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Pathopharmacology > Reproduction Drugs > Flashcards

Reproduction Drugs Flashcards

1
Q

What is menarche?

A

when hormones begin cycling

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2
Q

Estrogen is responsible for

A
  1. Uterine lining build up
  2. Decreased libido
  3. Impaired thyroid fx and blood sugar
  4. Mood/Depression/PMS
  5. Water retention
  6. Increases risk for breast/endometrial cancer
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3
Q

Progesterone is responsible for

A
  1. Maintaining uterine lining to allow pregnancy
  2. Decreasing uterine motility to increase implantation
  3. Maintenance of pregnancy
  4. Thickening cervical yucas (prevents bacteria from entering)
  5. Increasing blood sugar for embryo, anti insulin effect
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4
Q

When is progesterone released into circulation?

A

After ovulation

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5
Q

What organ releases GnRH and when?

A

Hypothalamus releases GnRH at puberty

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6
Q

Role of GnRH

A

Stimulates follicles to grow

  1. Follicles produce Estrogen (automatically released into circulation) & Progesterone (stays in follicle until ovulation)
  2. High estrogen = inc in LH (released by anterior pituitary)
  3. LH surge = burst follicle and ovum release = ovulation = progesterone release
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7
Q

What is the corpus luteum?

A

ruptured follicle that turns into endocrine gland after ovulation

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8
Q

Explain relationship between corpus luteum and estrogen/progestrone production

A

Corpus Luteum continues producing estrogen/progestrone for 10-14 days after ovulation, unless pregnancy occurs

If pregnant, will continue producing estrogen and progesterone until the placenta develops and becomes functional

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9
Q

Relationship between light and reproductive hormones

A

Inc light levels = LH/FSH release = early sexual maturation

Dec light = puberty/sexual development at later ages

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10
Q

What is menopause?

A

Women’s body no longer produces estrogen/progesterone

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11
Q

The loss of estrogen/progesterone leads to

A
  1. Dry vaginal tissues (Increased UTI, painful sex)
  2. Decreased bone density
  3. Vasospasms which cause hot flashes
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12
Q

When is a patient considered to be in menopause?

A

18 months are menstruation stops

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13
Q

What are the risks for hormone replacement therapies for menopause?

A
  1. Estrogen Only: inc risk for endometrial/breast cancer

2. Estrogen+Progesterone Combo: Increases the risk of CV disease, stroke, DVT

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14
Q

Function of Vas Deferens

A
  1. Stores sperm

2. Carries sperm from testes to be ejaculated

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15
Q

Function of Prostate Gland

A

produces enzymes to stimulate sperm maturation

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16
Q

Seminiferous tulles produce

A

sperm

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17
Q

Leydig cells produce

A

testosterone

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18
Q

What happens when FSH is released in males?

A
  1. Stimulates seminiferous tubules to produce sperm (spermatogenesis)
  2. stimulates Sertoli cells in seminiferous tubules to produce estrogens providing a negative feedback to pituitary and hypothalamus = decrease in release of GnRH, FSH and LH
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19
Q

Purpose of negative feedback in males

A

prevents overproduction of sperm in testes

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20
Q

What is andropause?

A

Atrophy of seminiferous tubules & interstitial cells leading to loss of testosterone effects

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21
Q

What is estrogen used for?

A
  1. Stimulate ovulation in women with hypogonadism
  2. Prevent conception
  3. Replace hormones after menopause
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22
Q

Contraindications of Estrogen Use

A
  1. Smoking (increase risk of clot)
  2. Grapefruit (inhibits metabolism = increase levels)
  3. St. Johns Wort (decrease effectiveness of BC with estrogen)
  4. Corticosteroids (toxic effects)
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23
Q

What is Estradol?

A

Is a potent endogenous female sex hormone, responsible for estrogen effects on the body

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24
Q

What is Estradol used for?

