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Reproductive Health Flashcards

1
Q

generic name and class

premarin

A

generic: conjugated estrogens
class:estrogens

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2
Q

indication

premarin

A

Abnormal uterine bleeding (acute); breast cancer (metastatic, palliative); postmenopausal osteoporosis prevention, prostate cancer (palliative); secondary amenorrhea due to hypoestrogenism, vasomotor symptoms associated with menopause with or without vulvar/vaginal atrophy associated with menopause

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3
Q

MOA

premarin

A

he mixture of estrogens in this product replace the estrogens produced by the body responsible for the development and maintenance of the fame reproductive system and secondary sex characteristics. Responsible for modulation of gonadotropins (luteinizing hormone and follicle stimulating hormone) through negative feedback

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4
Q

major contraindications

premarin

A

Angioedema or anaphylactic reaction to estrogens or any component of the formulation; undiagnosed
abnormal genital bleeding; DVT or PE (current or history of); active or history of arterial thromboembolic disease (eg, stroke, MI); breast cancer (except in appropriately selected patients
being treated for metastatic disease); estrogen-dependent tumor (known or suspected); hepatic impairment or disease; known protein C, protein S, antithrombin deficiency or other known
thrombophilic disorders; pregnancy

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5
Q

BBW

premarin

A

Endometrial cancer, breast cancer, cardiovascular disease, dementia, risk v. benefit

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6
Q

common ADRs

premarin

A

> more than 10%: Weight change, headache, migraine, depression, disorder of menstruation, breast pain
1-10%: Edema, vasodilation, abdominal pain, hirsutism, diarrhea, nausea, stomach cramps, vomiting, backache

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7
Q

rare but serious ADRs

premarin

A

Heart disease, HTN, MI, breast cancer, diabetes mellitus, hypercalcemia, venous thromboembolism,
anaphylaxis, cerebrovascular accident, cervical cancer, malignant neoplasm of endometrium of corpus uteri, ovarian cancer, PE

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8
Q

key counseling points

premarin

A

Discuss potential long-term adverse effects of hormone therapy including MI, stroke, DVT, PE, and breast cancer. Take at bedtime to minimize side effects. Take with or without meals

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9
Q

generic name and class

estrace

A

generic: estradiol
class: estrogens (oral)

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10
Q

indication

estrace

A

Abnormal uterine bleeding (acute); breast cancer (metastatic, palliative); postmenopausal osteoporosis prevention, prostate cancer (palliative); secondary amenorrhea due to hypoestrogenism, vasomotor symptoms associated with menopause with or without vulvar/vaginal atrophy associated with menopause

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11
Q

MOA

estrace

A

Estradiol (a form of estrogen) in this product replaces the estrogens produced by the body responsible for the development and maintenance of the fame reproductive system and secondary sex characteristics. Responsible for modulation of gonadotropins (luteinizing hormone and follicle stimulating hormone) through negative feedback

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12
Q

major contraindications

estrace

A

Angioedema or anaphylactic reaction to estrogens or any component of the formulation; undiagnosed abnormal genital bleeding; DVT or PE (current or history of); active or history of arterial
thromboembolic disease (eg, stroke, MI); breast cancer (except in appropriately selected patients being treated for metastatic disease); estrogen-dependent tumor (known or suspected); hepatic impairment or disease; known protein C, protein S, antithrombin deficiency or other known
thrombophilic disorders; pregnancy

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13
Q

BBW

estrace

A

Endometrial cancer, breast cancer, cardiovascular disease, dementia, risk v. benefit

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14
Q

common ADRs

estrace

A

1-10%: Weight change, nausea, vomiting, disturbance in mood, swelling of breast, depression

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15
Q

rare but serious ADRs

estrace

A

Heart disease, MI, DM, venous thromboembolism, anaphylaxis, cerebrovascular accident, PE, breast,
endometrial or ovarian cancer

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16
Q

key counseling points

estrace

A

Report abnormal vaginal bleeding or signs/symptoms of a thromboembolic disorder. Do not smoke during therapy, as this increases the risk of thromboembolic events.

