Reproductive System - Chapter 27 Flashcards
Contraception: Prevention of Pregnancy
- Behavioral
- Mechanical barriers
- Spermicidal
- Hormonal
- Surgical
Behavioral Contraception
- Abstinence
- Using a calendar to calculate fertile period and abstaining on those days
Spermicides
- Kill sperm
- Foams, jellies, creams
Mechanical Barrier Contraceptives
- Block sperm from entering the uterus
- Condoms, diaphragms, cervical cap
Surgical Methods for Contraception
-Female tubal ligation and male vasectomy
Types of Condoms
- Latex condoms
- Polyurethane condoms
- Lambskin condoms
- Invisible condoms
- Female condoms
Diaphragm
- Rx only in canada
- Spermicide is placed in the diaphragm before insertion
- Must be inserted before sexual intercourse and remain in the vagina for 6-8 hours after
Intrauterine Device (IUD)
- Prevents fertilization
- Do not protect against STI’s
- 2 Types: copper, and hormonal
- > 99% effective
Copper IUD’s
- Small T-shaped device wrapped in copper
- Stops sperm from making their way through the uterus into the fallopian tubes
- Nova T, FlexiT, Liberte
Hormonal IUD’s
- Progestin secreting device, inserted into the uterus
- Thickens cervical mucus, thins endometrial lining
- Release levonorgestrel
Generic: levonorgestrel
Plan B - oral
Mirena - IUD
Jaydess - IUD
Hormonal IUD’s ADR’s
- Acne
- Weight gain
- Headache
- Spotting for first 3 months
Oral Contraceptives (OCP or BCP)
- Contain a combination of an estrogen + a progestin or a progestin only
- Generally 21 or 28 day
OCP MOA
- FSH and LH secretion is inhibited through negative feedback
- Mature follicles do not develop and ovulation is prevented
Classification of Combination OCP’s
- First generation
- Second generation
- Third generation
- Fourth generation
First Generation Combination OCP’s
ee + ethynodiol or norethindrone as the progestin
Second Generation Combination OCP’s
ee + levonorgestrel
Third Generation Combination OCP’s
ee + norgestimate or desogestrel
Fourth Generation Combination OCP’s
ee + drospirenone
Oral Contraceptives ADR’s
- Loss of appetite
- Pain or muscle soreness
- Change in menstrual pattern
- Breast tenderness
- Cramping
- Signs of vaginal infection
- Blurred vision
- Weight gain
- DVT, thromboembolism, heart attack, stroke
OCP Contraindications
- Pregnancy
- Breastfeeding
- History of blood clots
- Smokers >35 years
- < 6 weeks postpartum
- Hypertension
- Focal migraine
Progestin Only OCP
- Known as minipill
- Used if there is a contraindication to estrogen
- Taken as 28 days of active pills
- Critical to take on time
Progestin Only OCP Examples
-norethindrone
Generic: norethindrone
Micronor
Non-oral Hormonal Contraceptives
-Progestin only hormone injection given by a health care professional every 12 weeks to prevent pregnancy
Non-oral Hormonal Contraceptives Examples
-medroxyprogesterone
Generic: medroxyprogesterone
Depo-Provera
Depo-Provera SC
Emergency Contraception
- Safe and effective way to prevent pregnancy after unprotected sex
- High dose of levonorgestrel
- Must take within 72 hours of unprotected sex
Emergency Contraception MOA
- Delays or prevents the ovaries from releasing an egg
- Alters cervical mucus and prevents fertilization
- Changes lining of uterus to make it difficult for a fertilized egg to implant
Menopause
- The termination of menstrual cycles
- Usually marked by 1 year without menstrual cycles
Symptoms of Menopause
- Nervousness
- Hot flashes
- Chills
- Excitability
- Fatigue
- Insomnia
- Heart palpitations
- Headache
- Numbness
Hormone Replacement Therapy
-Typically involves administration of oral or vaginal estrogens to minimize the symptoms of menopause
Dosage Forms of Estrogen Examples
- conjugated estrogens
- estradiol
- estropipate
Generic: conjugated estrogens
C.E.S
Premarin
Congest
Generic: estradiol (Oral)
Estrace
Generic: estradiol (Transdermal Patch)
Estradot
Climara
Oesclim
Generic: estradiol (Vaginal Ring)
Estring
Generic: estradiol (Transdermal gel)
Estrogel
Divigel
Generic: estradiol (Vaginal Tablet)
Vagifem
Generic: estropipate
Ogen
Progesterone Therapy Drugs Examples
- medroxyprogesterone
- progesterone
Generic: progesterone
Prometrium
Generic: medroxyprogesterone
Provera
Progesterone/Estrogen Combination Products Examples
- conjugated estrogens/medroxyprogesterone
- estradiol/norethindrone
- estradiol/drospirenone
- estradiol/progesterone
- ethinyl estradiol/norethindrone
Generic: conjugated estrogens/medroxyprogesterone
Premplus
Generic: estradiol/norethindrone
Estalis
Activelle
Activelle LD
Generic: estradiol/drospirenone
Angeliq
Generic: estradiol/progesterone
Estrogel Propak
Generic: ethinyl estradiol/norethindrone
femHRT
HRT ADR’s
- Nausea/vomiting
- Cramping
- Breast tenderness
- Spotting
