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Pharm > Reproductive and Genitourinary drugs > Flashcards

Reproductive and Genitourinary drugs Flashcards

1
Q

oral contraceptives - combination estrogen/progesterone prototype and other drug names

A

ethinyl estradiol and drospirenone (Yasmin)
Others: ethinyl estradiol and norethindrone (Ortho-Novum 1/35)

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2
Q

combo oral contraceptives EPA

A

suppresses secretion of FSH and LH, thus preventing ovulation. Progesterone thickens cervical mucus; prevents endometrium thickening. Drospirenone works similarly to spironolactone thereby decreasing ankle edema and treating PMS symptoms

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3
Q

combo oral contraceptives administration

A

PO at the same time every day

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4
Q

combo oral contraceptives therapeutic use

A

pregnancy prevention; PMS symptoms; stabilize menses; prophylactic uterine/ovarian cancer, PID, ovarian cysts

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5
Q

combo oral contraceptives ADRs

A

thromboembolism, abnormal uterine bleeding, promote growth of existing breast cancer, potential risk for HTN, hyperkalemia (drospirenone)

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6
Q

combo oral contraceptives contraindications and interactions

A

Pregnancy - teratogenic
BRCA1 gene mutation
ACE inhibitors
Many drug interactions: Rifampin, anti-seizure, and antifungal decreased effectiveness

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7
Q

combo oral contraceptives RN intervention and client education

A

Confirm absence of pregnancy FIRST
Additional method of birth control during 1st cycle of pills
Avoid salt substitutes (drospirenone)
Monitor K+ due to potential for hyperkalemia (drospirenone)
Monitor BP
Monitor for s/sx of DVT/PE/MI/Stroke
Avoid smoking
Monitor pattern and amount of uterine bleeding

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8
Q

contraceptives IUD prototype

A

levonorgestrel (Mirena) same drug as Plan B

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9
Q

estrogen and progesterone HRT prototype and other drug names

A

conjufated estrogen and medroxyprogesterone acetate (Prempo)
Others: transdermal combination of estradiol and norethindrone (CombiPatch)

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10
Q

estrogen and progesterone HRT EPA

A

binds to estrogen receptors and substitutes the fluctuating amounts of estrogen into a more stable amount of estrogen to prevent symptoms. Adding in progesterone suppresses tissue growth in the uterus thereby preventing hyperplasia of uterine lining

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11
Q

estrogen and progesterone HRT adminsitration

A

PO, vaginally, transdermal (CombiPatch)

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12
Q

estrogen and progesterone HRT therapeutic use

A

relieves symptoms of menopause

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13
Q

estrogen and progesterone HRT ADRs

A

nausea is very common, HTN, vaginal bleeding, edema, weight gain, possibly breast cancer. Risk for thromboembolic disorders increases w/ addition of progesterone

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14
Q

estrogen and progesterone HRT contraindications and interactions

A

History of thromboembolic events
suspect/confirmed breast, vaginal, cervical, endometrial cancer
Many drug interactions

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15
Q

estrogen and progesterone HRT RN intervention and client education

A

Monitor BP
Monitor for s/sx of DVT/PE/MI/stroke
Avoid smoking
Stop at least 4 weeks prior to surgery
Apply intravaginal/transdermal at bedtime
Monitor pattern and amount of uterine bleeding
Report persistent vaginal bleeding
D/C if any indication of breast cancer

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16
Q

estrogen HRT prototype and other drug names

A

conjugated equine estrogen (Premarin)
Others: transdermal estradiol (Estraderm); estradiol intravaginal tablets (Vagifem), estradiol cream (Estrace)

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17
Q

estrogen HRT EPA

A

binds to estrogen receptors and substitutes the fluctuating amounts of estrogen into a more stable amount of estrogen to prevent symptoms

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18
Q

estrogen HRT administration

A

PO and many other routes

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19
Q

estrogen HRT therapeutic use

A

relieves symptoms of menopause

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20
Q

estrogen HRT ADRs

A

nausea is very common, HTN, endometrial hyperplasia - inc risk for endometrial/ovarian cancer, thromboembolic disorders

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21
Q

estrogen HRT contraindications and interactions

A

History of thromboembolic events
suspect /confirmed breast, vaginal, cervical, endometrial cancer
Many drug interactions

