PHARM GROUP 2 Flashcards
WHI
WOMENS HEALTH INITIATIVE
1991 FINDINGS:
- HRT ASSOCIATED WITH INCREASED RISKS OF BREAST CANCER, HEART DISEASE, STROKE, AND BLOOD CLOTS
- DECREASED RISK OF HIP FRACTURES AND COLON CANCER
2008 STATEMENT
- HRT CAN BE BENEFICIAL FOR WOMEN CLOSE TO MENOPASUE FOR SYMPTOM RELEIF AND BONE LOSS PREVENTION.
- THE RISK-BENEFIT RATIO DECREASES WITH ADVANCING AGE
WHAT ARE THE 3 TYPES OF SYMPATHOMIMETIC DRUGS AND PROVIDE AN EXAMPLE OF EACH
- DIRECT-ACTING EX) EPINEPHRINE
- BINDS DIRECTLY TO RECEPTORS - INDIRECT-ACTING EX) AMPHETAMINE
- CAUSES RELEASE OF CATECHOLAMINES - MIXED-ACTING EX) EPHEDRINE
- BOTH DIRECT AND INDIRECT EFFECTS
ORAL CONTRACEPTIVE PILLS
TYPES…
MONOPHASIC: FIXED RATIO WITH ESTROGEN TO PROGESTIN THROUGHOUT THE CYCLE
BIPHASIC: FIXED ESTROGEN WITH VARYING PROGESTIN LEVELS
TRIPHASIC: VARYING LEVELS OF ESTROGEN AND PROGESTIN IN 3 PHASES
FOUR PHASIC - VARYING DOSES OF ESTRADIOL VALERATE AND DIENOGEST
WHAT CLASS OF MEDS OFTEN DECREASES THE EFFECTIVENESS OF COMBINED HORMONE CONCEPTION ?
ANTIBIOTICS
WHERE ARE THE TESTES LOCATED AND WHAT ARE THEIR PRIMARY FUNCTIONS ?
THE TESTES ARE LOCATED IN THE SCROTAL SAC.
PRIMARY FUNCTIONS…
- HORMONE PRODUCTION (TESTOSTERONE)
- SPERMATOGENESIS (SPERM PRODUCTION IN SEMINEFEROUS TUBULES)
HERBAL SUPPLEMENTS
SOY, RED CLOVER, BLACK COHOSH
- MAY HELP DECREASE HOT FLASHES, CAUTION IN WOMEN WITH BREAST CANCER OR LIVER DISEASE
VITAMIN E, EVENING PRIMROSE OIL, ST. JOHNS WORT, GINSENG, MELATONIN
- MAY OFFER SYMPTOMATIC RELIEF
PRIMARY EFFECTS OF ANTICHOLINERGICS (PARASYMPATHOLYTICS) ?
ANTICHOLINERGICS BLOCK THE ACTION OF ACETYLCHOLINE, CAUSING EFFECTS SUCH AS INCREASED HR, PUPIL DILATION, DECREASED GI MOTILITY, URINARY RETENTION, AND DECREASED BRONCHIAL SECRETIONS
MOA FOR POTASSIUM-SPARING DIURETICS
THEY INTERFERE WITH SODIUM-POTASSIUM EXCHANGE IN THE DISTAL TUBULE AND COLLECTING DUCT, PREVENTING EXCESSIVE LOSS OF POTASSIUM
TERBUTALINE
- DECREASES UTERINE CONTRACTIONS TO STOP PRE-TERM LABOT
- ONLY USE SQ AND SHORT TERM (<48-72 HRS)
SIDE EFFECTS:
- TACHYCARDIA AND HYPOGLYCEMIA IN MOTHER AND FETUSC
COMMON POTASSIUM-SPARING DIURETICS
AMILORIDE (MIDAMOR)
SPIRONOLACTONE (ALDACTONE)
TRIAMTERENE (DYAZIDE)
PROGESTIN-ONLY PILLS
INDICATIONS: FOR WOMEN WHO CANNOT TAKE ESTROGEN
EX) HISTORY OF VTE, BREASTFEEDING, OLDER AGE, SMOKING
SIDE EFFECTS: IRREGULAR BLEEDING, FATIGUE, DECREASED LIBIDO, MOOD CHANGES, WEIGHT GAIN
FORMS:
ORAL (MICORNOR, NOR QD, AYGESTIN)
- INJECTABLE (DEPO-PROVERA - ADMINISTERED EVERY 11-13 WEEKS, MAY DECREASE BONE DENSITY)
- IMPLANTABLE - NEXEPLON (UP TO 3 YEARS) CONTAINS BARIUM FOR DETECTION NOT RECOMMENDED FOR BMI > 30
MOA OF SPIRONOLACTONE (ALDACTONE)
SYNTHETIC STEROID THAT BLOCKS ALDOSTERONE RECEPTORS, REDUCING SODIUM REABSORPTION AND INCREASING POTASSIUM RETENTION
HOW DO DIURETICS LOWER BP ?
