Week 6 Drugs Affecting the Reproductive System ALREADY STARTED Flashcards
1
Q
Endocrine system is a system of __ and __ __ (aka ___ ) throughout the body
A
glands
circulating substances
messengers
2
Q
These circulating substances and messengers (which is part of the endocrine system) interact with the __ __. This interaction is termed __.
A
nervous system
feedback
3
Q
Feedback responses by the nervous system helps maintain __.
A
homeostasis
4
Q
We are so honored to be in the presence of such trust and faith in our abilities to care……
A
without judgments directed toward the patient
5
Q
Many patients and families ___ ____ that you will judge them or look down upon them in some way when it comes to content in this area and to aspects of our most private lives. We must be on our guard to not let this happen.
A
simply expect
6
Q
What are the different types of reproductive agents?
A
- oral contraceptives
- hormone replacement therapy (HRT)
- male reproductive agents
- Hormone therapy in transgender care
7
Q
What are the 3 types of male reproductive agents?
A
- testosterone
- anabolic steroids
- drugs for erectile dysfunction (ED)
8
Q
What are the MOST effective contraceptive option?
A
- Male/Female Sterilization
2. IUD/ IUS Implants
9
Q
The MOST effective contraceptive options prevent pregnancy __ of the time
A
> 99%
10
Q
What are VERY effective contraceptive options?
A
Pills
Injectables
Patch
Ring
11
Q
The VERY effective contraceptive options prevent pregnancy ~ __ - ___of the time
A
~91-99%
12
Q
What are MODERATELY effective contraceptive options?
A
Male/Female Condom
Sponge
Diaphragm
13
Q
The MODERATELY effective contraceptive options prevent pregnancy ~ __ - ___of the time
A
~81-90%
14
Q
EFFECTIVE contraceptive options include?
A
- fertility awareness
- cervical cap
- spermicide
15
Q
Effectiveness rates for most of the contraceptive method are expressed as __ __ , or the percentage of women who can be expected to become pregnant within the __ __ they use that method.
A
failure rates
first year
16
Q
Effectiveness rates are given with both __ use and __ use.
A
perfect
typical
17
Q
What does perfect use mean when it comes to effectiveness rates?
A
correct and consistent use of the method with every act of intercourse
18
Q
What does typical use mean when it comes to effectiveness rates?
A
actual use, including occasional, inconsistent, or incorrect use
19
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use NO METHOD?
A
850
20
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use WITHDRAWAL ?
A
270
21
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use a MALE CONDOM?
A
150
22
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use PILL?
A
80
23
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use an INJECTABLE?
A
30
24
Q
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use an IMPLANT?
A
0.5
25
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use IUD (LNG-IUS, Copper T)?
2-8
26
What are the number of unintended pregnancies among 1,000 women in their 1st year of (typical) use when they use STERILIZATION (M/F)?
1.5 -5
27
According to data from Trussell and WHO Global FP handbook, studies show withdrawal's failure rate at __ %
18%
28
Implants are __ times more effective than injectables.
60
29
IUDs are __-__ times more effective than pills.
10-40
30
Vasectomy is __ times more effective than condoms.
100
31
LAPMs are __-__ times more effective and this translates into much lower greatly reduction the deleterious health, economic, and social effects of unintended pregnancies
30-50
32
In pregnancy and postpartum the use of __ and __ __ are a concern
prescription
| nonprescription
33
Many maternal physiologic changes of pregnancy and postpartum affect __ __ and __
drug action and use
34
There are a __ number of drugs conclusively safe for embryo
limited
35
What are substances that cause developmental abnormalities?
teratogens
36
Teratogenic fetus results in characteristic set of __
malformations
37
Teratogens exert effects at a __ stage of fetal development
particular
38
What are two teratogens and their detrimental effects to the fetus?