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17
Q

generic name and class

alora, climara, minivelle, menostar, vivelle-DOT, estraderm

A

generic: estradiol transdermal patch
class: estrogens

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18
Q

generic name and class

prometrium

A

generic: progesterone
class: progestins

oral, vaginal gel or insert

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19
Q

indication

prometrium

A

Prevention of estrogen-induced endometrial hyperplasia (oral) )while conjugated estrogens are administered; secondary physiologic amenorrhea (oral or gel); assisted reproduction for infertile women (gel or insert)

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20
Q

MOA

prometrium

A

Progesterone transforms proliferative endometrium into secretory endometrium. Systemically administered progesterone inhibits gonadotropin production, which in turn prevents follicular maturation and ovulation

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21
Q

major contraindications

prometrium

A

Abnormal vaginal bleeding, history of estrogen- or progesterone-dependent neoplasia, active or history of DVT or PE, known or suspected pregnancy

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22
Q

BBW

prometrium

A

Should not be used for the prevention of cardiovascular disorders, dementia or breast cancer

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23
Q

common ADRs

prometrium

A

> 10%: weight changes, headache, amenorrhea, breast tenderness, abdominal pain
1-10%: nausea, asthenia, feeling nervous, break through bleeding

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24
Q

rare but serious ADRs

prometrium

A

Thromboembolism (DVT, PE), thrombophlebitis, osteoporosis

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25
key counseling points | prometrium
If using for amenorrhea, menstrual bleeding should occur 3-7 d after last oral dose. Report if menstruation does not occur within 7 d after last dose. For vaginal formulation, avoid using other vaginal drugs within 6 h before or 6 h after using progesterone
26
generic name and class | provera - oral, depo-provera - injection
generic: medroxyprogesterone class: progestins
27
indication | medroxyprogesterone
Abnormal uterine bleeding unrelated to menstrual cycle (oral); prevention of estrogen-induced endometrial hyperplasia (oral); secondary physiologic amenorrhea (oral); prevention of pregnancy (injection); endometriosis (injection)
28
MOA | medroxyprogesterone
Medroxyprogesterone transforms proliferative into secretory endometrium. Androgenic and anabolic effects have been noted, but the drug is devoid of significant estrogenic activity.
29
major contraindications | medroxyprogesterone
Hypersensitivity to medroxyprogesterone, abnormal genital bleeding, history of estrogen- or progesterone-dependent neoplasia, active or history of DVT or PE, severe liver dysfunction, known or suspected pregnancy
30
BBW | medroxyprogesterone
Increased risk of cardiovascular disorders, breast cancer and dementia; loss of BMD; not for long-term use
31
common ADRs | medroxyprogesterone
>10%: Weight gain, headache, amenorrhea, breast tenderness, nervousness 1-10%: Abdominal pain, asthenia, breakthrough bleeding
32
rare but serious ADRs | medroxyprogesterone
DVT, thrombophlebitis, osteoporosis, PE
33
key counseling points | medroxyprogesterone
Menstrual bleeding should occur 3-7 d after last dose. Contact HCP if menstruation does not occur within 7 d after last dose. Do not use if you become pregnant.
34
class of oral contraceptives
estrogen/progestin combo
35
indication | oral contraceptives
contraception and some for acne
36
MOA | oral contraceptives
As contraceptives, estrogens suppress follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to inhibit ovulation, cause edematous endometrial changes that are hostile to implantation of the fertilized ovum, accelerate ovum transport, and produce degeneration of the corpus luteum (luteolysis). Progestins inhibit ovulation by suppression of LH, inhibit sperm capacitation, slow ovum transport, produce a thinning endometrium that hampers implantation, and cause cervical mucus changes that are hostile to sperm migration
37
major contraindications | oral contraceptives
Hypersensitivity to ethinyl estradiol or progestin component, history or risk of thromboembolic disorders, breast or endometrial cancer, uncontrolled HTN, hepatic disease, known or suspected pregnancy, thrombogenic cardiac value or rhythm disease, headaches with focal neurologic symptoms; women >35 y of age who smoke
38
BBW | oral contraceptives
Women >35 y of age who smoke
39
common ADRs | oral contraceptives
more than 10%: weight change, breast tenderness, breast swelling 1-10%: Bloating, nausea, stomach cramps, vomiting, depression
40
rare but serious ADRs | oral contraceptives
Arterial thromboembolism, AMI, thrombophlebitis, cerebral hemorrhage, cerebral thrombosis, PE, HTN
40
key counseling points | oral contraceptives