A
  1. Menopause
  2. Prevent osteoporosis in postmenopausal women
  3. Ovarian failure
  4. Inoperable breast/ prostatic cancer (inhibits growth of hormone sensitive tissue)
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25
Q

Adverse effects of Estradol

A
  1. Corneal changes
  2. Cholasma
  3. Hepatic Adenoma (liver tumor)
  4. Peripheral edema
  5. Photosensitivity
  6. GI Symptoms
  7. Change in menstrual flow (breakthrough bleeds, dysmenorrhea)
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26
Q

What is Cholasma?

A
  1. Large brown patches on skin, mainly on face

2. Temporary condition due to hormone changes

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27
Q

Purpose of Norethindrone Acetate

A
  1. Inhibits secretion of pituitary FSH and LH
  2. Prevent ovulation
  3. Inhibits uterine contractions
  4. Makes a proliferative endometrium into a secretory endometrium
28
Q

What is Norethindrone Acetate used for?

A
  1. Amenorrhea (no period) treatment
  2. Abnormal uterine bleeding from hormonal imbalance
  3. Treatment of endometriosis
  4. Component of hormonal contraceptives
29
Q

Proliferative Endometrium vs Secretory Endometrium

A

Proliferative: cellsaremultiplying and spreading = rise in estrogen = thick endometrium

Secretory: lining is prepared for pregnancy or sloughed if not pregnant

30
Q

Adverse Effects of Norethindrone Acetate

A
  1. Venous thromboembolism
  2. Diplopia or loss of vision
  3. Migraine headache
  4. Breakthrough bleeding or spotting
  5. Amenorrhea
  6. Fluid retention – weight increase
  7. Edema
  8. Cholasma
31
Q

Teaching for Oral Contraceptives

A
  1. Need other protection against sexually transmitted diseases
  2. Avoid smoking
  3. Oral contraceptives need to be taken daily
  4. Adverse effects she may experience
32
Q

Purpose of Estrogen Receptor Modulators

A

Used to stimulate specific estrogen receptors to achieve therapeutic effects of increased bone mass without stimulating the endometrium

33
Q

What are the Estrogen Receptor Modulators?

A
  1. Raloxifene

2. Toremifene

34
Q

Therapeutic use for Raloxifene

A
  1. Used to prevent and treat osteoporosis in postmenopausal women
35
Q

What does Raloxifene do?

A

Increase bone mineral density without stimulating the endometrium

36
Q

Adverse Effects of Raloxifene

A
  1. Venous thromboembolism
  2. Hot flashes
  3. Skin rash
  4. N/V
  5. Vaginal bleeding
  6. Depression
  7. Lightheadedness
  8. Headaches
37
Q

Patient Education for Raloxifene

A
  1. Take with food to decrease GI upset
  2. Take analgesics for headaches as needed
  3. Strongly recommend smoking cessation
  4. Monitor for swelling and fluid retention
  5. Monitor for changes in vision
  6. Monitor LFT’s and renal function
38
Q

What is Clomiphene?

A

Fertility drug

39
Q

What is Clomiphene used for?

A

To stimulate functioning ovaries or to stimulate increased FSH and LH levels by hypothalamus by binding available estrogen sites in women

40
Q

What is necessary before Clomiphene is administered?

A
  1. Normal liver function

2. Normal endogenous estrogens

41
Q

What is the off-label use for Clomiphene?

A

treats male sterility

42
Q

Adverse effects of Clomiphene

A
  1. Vasomotor flushing
  2. Abdominal discomfort
  3. Distention and bloating
  4. N/V
  5. Ovarian enlargement
  6. Breast tenderness
  7. Ovarian overstimulation
  8. Multiple pregnancies
  9. Increased risk birth defects
43
Q

What is Oxytocin used for?

A

to stimulate labor and improve uterine contractions and control postpartum bleeding

44
Q

Before administering Oxytocin, what should a nurse do?