1. Cigarette smoking (intrauterine growth restriction, stillbirth)
2. Alcohol (neurocognitive delay, miscarriage)
39
What are the 5 FDA pregnancy categories?
A. Studies show no fetal risk.
B. No fetal risk in animal studies; no risk assumed in
humans.
C. Fetal risk in animal studies; weigh risk vs. benefit.
D. Proven fetal risk; weigh risk vs. benefit if life-
threatening
X. Proven fetal risk; risk > benefit; avoid in pregnancy
40
Which drugs have a significant teratogenic effects/adverse effects?
```
ACE Inhibitors
Amphetamines
Androgens
Busulfan
Cocaine
Diazepam
Ethanol
Heroin
Metronidazole
Phenytoin
Smoking
Thalidomide
Tetracycline
Warfarin
```
41
For the maternal pt, medications may have different effects on __ __ due to __ __
reproductive tissues
hormonal changes
42
Physiologic changes during pregnancy may lead to need for __
medications
43
What are two examples of meds that pregnant pts need because of physiologic changes?
Cardiac Glycoside and Diuretics for heart failure due to increased cardiac workload during pregnancy
44
In the menstrual cycle, the menarche average age is
11.6 years
45
At the start of the menstrual cycle, ovaries being a __ to __ year period of cyclic function
30-40
46
In menopause, there is a failure to respond to __ secreted by the __ __ __
gonadotropoins
anterior pituitary gland
47
Gonadotropins are produeced by
anterior pituitary
48
What role does follicle-stimulating hormone (FSH) play in women and men?
Women: follicle development
Men: spermatogenesis
49
What role does Luteinizing hormone (LH) play in women and men?
Women: estrogen and progesterone production, mid-cycle surge leads to ovulation
Men: testosterone production
50
Interaction of __ and __ are necessary for ovulation and sperm maturation
FSH ; LH
51
What are the therapeutic uses for estrogen and progestin?
1. contraception
| 2. menopausal hormone therapy
52
What are the two estrogen- and progesterone-receptor antagonists?
1. Anti-estrogen
| 2. Anti-progestin
53
What is anti-estrogen used for?
hormone responsive to breast cancer and infertility
54
What is anti-progestin used for?
medical abortion
55
What are the most commonly prescribed contraceptives?
Estrogen-Progestin Combination Products
56
Estrogen-Progestin Combination Products are __ to use, have a __ degree of effectiveness, and are relatively __.
easy
high
safe
57
Estrogen-Progestin Combination Products are differentiated based on the __ of the __ component and type of __ used
strength
estrogen
progestin
58
The goal of Estrogen-Progestin Combination Products is to have the __ __ and fewest undated __ __
best protection; side effects
59
Estrogen-Progestin Combination Products can be administered:
oral
transdermal
transvaginal
60
What is the physiologic mechanism of oral contraceptives?
1. suppresses pituiatry secretion of FSH and LH
2. Creates changes in the endometrium to make it less favorable for implantation of fertilized ovum
3. Change quantity and viscosity of the cervical mucus to make it hostile to sperm
61
What are factors influencing a woman's use of contraceptives?
1. cultural/personal attitudes
2. personal situation
3. contraceptive use/ knowledge
4. sexual education
5. media
6. health care system barriers
62
How does the media influence a woman's use of contraceptives?
the media overemphasizes sex while virtually ignoring contraception
63
How does sexual education influence a woman's use of contraceptives?
Lack of comprehensive sexual education and emphasis on abstinence-only sex ed
64
How do cultural/personal attitudes influence a woman's use of contraceptives?
Cultural and personal attitudes and barriers that prevent patients from adequately assessing pregnancy risk and using contraceptives when they don’t want to become pregnant
65
How does partner situation influence a woman's use of contraceptives?
Partner situation (eg, partner’s feeling about contraception, situations involving intimate partner violence)
66
What health care barriers are there that influence a woman's use of contraceptives?