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22
Q

estrogen HRT RN intervention and client education

A

Monitor BP
Monitor for s/sx of DVT/PE/MI/stroke
Avoid smoking
Stop at least 4 weeks prior to surgery
Apply intravaginal/transdermal at bedtime
Monitor pattern and amount of uterine bleeding
Report persistent vaginal bleeding
D/C if any indication of breast cancer

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23
Q

hormone: androgen - testosterone prototype

A

testosterone (Androderm)

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24
Q

testosterone therapeutic uses

A

Treatment of male hypogonadism, delayed puberty, and testicular failure
Treatment of breast cancer in females
Hormone therapy for transgender males (AFAB)
EPA: synthetic testosterone

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25
Q

testosterone administration

A

PO
IM - gluteal muscle
Intranasal
Transdermal patch: Apply to upper arm, back, abdomen, thigh, Once daily, Rotate sites. Gel - cover - do not get wet for several hours. Underarm liquid
Buccal upper gums: Pressure w/ finger x30 sec, Alternate sides of gums, Bitter taste, changes in taste
Subcutaneous - implantable or injection

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26
Q

testosterone ADRs

A

Virilization - development of male physical characteristics (increased muscle bulk, body hair, deep voice), in females/children
Hypertension - increased risk of cardiovascular events
Increased growth of undiagnosed prostate CA
edema/weight gain
Gynecomastia
17-alpha-alkylated androgens (PO) are hepatotoxic (methyltestosterone, oxandrolone)
Abnormal bone growth - premature epiphyseal closure in children
Neuropsychiatric symptoms w/ abuse: increased irritability/aggression

27
Q

testosterone RN interventions and client education

A

Educate on virilization effects - reversible with discontinuation w/discontinuation
Prostate CA screening
Periodical monitoring of weight, sodium levels
w/ children and young adults monitor height, x rays 2x per year
Monitor LFTs - educate on s/sx of liver fx
Monitor for/educate on gynecomastia
May experience changes in mood, energy, and libido

28
Q

testosterone contraindications and interactions

A

Teratogenic! Males w/ breast, prostate CA, or urinary obstruction from BPH.
Black box warning for HTN
Increase action of insulin/antidiabetic meds
Increase effects of warfarin

29
Q

5-alpha reductase inhibitors prototype

A

finasteride (Proscar)

30
Q

5-alpha reductase inhibitors therapeutic use

A

BPH. Also, male pattern baldness (propecia)
Reduces risk of prostate cancer

31
Q

5-alpha reductase inhibitors administration

A

PO

32
Q

5-alpha reductase inhibitors EPA

A

inhibits 5-alpha reductase, the enzyme responsible for converting testosterone to 5-alpha DHT = inhibits metabolism of testosterone, causing decreased proliferation of prostatic cells - reducing the enlargement of the prostate gland and mechanical obstruction of the urethra
Can take 6-12 months for prostate reduction and symptom improvement

33
Q

5-alpha reductase inhibitors ADRs

A

reduced libido, ejaculate volume, and gynecomastia

34
Q

5-alpha reductase inhibitors RN intervention and client education

A

Hazardous drug precautions: Pregnant caregivers, nurses, or pharmacists should not handle (especially if crushed) the drug, which can be absorbed and harmful to a male fetus
Monitor for and educate pt on the adverse effects
Baseline PSA, monitor periodically
Cancer screening

35
Q

5-alpha reductase inhibitors contraindications and interactions

A

Women, children, pregnancy. Caution with additional obstructive urinary disorder and liver impairment

36
Q

alpha 1 - adrenergic blockers prototype and other drug names

A

tamsulosin (Flomax)
Others: silodosin, alfuzosin, terazosin, doxazosin (nonspecific)

37
Q

alpha 1 - adrenergic blockers therapeutic use

A

treats BPH and improves urination. Initial monotherapy

38
Q

alpha 1 - adrenergic blockers administration

A

PO, once daily - take 30 min after eating a meal/same time each day. Do not crush or chew

39
Q

alpha 1 - adrenergic blockers EPA

A

blocks alpha 1 adrenergic receptors = smooth muscle relaxation in the prostate and outlet of the bladder - increased urinary flow

40
Q

alpha 1 - adrenergic blockers ADRs

A

ejaculation irregularities, HA, dizziness
Other non specific alpha antagonists = hypotension/fainting

41
Q

alpha 1 - adrenergic blockers RN intervention and client education

A

Educate on altered ejaculation
- Reduced volume, possible failure, retrograde
If taking non-specific (alfuzosin, terazosin, doxazosin) educate on orthostatic hypotension
- Monitor BP
- Change positions slowly
- Do not drive if dizziness occurs