A

Check history of cesarean prior to use - could compromise previous scar tissue

45
Q

Adverse Effects of Oxytocin

A
  1. cardiac arrhythmias
  2. hypertension
  3. fetal bradycardia
  4. uterine hypertonicity/spasm and possible rupture
  5. N/V
  6. pelvic hematoma
  7. Severe water intoxication when used for prolonged periods
46
Q

How does oxytocin cause water intoxication?

A

ADH released in response to oxytocin activity, causing fluid retention by the kidney.

47
Q

Nursing Interventions for Oxytocin

A
  1. Fetal Status
  2. Monitor neurological statys
  3. Monitor for HTN
  4. Assess for adventitious sounds
  5. Assess for labor pattern
  6. Monitor bleeding
48
Q

What does Dinoprostone do?

A

Stimulate uterine activity dislodging any implanted trophoblasts and preventing implantation of any fertilized egg; abortion pill

49
Q

What is Dinoprostone used for?

A
  1. Pregnancy termination from 12-20 weeks

2. Uterus evacuation for missed abortions or or intrauterine fetal death

50
Q

Adverse Effects of Dinoprostone

A
  1. Headache
  2. N/V
  3. paresthesias
  4. hypotension
  5. uterine pain or rupture
  6. backache
  7. chills
  8. fever
  9. diaphoresis
51
Q

What are trophoblasts?

A

Layer of tissue that nourishes embryo and forms major part of placenta

52
Q

What is testosterone used for?

A
  1. Inoperable breast cancer

2. Replacement therapy in hypogonadism

53
Q

Actions of Testosterone

A
  1. Growth and development of male sex organs
  2. Maintenance of secondary sex characteristics
  3. Stimulates RBC production
  4. Increases protein anabolism
54
Q

Adverse Effects of Testosterone

A
  1. Dizziness
  2. Sleep disorders
  3. Androgenic effects (acne, deepening voice, oily skin, hirsutism)
  4. Hypoestrogenic effects (flushing , sweating, vaginitis, nervousness, emotional lability)
  5. Polycythemia
  6. Nausea
  7. Rash
  8. Fatigue
  9. May cause decreased thyroid function
  10. Hepatocellular cancer
  11. Increased creatinine
55
Q

What labs should a nurse monitor when administering Testosterone?

A
  1. CBC
  2. Thyroid Fx
  3. Liver Fx
  4. Creatinine Clearance
56
Q

What is Oxandrolone?

A

testosterone analogues with more anabolic or protein building effects than androgenic effects

57
Q

What is Oxandrolone used for?

A
  1. Used to promote tissue building effects and tissue repair in debilitated patients
  2. Promote weight gain – reverses catabolic processes
  3. HIV related cachexia and wasting
  4. Increase hematocrit
58
Q

Adverse Effects of Oxandrolone

A
  1. Development of manly features (deep voice, penis grows, hair) in pre pubertal males
  2. Change in libido, baldness, painful erection in post pubertal males
59
Q

Effects of Oxandrolone in women

A
  1. Hirsutism
  2. Hoarseness
  3. Clitoral enlargement
  4. Baldness.
  5. Menstrual irregularities
60
Q

Oxandrolone Off Label Use

A
  1. Cardiomyopathy
  2. Hepatic carcinoma
  3. Personality changes
  4. Sexual dysfunction
61
Q

Contraindications of Oxandrolone

A

interact with oral anticoagulants and antidiabetic agents which may not be metabolized normally

62
Q

What is Sildenafil used for?

A
  1. To treat erectile dysfunction in the presence of sexual stimulation
  2. Treatment of pulmonary arterial hypertension
63
Q

How does Sildenafil work?

A

Relaxes smooth muscle to allow blood flow into penis - lasts 4 hrs

64
Q

Adverse Effects of Sildenafil

A

headache, flushing, dyspepsia, UTI, rash

65
Q

Contraindications of Sildenafil

A
  1. Structural Abnormalities in Penis
  2. Bleeding Disorders
  3. Coronary Artery Disease
  4. Congenital prolonged QT
  5. Hepatic/Renal Disorders
  6. Hypotension/Severe Hypertension

Pathopharmacology (6 decks)

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