Reproductive Flashcards
Estrogens
+ conjugated equine estrogen (Premarin)
OTHER ESTROGEN: Estradiol.
INDICATIONS: Contraception, PMS symptoms, post-menopausal osteoporosis, dysmenorrhea, prostate cancer.
SIDE EFFECTS: Embolic events (DVT, PE, MI, stroke), hypertension, weight gain, edema, increased risk of some cancers.
KEY POINTS: Contraindicated in patients who SMOKE, have HYPERTENSION, are at HIGH RISK FOR EMBOLIC EVENTS, or have estrogen-dependent cancer.
Progesterones
+ medroxyprogesterone (Provera)
INDICATIONS: Contraceptions (alone or with estrogen), counters adverse effects of estrogen.
SIDE EFFECTS: Embolic events (DVT, PE, MI, stroke), menstrual changes, edema, increased risk of breast cancer.
KEY POINTS: Delay conception for 3 months after discontinuing use of medication. Contraindicated in patients who are at high risk for embolic events.
Androgens
+ testosterone (Androderm-50)
INDICATIONS: Delayed puberty in boys, hypogonadism, postmenopausal breast cancer.
SIDE EFFECTS: Acne, hypercholesterolemia, edema, liver dysfunction, polycythemia (increase in Hct and Hgb), premature epiphyseal closure. In women, causes deepening of voice, baldness, hirsutism.
KEY POINTS: Contraindicated in patients with prostate cancer. High abuse potential.
BPH Medication: Androgen Inhibitor
+ finasteride (Proscar)
INDICATIONS: Benign prostatic hyperplasia IBPH), baldness.
MODE OF ACTION: Inhibits 5-alpha-reductase, which prevents conversion of testosterone. This results in reduced prostate size and increased hair growth.
SIDE EFFECTS: Erectile dysfunction, gynecomastia.
KEY POINTS: Pregnant women should not handle medication.
BPH Medication: Peripherally acting antiadrenergic
+ tamsulosin (Flomax)
INDICATIONS: Benign prostatic hyperplasia (BPH).
MODE OF ACTION: Antagonizs alpha-1-adrenergic receptors in the prostate, which relaxes the smooth muscles of the prostate. This results in improved urine flow.
SIDE EFFECTS: Hypotension, dizziness, headache, issues with ejaculation.
KEU POINTS: Take at the same time every day (30 minutes after a meal). Monitor BP.
Erectile Dysfunction Medication
+ sildenafil (Viagra)
INDICATIONS: Erectile dysfunction.
MODE OF ACTION: Enhances effect of nitric oxide released during sexual stimulation, resulting in increased blood flow to the corpus cavernous.
SIDE EFFECTS: Priapism (prolonged erection), MI.
KEY POINTS: DO NOT TAKE WITH OTHER NITRATES (such as nitroglycerin). Use cautiously in men with cardiovascular disease.
Uterine Stimulant
+ oxytocin (Pitocin)
INDICATIONS: Induction (or enhancement) of labor.
MODE OF ACTION: Uterine stimulant.
SIDE EFFECTS: Uterine rupture, painful contractions.
KEY POINTS: Closely monitor contractions (should be less than 60 seconds, eery 2-3 minutes) and maternal/fetal BP and pulse. Magnesium can be used to relax the uterus.
Medications to treat Pre-term labor+ terbutaline sulfate (Brethine)Sever
INDICATIONS: Preterm labor; delays but does not prevent labor. Also used for COPD, asthma.
MODE OF ACTION: Activates beta-2-adrenergic receptors, causing relaxation of the uterus. Also results in bronchodilator.
SIDE EFFECTS: Tachycardia, angina, restlessness, tremor.
KEY POINTS: Contraindicated for gestation of 34 weeks or greater, and for cervical dilation greater than 6 cm.
Opioid Analgesic during Labor
+ meperidine hydrochloride (Demerol)
INDICATIONS: Severe pain during labor.
MODE OF ACTION: Binds to opioid receptors in CNS. Decreases pain without causing significant respiratory depression in the mom or baby.
SIDE EFFECTS: GI upset, sedation, dry mouth, hypotension, decreased FHR.
KEY POINTS: Labor should be well established, and the mom’s cervix should be at least 4 cm dilated prior to administration. In case of respiratory depression, administer naloxone.