1. delayed initiation of contraception, common myths and misperceptions about obtaining and using contraceptives
2. insurance barriers (eg, lack of insurance or aspects of insurance that interfere with effective use of contraceptives)
3. and clinician limitations (including lack of experience and training in providing certain contraceptive methods and/or counseling)
67
What are the three types of estrogen-progestin combination BCPs (Birth Control Pills)?
1. Monophasics
2. Biphasics
3. Triphasics
68
Monophasic BCPs are __ __ . They have a fixed ratio of __ and __ throughout the cycle
most common
| estrogen; progestin
69
Biphasic BCPs have fixed __ but their __ varies
estrogen
| progesterone
70
Triphasic BCPs are the __ combination pill. In low doses, they have __ __ __ (e.g. __)
Either __ or __ varies during 3 phases
newest
few side effects; bleeding
estrogen; progesterone
71
Is withdrawal bleeding a true menstrual period?
no
72
In withdrawal bleeding, bleeding can...
vary in amount and duration
73
Researchers have established that a monthly episode of withdrawal bleeding is...
NOT necessary to maintaining a healthy uterus
74
What is an EXTENDED CYCLE BCP?
Loestrin 24 Fe (Norethindrone acetate/ethinyl estradiol and ethinyl estradiol and ferrous fumarate)
75
Loestrin 23 Fe is a...
It has also has __ days of __ __ pill
24 day active hormonal therapy
4 ; iron supplement
76
What are 2 Continuous Dosing BCPs?
1. Seasonale (Jolessa)& Seasonique
4 periods per year, may have break thru bleeding
2. Lybrel- Continuous dose 28 day packets
Taken continuously without interruption for withdrawal menses
77
Estrogen Combination BCPs with Drospirenone (drsp) is a progestin derived from __ and not __
spirinolactone
testosterone
78
What are 3 examples of Estrogen Combination BCPs with Drospirenone (drsp)?
1. Yasmin (Drospirenone and Ethinyl Estradiol) - monophasic
2. Yaz (Drospirenone/Ethinyl Estradiol) – 24 day active
3. Beyaz (Ethinyl Estradiol, Drospirenone, and Levomefolate) – promotes healthy folic acid levels
79
Estrogen Combination BCPs with Drospirenone (drsp) are used in combination with __ __
ethinyl estradiol
80
Estrogen Combination BCPs with Drospirenone (drsp) may increases __
potassium
81
Estrogen Combination BCPs with Drospirenone (drsp) should NOT be taken if you have __, __, or __ disease
kidney, liver, adrenal
82
If you are taking other drugs long term that increase potassium levels other than Estrogen Combination BCPs with Drospirenone (drsp), you should get routine __ __ to check potassium.
blood test
83
Which drugs when taken with Estrogen Combination BCPs with Drospirenone (drsp) should you make sure to check Potassium levels?
```
1.NSAIDs
Ibuprofen, naproxyn
2.K + sparing diuretics
Spironolactone
3.ACE inhibitors
Capoten, Vasotec, Zestril
4.Angiotensin-II receptor antagonists
Cozaar, Diovan, Avapro
5.Heparin
```
84
Progestin only BCPs are known as the "__-__"
mini-pill
85
Progestin Only BCPs alter __ __ and alter __ to inhibit implantation
cervical mucus
| endometrium
86
Progestin Only BCPs are designed to decrease
circulatory side effects
87
Progestin Only BCPs have an increased risk of __ and break thru __ .