42
Q

alpha 1 - adrenergic blockers contraindications and interactions

A

Erectile dysfunction meds (sildenafil)
Female and children
Caution in patients with hypotension (non selective meds) - any drugs causing hypotension

43
Q

phosphodiesterase type 5 (PDE5) inhibitors prototype and other drug names

A

sidenafil (Viagra)
Others: vardenafil (Levitra), tadalafil (Cialis)

44
Q

PDE5 inhibitors therapeutic use

A

erectile dysfunction

45
Q

PDE5 inhibitors administration

A

PO, do not take more than 1 a day

46
Q

PDE5 inhibitors EPA

A

blocks PDE5 - which normally ends an erection

47
Q

PDE5 inhibitors ADRS

A

priapism, HA, hypotension, fainting, and dizziness. Rare ones are hearing loss and vision loss

48
Q

PDE5 inhibitors RN intervention and client education

A

If prolonged erection (>4 hrs) go to ER
Monitor for adverse effects: Mild analgesic for HA, Monitor BP if dizzy, Stop if hearing or vision loss occurs
Take 1 hr prior to sexual activity
High fat foods decrease effects of dildenafil and vardenafil
DO NOT take within 24 hrs of nitrates

49
Q

PDE5 inhibitors contraindications and interactions

A

Nitrates
Caution w/ recent cardiovascular events
CYP3A4 inhibitors increase effects (grapefruit juice, other meds)
Interaction w/ Tamsulosin = hypotension

50
Q

anticholinergic/urinary antispasmodics prototype

A

oxybutynin (Ditropan)

51
Q

anticholinergic/urinary antispasmodics therapeutic use

A

spastic bladder conditions (neurogenic bladders), overactive bladders: incontinence, urgency, frequency

52
Q

anticholinergic/urinary antispasmodics administration

A

PO, XR tablet, transdermal

53
Q

anticholinergic/urinary antispasmodics EPA

A

blocks muscarinic receptors in the detrusor muscle = bladder relaxation and contraction of internal sphincter

54
Q

anticholinergic/urinary antispasmodics ADRs

A

anticholinergic = DRY
Dry mouth, constipation, blurred vision, mydriasis (dilated pupils), dry eyes, decreased sweating = increased temp. HA, dizziness, and drowsiness

55
Q

anticholinergic/urinary antispasmodics RN intervention and client education

A

Monitor for anticholinergic effects/crisis
Urinary retention can cause overdistended bladder and UTIs (w/lack of sensation)
Caution in high heat, excessive temperatures - risk for hyperthermia
Drink lots of water
Increase fiber intake

56
Q

anticholinergic/urinary antispasmodics contraindications and client interaction

A

Closed angle glaucoma, myasthenia gravis, GI/GU obstruction
CYP3A4 inhibitors (grapefruitjuice, other meds - antibiotics/antifungals) = increased toxicity
CYP3A4 inducers (phenytoin, rifampin, carbamazepine) decrease effectiveness

57
Q

cholinergic/urinary stimulant prototype

A

bethanechol (Urecholine)

58
Q

cholinergic/urinary stimulant therapeutic use

A

non-obstructive urinary retention

59
Q

cholinergic/urinary stimulant administration

A

PO, empty stomach

60
Q

cholinergic/urinary stimulant EPA

A

actrivates muscarinic receptors in the detrusor muscle that lines the bladder = bladder contraction. Also relaxes internal sphincter

61
Q

cholinergic/urinary stimulant ADRs

A

cholinergic = wet - salivation, lacrimation, diarrhea (GI secretions - excess acid). Hypotension and bradycardia! dizziness/faining. Bronchoconstriction. Watch for cholinergic crisis

62
Q

cholinergic/urinary stimulant RN intervention and client education

A

Monitor BP, HR, resp status
Monitor for urinary output: Bedpan, urinal nearby, call bell within reach, bed alarm on
Educate regarding s/sx of hypotension
- sit/lie down if dizzy
- Do not drive

63
Q

cholinergic/urinary stimulant contraindications and interactions

A

Hypotension, hyperthyroidism, asthma, GI ulcers, obstructive urinary retention
Cholinesterase inhibitors worsen cholinergic effects
Promcainamide, quinidine, atropine, epinephrine interfere with therapeutic efffects

Pharm (13 decks)

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