BY PROMOTING SODIUM EXCRETION WHICH LOWERS BLOOD VOLUME AND VASCULAR RESISTANCE
INTERACTIONS OF THIAZIDE DIURETICS
CORTICOSTEROIDS
DIGOXIN
LITHIUM
NSAID’S
ORAL HYPOGLYCEMIC DRUGS
WHERE IS TESTOSTERONE PRODUCED IN THE MALE BODY ?
TESTOSTERONE IS PRODUCED BY INTERSTITIAL CELLS LOCATED BETWEEN THE SEMINEFEROUS TUBULUES IN THE TESTES
HOW DOES METALAZONE DIFFER FROM OTHER THIAZIDE DIURETICS ?
- MORE POTENT ESPECIALLY IN PATIENTS WITH RENAL INSUFFICIENCY
- OFTEN USED IN COMBINATION WITH LOOP DIURETICS FOR SEVERE CHF
WHAT IS BETHANECHOL (URECHOLINE) USED FOR, AND HOW DOES IT WORK ?
USED TO TREAT POST-OP AND POSTPARTUM NONOBSTRUCTIVE URINARY RETENTION, AND NEUROGENIC ATONY OF THE BLADDER. IT STIMULATES CHOLINERGIC RECEPTORS, PROMOTING BLADDER CONTRACTION, GI PERISTALSIS, AND BRONCHOCONSTRICTION
WHICH ORGANS AND SYSTEMS ARE RESPONSIBLE FOR REGULATING BP AND HOW ?
KIDNEYS:
CONTROL FLUID VOLUME VIA INFILTRATION AND INFLUENCE BP BY RELEASING RENIN, ACTIVATING THE RAAS.
THIS SYSTEM INCREASES BP THROUGH VASOCONSTRICTION AND SODIUM/WATER RETENTION
BLOOD VESSELS:
ARTERIAL TONE (CONSTRICTION VS DILATION) DETERMINES PERIPHERAL RESISTANCE, IMPACTING BP
HORMONES: CATECHOLAMINES (EPINEPHRINE AND NOREPINEPHRINE), ADH, AND ALDOSTERONE REGULATE BP
WHAT SHOULD BE MONITORED WHEN ADMINISTERING DIURETICS ?
INTAKE AND OUTPUT
BP
ELECTROLYE LEVELS (POTASSIUM AND SODIUM)
SIGNS OF ORTHOSTATIC HYPOTENSION
WHAT IS DEPO-PROVERA AND WHAT ARE ITS SIDE EFFECTS AND LONG TERM CONSIDERATIONS ?
AN INJECTABLE PROGESTIN-ONLY CONTRACEPTIVE GIVEN EVERY 11-13 WEEKS
CAN LEAD TO DECREASED BONE DENSITY AFTER 2 YEARS, SO CALCIUM AND VITAMIN D SUPPLEMENTATION IS RECOMMENDED
SIDE EFFECTS
- WEIGHT GAIN
- FATIGUE
- IRREGULAR BLEEDING
- MOOD CHANGES