- Headaches
- Weight gain
- Increased risk of breast cancer, coronary artery disease, blood clots, stroke
Menstrual Disorders
- Premenstrual syndrome
- Dysmenorrhea
- Amenorrhea
- Dysfunctional uterine bleeding
Premenstrual Syndrome (PMS)
-Condition that involves a collection of symptoms that regularly occur in women during the premenstrual phase of their cycles
Symptoms of PMS
- Headache
- Irritability
- Fatigue
- Nervousness
- Weight gain
- Sleep changes
- Depression
Premenstrual Dysphoric Disorder (PMDD)
-Severe form of
PMS
-Symptoms worsen with age
-Treated with antidepressants
Drugs Used to Treat PMDD Examples
- fluoxetine
- sertraline
- paroxetine
Generic: fluoxetine
Prozac
Generic: sertraline
Zoloft
Generic: paroxetine
Paxil
Paxil CR
PMDD Drugs Warning Labels
- MAY CAUSE DIZZINESS
- MAY IMPAIR ABILITY TO DRIVE
- AVOID ALCOHOL
- SWALLOW WHOLE; DONT CRUSH OR CHEW
Dysmenorrhea
-Term used to describe menstrual cramps
Dysmenorrhea Medications
- OCP’s
- NSAIDS
NSAID’s Used For Dysmenorrhea Examples
- ibuprofen
- naproxen sodium
- naproxen
- mefenamic acid
Generic: ibuprofen
Advil
Motrin
Generic: naproxen sodium
Aleve
Anaprox
Anaprox DS
Generic: naproxen
Naprosyn
Naprosyn-E
Naprelan
Generic: mefenamic acid
Ponstan
Amenorrhea
- The absence of normal menstruation
- Primary or secondary
Primary Amenorrhea
-Failure of menstruation cycles to begin
Secondary Amenorrhea
-Slows to 3-4 cycles per year
Causes of Primary Amenorrhea
- Hormone imbalances
- Genetic disorders
- Brain lesions
- Structural deformities
Causes of Secondary Amenorrhea
- Excessive weight loss
- Pregnancy
- Lactation
- Menopause
- disease
- Intensive sports training
- Malnutrition
Treatment of Amenorrhea Drugs Examples
-Bromocriptine
Generic: bromocriptine
Parlodel
Treatment of Amenorrhea Drugs Warning Labels
- TAKE WITH FOOD OR MILK
- MAY CAUSE DROWSINESS
- LIMIT ALCOHOL USE
Dysfunctional Uterine Bleeding (DUB)
-Irregular or excessive uterine bleeding resulting from a structural problem or hormonal imbalance
STI’s
-Caused by communicable pathogens
Disorders caused by STI’s
- PID
- Salpingitis
- Vaginitis
Pelvic Inflammatory Disease (PID)
- An STI involving development of scar tissue in uterus, uterine tubes, ovaries, etc.
- Major cause of infertility
Vaginitis
-Inflammation or infection of vaginal lining
Salpingitis
-Inflammation of the fallopian tubes
Infertility
-Failure to conceive after 1 year of regular unprotected intercourse
Treatment of Infertility
- Antiestrogens
- Gonadotropins
- GnRH antagonists
- GnRH agonists
- Progesterone
Antiestrogens Examples
-clomiphene
Generic: clomiphene
Clomid
Serophene
Gonadotropins Examples
- follitropin alpha
- follitropin beta
- urofollitropin
- human chorionic gonadotropin
- menotroopin
Generic: follitropin alpha
Gonal-f
gonal-f Pen
Generic: follitropin beta
Puregon
Generic: urofollitropin
Bravelle
Generic: human chorionic gonadotropin
Pregnyl
Generic: menotropin
Menopur
Repronex
GnRh Antagonists Examples
- cetrolix
- ganirelix
Generic: cetrorelix
Cetrotide
Generic: ganirelix
Orgalutran
GnRh Agonist Examples
-gonadorelin
Generic: gonadorelin
Lutrepulse
LnRh Analog Example
-triptorelin
Generic: triptorelin
Decapeptyl
Generic: progesterone
Crinone
Gonadotropins ADR’s
- Headache
- Lightheadedness
- Nausea
- Flushing
- Inflammation at injection site
Clomiphene ADR’s
- Visual disturbances
- Dizziness and lightheadedness
- Multiple births
Treatment of Androgen Deficiency in Males
-Anabolic-androgenic steroids
Anabolic-Androgenic Steroids Examples
-testosterone
Generic: testosterone
Andriol (Oral) Androderm (Patch) AndroGel (Gel) Axiron (Underarm) Delatestryl (IM) Depo-Testosterone (IM) Testim 1% (Gel)
Anabolic-Androgenic Steroids ADR’s
- Gynecomastia
- Impotence
- Penis enlargement
- Nausea
- Jaundice
- Headache
- Anxiety
- Depression
- Etc
Endometriosis
- Benign but very painful condition characterized by the presence of functioning endometrial tissue outside of the uterus
- Causes infertility, dysmenorrhea, and severe pain
Treatment of Endometriosis
- Combined OCP’s
- Progestins
- Danazol
- GnRh agonists
Progestins for endometriosis
- dienogest
- norethindrone
- medroxyprogesterone
- levonorgestrel
Generic: dienogest
Visanne
Generic: norethindrone (for endometriosis)
Norlutate
Generic: danazol
Cyclomen
-Supresses output of FSH and LH
GnRh Agonists for Endometriosis
- buserelin
- goserelin
- leuprolide
- nafarelin
Generic: buserelin
Suprefact
Generic: goserelin
Zoladex
Warning Labels
- STORE AT ROOM TEMP
- DO NOT FREEZE
Generic: leuprolide
Lupron
Warning Labels
- SHAKE WELL
- STORE AT ROOM TEMP
- DISCARD UNUSED PORTION
- ROTATE INJECTION SITE
Generic: nafarelin
Synarel
Warning Labels
-DO NOT USE NASAL DECONGESTANTS FOR 30 MINUTES AFTER