Hormonal contraceptives do not protect against HIV infection or other sexually transmitted diseases. Take this drug at approximately the same time each day. If spotting occurs and no doses have been missed, continue to take tablets even if spotting continues. Report immediately if new severe or persistent headache; blurred or loss of vision; shortness of breath; severe leg, chest, or abdominal pain; or any abnormal vaginal bleeding occur. If you miss 1 dose, take it as soon as you remember it and take the next tablet at the correct time even if you take 2 tablets on the same d or at the same time. If you miss 2 doses in wk 1 or 2, take 2 tablets on the day you remember and 2 tablets the next day. If you miss 2 doses in wk 3 or miss 3 or more active tablets, (if you start on day 1) start a new pack the same day or (if you start on Sunday) take 1 tablet daily until Sunday and then start a new pack that day. Use an alternative form of contraception for the next 7 d after you miss 2 or more doses in weeks 1, 2, or 3.
41
generic name and class | nuvaring
generic: ethinyl estradiol/etonogestrel ring class: estrogen/progestin combo
42
indication | nuvaring
contraception
43
MOA | nuvaring
same as COC
44
major contraindications | nuvaring
Hypersensitivity to ethinyl estradiol or progestin component; history of thromboembolic disorders, endometrial cancer, uncontrolled HTN, pregnancy; smoking ≥15 cigarettes per d and >35 y of age
45
BBW | nuvaring
smoking risk
46
common ADRs | nuvaring
more than 10%: headache, intermenstrual bleeding, vaginitis 1-10%: Mood changes, acne, weight gain, amenorrhea, nausea, vomiting, abdominal pain, vaginal discharge
47
rare but serious ADRs | nuvaring
AMI, anaphylaxis, angioedema, thromboembolism, galactorrhea not associated with childbirth, hypersensitivity reaction, toxic shock syndrome, urticaria, thromboembolism
48
key counseling points | nuvaring
Same as COC. If the vaginal ring is inadvertently expelled or removed, it may be rinsed in cool to lukewarm water and reinserted as soon as possible, at the latest within 3 h. If the ring-free interval has been extended beyond 7 d or if the vaginal ring has been left in place for >4 wk, an additional form of contraception must be used until the vaginal ring has been used continuously for 7 d.
49
generic name and class | androgel, androderm
generic: testosterone class: testosterone
50
indication | testosterone
hypogonadism (men)
51
MOA | testosterone
estosterone is an endogenous androgen. Androgens are responsible for normal growth and development of male sex organs. Testosterone is involved in the growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution; laryngeal enlargement; vocal cord thickening; alterations in body musculature; and fat distribution
52
major contraindications | testosterone
hypersensitivity to testosterone; men with breast or prostate cancer; women (in cross contamination) who are pregnant, who may become pregnant, or who are breast-feeding
53
BBW | testosterone
Secondary exposure (topical), BP increases (oral); pulmonary oil microembolism (injectable)
54
common ADRs | testosterone
more than 10%: Benign prostatic hyperplasia, testicular atrophy, PSA increase 1-10%: Acne, headache, gynecomastia, alopecia, impotence, aggressive behavior, HTN
55
rare but serious ADRs | testosterone
Cardiac arrest, cerebrovascular accident, hepatotoxicity, hallucinations, hostility, and aggression
56
key counseling points | testosterone
Gel to be applied to clean, dry, intact skin of the shoulders and upper arms and/or abdomen but should not be applied to genitals. Gel should be allowed to dry well; swimming and showering should be avoided for 5-6 h after application. Patients should keep application site covered, as direct skin contact can transfer drug to others. Virilization has been reported in children who were secondarily exposed to testosterone gel. Male patients should report too frequent or persistent erections. Female sexual partners of patients using drug should report male-like changes. Do not use higher doses than you have been prescribed, or combine with other anabolic steroids, serious adverse effects can occur. Seek medical attention if chest pain, shortness of breath, signs of stroke, or behavioral changes.
57
generic name and class | folacin-800
generic: folic acid class: supplements for reproductive health
58
indication | folic acid
Megaloblastic and macrocytic anemia due folic acid deficiency
59
MOA | folic acid
Folic acid is required for the conversion of deoxyuridylate to thymidylate, which is a rate-limiting step in DNA synthesis. Folic acid deficiency presents clinically as macrocytic anemia when red blood cells are unable to extrude their nucleus
60
major contraindications | folic acid
hypersensitivity
61
common ADRs | folic acid
more than 10%: loss of appetite 1-10%: confusion, irritation
62
rare but serious ADRs | folic acid
anaphylaxis
63
key counseling points | folic acid
May require several weeks for maximum effect. Avoid alcohol as it inhibits the absorption of folic acid.
64
generic name and class | precare, prenexa
generic: prenantal vitamin class: supplements for reproductive health
65
indication | prenatal
diet supplementation during pregnancy
66
MOA | prenatal
Provide vitamin and mineral supplementation throughout pregnancy and during the postnatal period for both the lactating and the non-lactating mother. It is also useful for improving nutritional status prior to conception
67
major contraindications | prenatal
hypersensitivity
68
BBW | prenatal
iron toxicity (some formulations)
69
common ADRs | prenatal
more than 10%: Nausea 1-10%: vomiting, constipation
70
key counseling points | prenatal
May contain iron, so important to keep out of the reach of children. Take in the evening if morning sickness present. May take with food to avoid GI upset, but administration with milk will decrease extent of iron absorption. May darken stool due to iron content.

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