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Pharmacology Exam #3 > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

ethinyl estradiol & drospirenone (Yasmin): Class

A

Oral contraceptives - combination estrogen/progesterone

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2
Q

ethinyl estradiol & drospirenone (Yasmin): other medications

A

ethinyl estradiol & norethindrone (Ortho-Novum 1/35)

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3
Q

ethinyl estradiol & drospirenone (Yasmin): EPA

A

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

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4
Q

ethinyl estradiol & drospirenone (Yasmin): Use

A

Pregnancy prevention; PMS symptoms; Stabilize menses; Prophylactic uterine/ovarian cancer, PID, ovarian cysts

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5
Q

ethinyl estradiol & drospirenone (Yasmin): ADRs

A

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

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6
Q

ethinyl estradiol & drospirenone (Yasmin): Contraindications

A

Pregnancy – teratogenic
BRCA1 gene mutation
ACE inhibitors
Many drug interactions: Rifampin, anti-seizure, & antifungal dec effectiveness

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7
Q

ethinyl estradiol & drospirenone (Yasmin): RN Intervention

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 & amt of uterine bleeding
D/C if any indication of breast cancer

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8
Q

levonorgestrel (Mirena) (same as Plan B): class

A

Contraceptives - Intrauterine Device (IUD)

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9
Q

levonorgestrel (Mirena): Use

A

Pregnancy prevention; Tx PMS symptoms and heavy periods; emergency contraception (120 hours after unprotected sex); endometriosis; Fibroids

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10
Q

levonorgestrel (Mirena): ADRs

A

acne, migraines, vaginitis, ovarian cysts, hair loss, decreased libido, menstrual pattern changes, unwanted hair growth; Pelvic inflammatory disease (PID); ectopic pregnancy (MEDICAL EMERGENCY); uterine perforation

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11
Q

levonorgestrel (Mirena): EPA

A

thins uterine lining, thickens cervical mucus to prevent sperm from entering, inhibits sperm from reaching/fertilizing the egg

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12
Q

levonorgestrel (Mirena): Contraindication

A

Pregnancy – teratogenic
PID
Past or current breast, cervical, or uterine cancer
< 6 weeks post partum

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13
Q

levonorgestrel (Mirena): RN Intervention

A
  • Confirm absence of pregnancy FIRST
  • Avoid smoking
  • Monitor pattern & amt of uterine bleeding
  • Teach client to feel for IUD strings with a clean finger once/month after menses: Call provider if strings seem shorter or longer than usual/can’t locate string/unable to feel IUD
  • Report any sudden abdominal pain/cramping/vaginal bleeding, abnormal discharge, fever
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14
Q

How does Plan B work?

A

take within 72 hours of unprotected sex and it works by delating ovulation

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15
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): Class

A

Estrogen & Progesterone Hormone Replacement Therapy (HRT)

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16
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): other medications

A

transdermal combination of estradiol & norethindrone (CombiPatch)

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17
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): 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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18
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): use

A

Relieves symptoms of menopause

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19
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): 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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20
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): Contraindications

A
  • History of thromboembolic events
  • Suspect/confirmed breast, vaginal, cervical, endometrial cancer
  • Many drug-on-drug interactions
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21
Q

conjugated estrogen & medroxyprogesterone acetate (Prempo): RN Interventions

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 @ bedtime
Monitor pattern & amt of uterine bleeding
Report persistent vaginal bleeding
D/C if any indication of breast cancer

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22
Q

conjugated equine estrogen (Premarin): Class

A

estrogen hormone replacement therapy (HRT)

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23
Q

conjugated equine estrogen (Premarin): other medications

A

transdermal estradiol (Estraderm); estradiol intravaginal tablets (Vagifem); estradiol cream (Estrace)

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24
Q

conjugated equine estrogen (Premarin): 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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25
Q

conjugated equine estrogen (Premarin): Use

A

relieves symptoms of menopause

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26
Q

conjugated equine estrogen (Premarin): ADRs

A

Nausea is very common; HTN; endometrial hyperplasia - increase risk for endometrial/ovarian cancer; thromboembolic disorders

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27
Q

conjugated equine estrogen (Premarin): Contraindication

A
  • History of thromboembolic events
  • Suspect/confirmed breast, vaginal, cervical, endometrial cancer
  • Many drug-on-drug interactions
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28
Q

conjugated equine estrogen (Premarin): RN Intervention

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 @ bedtime
Monitor pattern & amt of uterine bleeding
Report persistent vaginal bleeding
D/C if any indication of breast cancer

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29
Q

testosterone (Androderm): class

A

hormone: Androgen - Testosterone

30
Q

testosterone (Androderm): Use

A
  • Treatment of male hypogonadism, delayed puberty, and testicular failure
  • Treatment of breast cancer in females
  • Hormone therapy for transgender males (assigned female at birth)
31
Q

testosterone (Androderm): EPA

A

synthetic testosterone

32
Q

testosterone (Androderm): administration

A

PO, IM, Intranasal, Transdermal patch (rotate sties each week), Buccal upper gums (pressure for 30 seconds, change taste), Subcutaneous

33
Q

testosterone (Androderm): ADR

A

virilization - development of male physical characteristics (increased muscle bulk, body hair, deep voice), hypertension, increased growth undiagnosed prostate cancer, edema/ weight gain, gynecomastia, hepatotoxic, abnormal bone growth (premature epiphyseal closure in children), neuropsychiatric symptoms with abuse

34
Q

testosterone (Androderm): RN Interventions

A

educate on virilization, prostrate cancer screening, periodical monitoring of weight and sodium levels, monitor in children, monitor LFTs, may experience changes in mood, energy, libido

35
Q

testosterone (Androderm): contraindications

A

teratogenic, breast/prostate cancer, urinary obstruction from BPH, HTN

36
Q

testosterone (Androderm): interactions

A

increase action of insulin/ antidiabetic medications, increases effect of Warfarin

37
Q

finasteride (Proscar): class

A

5-alpha Reductase Inhibitor

38
Q

finasteride (Proscar): Use

A

BPH (benign prostatic hyperplasia), male pattern baldness (Propecia)

39
Q

finasteride (Proscar): 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.

