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Pharmacology for Advanced Practice Nurses > Reproductive deck 2 > Flashcards

Reproductive deck 2 Flashcards

1
Q

Progestin antagonists example and use

A

Mifepristone (Mifeprex)
Mifepristone inhibits the activity of both endogenous and exogenous progesterone; without progesterone to maintain the pregnancy, termination results.

Will act as an ABORTIFACIENT when used in conjunction with misoprostol during the first 7 weeks of pregnancy.

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2
Q

Gonadotropin-releasing hormone what is is ant use

A

A stimulant in pulsatile doses if the patient has a functional pituitary gland and an ovary to produce the luteinizing hormone surge initiating ovulation - Used to initiate ovulation

Also used to treat endometriosis and uterine fibroids and to suppress prostate cancer

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3
Q

Human menopausal gonadotropin: follitropin (Fertinex), menotropins (Pergonal, Humegon)
Men:

A

stimulate spermatogenesis

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4
Q

Human menopausal gonadotropin: follitropin (Fertinex), menotropins (Pergonal, Humegon)
women:

A

stimulate maturation of follicules and ovulation

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5
Q

Lacation supression drugs MOI and also works for

A

Has an inhibitory effect on pituitary gland, which produces prolactin
Also works for hyperprolactinemia
Also used in Parkinson’s disease

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6
Q

Bromocriptine begins to work and has

A

Begins to work within 2 hours

Many drug interactions

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7
Q

Erectile dysfunction drugs PDE5 examples

A

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

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8
Q

PDE5 contrindications

A

In patients using nitrates because of a risk of severe, even fatal hypotension

Alpha blockers have additive hypotension effect

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9
Q

PDE5 inhibitors Small studies in women

A

Small studies in women are inconclusive

Used in neonatal intensive care unit for persistent pulmonary hypertension

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10
Q

Addyi is also known as

A

pink viagra

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11
Q

Addyi is used in and what is the black box warning

A

For women with diagnosed with severe sexual dysfunction (serotonin and dopamine agonist)
Black Box warning for severe hypotension when used with alcohol

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12
Q

Addyi does not have a

A

a same day effect as with PDE5 inhibitors for men; takes about 3 months for full effect, and many do not benefit at all.

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13
Q

Estrogen has positive effects on

A

bone mass, increases serum triglycerides, and improves ratio of high-density lipoprotein to low-density lipoprotein.

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14
Q

Estrogen stimulates

A

coagulation and fibrinolyticpathways.

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15
Q

Progesterone increases

A

body temperature and insulin levels.

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16
Q

Progesterone may depress

A

the central nervous system.

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17
Q

Two formulations of estrogen are available in contraceptive preparations

A

ethinyl estradiol and mestranol.

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18
Q

First-generation progesterones

A

Norethindrone, norethindrone acetate, and ethynodiol diacetate

19
Q

Second-generation progesterones

A

Norgestrel and levonorgestrel

20
Q

Third-generation progesterones

A

Desogestrel and norgestimate

21
Q

Fourth-generation progesterones

A

Spironolactone derivative: drospirenone

19-nortestosterone derivative: dienogest

22
Q

Progestins are primarily responsible for

A

the contraceptive effect

23
Q

Progestins exhibit a negative

A

effect in the hypothalamic-pituitary-ovarian axis.

24
Q

Progestins cause atrophy

A

of the endometrium, preventing implantation.

25
Q

The estrogen component improves

A

efficacy by suppressing FSH release

26
Q

Estrogen provides

A

cycle control

27
Q

Contraceptives goal of treatment

A

Use the safest, best-tolerated, and most effective method that the patient desires.
Safety
Tolerance
Effectiveness

28
Q

Rational Drug Selection Contraceptives three steps

A

Start with absolute contraindications.
Delivery method should be of patient’s choice.

Fine tune based on:
Menstrual pattern
Side-effect profile

Consider:
Patient’s desire for discretion
Timing of subsequent pregnancy

29
Q

All types of oral contraception (OC) have similar

A

effectiveness

30
Q

Contraceptive cost

A

Retail cost of OC is $30 to $100 per cycle.
Generic OC is available on $4 retail lists.
Intrauterine device (IUD) or implant: upfront cost is expensive, but may have lower overall cost.

31
Q

Noncontraceptive Benefits

A

Decreased dysmenorrhea, menstrual irregularities, and menstrual blood loss

Lessening of acne and hirsutism
Fewer ovarian cysts

Significantly reduced endometrial and ovarian cancer risk

Lower incidence of benign breast conditions, such as fibrocystic changes and fibroadenoma

Reduced risk of hospitalization for gonorrheal pelvic inflammatory disease

Suppression of endometriosis in women who do not currently desire pregnancy

32
Q

Contracepive drug interactions

A

Tuberculosis drugs, antiepileptic drugs, St. John’s Wort

33
Q

lipid levels affected by

A

OC

34
Q

Adverse drug reactions for OC

A

Venous thromboembolism risk increases three to five times with OC use
Also: cholestatic jaundice, benign hepatic neoplasms, myocardial infarction, stroke, and neurological migraines

35
Q

OC traditional dosing

A

21 days active drug + 7 days inactive tablets with withdrawal bleed during inactive tablets

36
Q

Extended cycle OC

A

84 days of active drug, then 7 days off

Withdrawal bleed once every 3 months

37
Q

Monophasic OC

A

same dose of estrogen and progestin for full cycle

38
Q

Biphasic and Triphasic dosing for OC

A

Biphasic: vary the dose of progestin
Triphasic: vary the dose of estrogen, progestin, or both

39
Q

Starting method first day

A

Pills started on first day of menstrual cycle

No back up method needed

40
Q

Starting method sunday start

A

First pill taken on the Sunday following the start of menses
Back up method for first 7 days
Menses only occur during the week

41
Q

OC quick start “same day”

A

Quick or “same-day” start
First pill taken on the day of the office visit
Back up method for first 7 days (like condom) because not as effective for the first 7 days

42
Q

What to do if doses are missed of OC

A

follow what is said to them on the handout for the medication

43
Q

50% of women discontinue OC because of

A

side effects

Pharmacology for Advanced Practice Nurses (50 decks)

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