Repoductive Meds

Question 1

Androgen prototype

Answer 1

Testosterone (Duratest, Testoderm)

Question 2

Indications for testosterone

Answer 2

hypogonadism, breast cancer, prevention of ovulation to treat endometriosis

Question 3

Phosphodiesterase type 5 recptors (PDE5) inhibitors

Answer 3

Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra)

Question 4

Indications for PDE5 inhibitors

Answer 4

Treatment of penile erectile dysfunction

Tx of pulmonary arterial HTN

Question 5

Actions of PDE5 inhibitors

Answer 5

Selectively inhibit phosphodiesterase type 5 receptors (PDE5)-> increase nitrous oxide levels, which activates cGMP, a second messenger molecule, to cause a prolonged smooth muscle relaxation-> increased flow of blood into the corpus cavernosum

Question 6

Cautions with PDE5 inhibitors/ Sildenafil

Answer 6

CAD, Hypotension or severe HTN

Bleeding issues

Question 7

D2D with PDE5 inhibitors/ viagra

Answer 7

ketoconozole, nitrates, e-mycin, cimetidine (tegument), ritonavir & grapefruit juice, alpha blockers

Question 8

Actions of androgens / testosterone

Answer 8

• Increase the retention of nitrogen, sodium, potassium
• Decrease the urinary excretion of calcium (hypercalcemia)
• Increase protein anabolism – holding on to protein and water.
• Decrease protein catabolism
• Increase the production of red blood cells

Question 9

Adverse effects of androgens/ testosterone

Answer 9

Dizziness, headache, sleep disorders,
fatigue, rash, androgenic effects (acne, deepening
voice, oily skin), hypoestrogenic effects (fl ushing,
sweating, vaginitis), polycythemia, nausea,
hepatocellular carcinoma.

Question 10

Advrese effects for PDE5 inhibitor/ Sildenafil

Answer 10

HA, vision issues, flushing, dyspepsia, UTI, rash

Question 11

Anabolic Steroids

Answer 11

Oxandrolone (oxadrin)

Question 12

Indications for anabolic steroids Oxandrolone

Answer 12

• treat anemia, certain cancers, and angioedema,
• promote weight gain and tissue repair (help weight gain)
• Protein anabolism (construction of molecules) if the body is eating its own protein,

Question 13

Side effects of anabolic steroids

Answer 13

• hepatotoxicity= Watch liver enzymes
• CV risk of worsening ASD (increase LDL and decreased HDL)
• Virilism effects- females deeper voice, loss of hair, growth of facial hair, changes in mense, acne. Males acne, gyncomastia, impotence, priapism

Warn- cardiomyopathy, hepatic CA, personality changes, sexual dysfunction.

Question 14

Estrogen

Answer 14

Estradiol

Question 15

Actions of estradiol

Answer 15

• protects the heart from artherosclerosis
• retains Ca+ in the bones
• maintains the secondary female sex characteristics, labia stays plum, vagina is moist

Question 16

Indications for estradiol

Answer 16

• hormone replacement therapy
• palliative and preventive therapy during menopause
• endometerosis and dysfunctional uterine bleeding
• contraception
• TREATMENT OF PROSTATE CANCER

Question 17

Contraindications for estradiol

Answer 17

allergy, pregnancy, idiopathic (unk cause) bleeding, breast CA, estrogen dependent CA, and thromboembolic disorders.

Caution - no smoking

Question 18

Adverse effects for estradiol

Answer 18

Break through bleeding, dysmenorrhea, anemorrhea, libido changes, photo-sensitivity, abd cramps

Question 19

D2D for estradiol

Answer 19

drugs that increase hepatic metabolism, corticosteroids, grapefruit juice, CNS drugs (phenytoin & Barbituates), antibiotics.

Question 20

Estrogen Receptor Modulators

Answer 20

Raloxifene

Question 21

Actions for Raloxifene

Answer 21

modulating effects on estrogen receptors, used to stimulate specific estrogen receptors to increase bone mineral density.

Question 22

Indications for raloxifene

Answer 22

postmenopausal osteoporosis

Question 23

Contraindications for raloxifene

Answer 23

pts with a history of venous thrombosis and smoking

Question 24

Adverse effects of raloxifene

Answer 24

GI upset, changes in fluid balance: HA, dizzy, visual changes. Hot flashes, skin rash, edema, and vaginal bleeding.

Question 25

D2D raloxifene

Answer 25

cholstyramine, highly protein bound drugs

Warfarin (reduced effects)

Question 26

Nursing considerations for Estrogen and ERM

Answer 26

give with food, monitor liver test, monitor PT

Question 27

Progestins

Answer 27

norethindrone acetate

Question 28

Action of norethindrone acetate

Answer 28

• tansform the proliferative endometrium into a secretory endometrium (pregnancy will not occur)
• inhibit the secretion of FSH and LH
• prevent follicle maturation and ovulation
• inhibits uterine contractions
• povera can be used in secondary amenorrhea

Question 29

Indication of norethindrone acetate

Answer 29

• contraception
• treatment of primary and secondary amenorrhea
• endometriosis