40
Q

How long does it take for prostate reduction and symptoms improvement take place?

A

6 - 12 months

41
Q

finasteride (Proscar): ADRs

A

reduced libido, ejaculate volume, and gynecomastia

42
Q

finasteride (Proscar): RN Interventions

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 baseline PSA (prostate specific antigen)
  • cancer screening
43
Q

finasteride (Proscar): contraindications

A

women, children, pregnancy, caution with obstructive urinary disorder and liver impairments

44
Q

tamsulosin (Flomax): Class

A

Alpha1 - adrenergic blockers

45
Q

tamsulosin (Flomax): other medications

A

silodosin, alfuzosin, terazosin, doxazosin (nonselective alpha antagonists)

46
Q

tamsulosin (Flomax): Use

A

Treats BPH and improves urination.
Initial monotherapy

47
Q

tamsulosin (Flomax): administration

A

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

48
Q

tamsulosin (Flomax): EPA

A

blocks alpha1-adrenergic receptors = smooth muscle relaxation in the prostate and outlet of bladder - increased urinary flow

49
Q

tamsulosin (Flomax): ADRs

A

ejaculation irregularities, headache, dizziness, nonspecific: hypotension/fainting

50
Q

tamsulosin (Flomax): RN Interventions

A

educate on altered ejaculation (reduced volume, failure, retrograde), educate on orthostatic hypotension

51
Q

tamsulosin (Flomax): contraindications

A

contraindicated with erectile dysfunction drugs (sildenafil), females/children, hypotension (non-selective meds) – any drugs causing hypotension

52
Q

sildenafil (Viagra): class

A

phosphodiesterase type 5 (PDE5) Inhibitors

53
Q

sildenafil (Viagra): other medications

A

vardenafil (Levitra), tadalafil (Cialis)

54
Q

sildenafil (Viagra): Use

A

Erectile dysfunction

55
Q

sildenafil (Viagra): administration

A

PO, do not take more than once a day!

56
Q

sildenafil (Viagra): EPA

A

blocks PDE5 that normally ends an erection

57
Q

sildenafil (Viagra): ADRs

A

priapism, headache, hypotension, fainting, dizziness, rare: hearing loss, vision loss

58
Q

sildenafil (Viagra): RN Intervention

A

if erection more than 4 hours go to ER, take 1 hour prior to sexual activity, high fat foods decrease effects, DO NOT take within 24hrs of nitrates (Nitroglycerin) - used to treat angina: live threatening hypotension

59
Q

sildenafil (Viagra): contraindication

A

Nitrates, caution with recent cardiovascular events, CYP3A4 inhibitors increase effects (grapefruit juice), interactions with Tamsulosin - hypotension

60
Q

oxybutynin (Ditropan): class

A

anticholinergic/ urinary antispasmodics

61
Q

oxybutynin (Ditropan): use

A

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

62
Q

oxybutynin (Ditropan): EPA

A

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

63
Q

oxybutynin (Ditropan): ADR

A

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

64
Q

oxybutynin (Ditropan): RN Interventions

A

Monitor for anticholinergic effects/crisis,
Urinary retention can cause overdistended bladder and UTI,
Caution in high heat, excessive temperatures - risk for hyperthermia, Drink lots of H20!, Increase fiber intake

65
Q

oxybutynin (Ditropan): contraindication

A
  • closed-angle glaucoma, myasthenia gravis, GI/GU obstruction.
  • CYP3A4 inhibitors (grapefruit juice, other meds- antifungals/antibiotics) = increased toxicity
  • CYP3A4 inducers (phenytoin, rifampin, carbamazepine) decrease effectiveness
66
Q

bethanechol (Urecholine): Class

A

Cholinergic/ Urinary Stimulant

67
Q

bethanechol (Urecholine): Use

A

non-obstructive urinary retention

68
Q

bethanechol (Urecholine): administration

A

PO, empty stomach

69
Q

bethanechol (Urecholine): EPA

A

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

70
Q

bethanechol (Urecholine): ADRs

A
  • Cholinergic = wet - salivation, lacrimation, diarrhea (GI secretions – excess acid)
  • Hypotension and Bradycardia! Dizziness/fainting
  • Bronchoconstriction
  • Watch for cholinergic crisis!
71
Q

bethanechol (Urecholine): RN Interventions

A

monitor RP, HR, and respiratory status, monitor for urinary output, educate regarding hypotension

72
Q

bethanechol (Urecholine): Contraindication

A
  • hypotension, hyperthyroidism, asthma, GI ulcers, obstructive urinary retention.
  • Cholinesterase inhibitors worsen cholinergic effects
  • Procainamide, quinidine, atropine, epinephrine interfere with therapeutic effects.

Pharmacology Exam #3 (10 decks)

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