • Migraine
  • Breast Cancer:
  • Thromboembolism
  • SLE
A
  • Diabetes: Effects of CHCs on carbohydrate and lipid metabolism is believed to be due to the progestin component. Diabetic women with vascular disease (e.g. nephropathy, retinopathy, neuropathy, or other vascular disease or diabetes of more than 20 years’ duration) should not use CHCs.
  • Migraine: Women of any age who have migraine with aura should not use CHC. Women who develop migraines (with or without aura) while receiving CHC should discontinue use and consider a progestin-only option.
  • Breast Cancer: Association with risk of cancer inconsistent. Not recommended in patient with personal history of cancer
  • Thromboembolism: Estrogens increase hepatic production of factor VII, factor X, and fibrinogen in the coagulation cascade, therefore increasing the risk of thromboembolic events (deep vein thrombosis, pulmonary embolism
  • SLE: CHCs should be avoided in women with SLE and antiphospholipid antibodies or vascular complications

Clinical Medication: HEENT (39 decks)

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