pregnancy
| break thru
88
If a progestin only BCP pill is taken more than __ __ late, back up contraception for __ hours
3 hours
48
89
Progestin Only BCPs: all __ pills are active
28
90
Ortho-Eva Transdermal Patch is a patch that is placed :
once a week for 3 weeks in a row
91
Ortho-Eva Transdermal Patch:
| FOURTH week is __-__ to allow for withdrawal bleeding
patch-free
92
Ortho-Eva Transdermal Patch works in a similar manner to:
Combined Oral Contraceptive pills
93
Depo-Provera is a highly __, __-acting injectable __ in the form of __ __
effective; long
progestin
depot-medroxyprogesterone acetate (DMPA or MPA)
94
What is characteristic of using Depo-Provera? (2)
1. Anovulation
| 2. Amenorrhea
95
The NuvaRing Transvaginal Contraception is __ __ in diameter and is a __ __ __ inserted into the vagina
2 inches
| flexible indwelling ring
96
The NuvaRing Transvaginal Contraception is:
| __-___, __, __ (or almost __)
non-biodegradable
transparent
colorless
colorless
97
What is an example of an implantable progestin?
Nexplanon
98
Nexplanon is a __-__ device that contains __ __
single-rod
| progestin etonogestrel
99
Nexplanon lasts for __ __
3 years
100
Most monophasics are __ and __ tablets
21 ; 28
101
The 28 tablets in monophasics include __ __ __
7 placebo "counters"
102
For Monophasics, you start the 1st __ after menstruation. Back up method at least __ days.
On the first menstrual cycle day, this is no need for __ __ method.
For monophasics, you start __.
Sunday
7
back up
quickly
103
Consult __, __, or __ for complete information about start dates and back-up methods for missed doses of monophasics
lexicomp
micromedex
uptodate
104
What are BCP Contraindications?
```
Pregnancy
Breast feeding 35y/o
Hx DVT, PE, or stroke
Endometrial CA
Multi CV risk factors
Age, smoking, DM, HTN
Ischemic/valve HD
Major surgery & prolonged immobilization
Breast cancer
```
105
If you have diabetic __, __, __, it is a BCP contraindication. Diabetes of greater than __ __ duration is also a contraindication b/c BCPs can increase __ __.
IF you have have __ __ __ or __ it is also a contraindication.
nephropathy, retinopathy, neuropathy
20 years
blood glucose
active viral hepatitis
cirrhosis
106
What should you be cautious about for a person who is going to take BCPs?
IF the person has:
1. Undiagnosed genital bleeding
2. Postpartum 15 cig/day
5. Gallbladder disease
6. Past history of breast cancer > 5 years
7. Drugs that affect liver enzymes
8. Mild hypertension without other risk factors for cardiovascular disease
9. Hyperlipidemia
10. insulin dependent diabetes
11. Known hyperlipidemia
107
What should you assess for a person on oral contraceptives?
1. Drug and herb use
2. Baseline BP and weight
3. Pregnancy status
4. Hx contraindications, esp. smoking and HTN
108
What are nursing diagnoses for person on oral contraceptives?
1. Deficient knowledge
2. Noncompliance
3. Risk for impaired liver function
4. Nausea
109
What should be included in the planning for person on oral contraceptives?
1. Client will use method suitable to lifestyle & risk factors
2. Client will take BCPs as prescribed & report side effects
110
What are nursing interventions for person on oral contraceptives?
1. Separate personal views from those of client
2. Concurrent use of some drugs & herbs may ↓ effectiveness
therefore, Use alternate contraceptive methods
111
What should you educate the patient about on oral contraceptives?
Oral contraceptives:
1. ↓ risk Fe deficiency anemia
2. May ↓ risk uterine, ovarian, & endometrial cancers
3. Thromboembolism risk assoc with ↑ dose estrogen
4. Doesn’t protect against STDs
112
What are rare side effects of oral contraceptives?
Thromboembolism, PE, MI, CVA, retinal thrombosis
113
What is the pneumonic for dangerous side effects of oral contraceptives?
ACHES
114
What does ACHES stand for?
A - abdominal pain (severe)
C - chest pain or SOB
H - headaches (severe); dizziness, weakness, numbness, speech difficulties
E = eye disorders
S - severe leg pain or calf/thigh swelling
115
What are 3 types of emergency contraceptions?
1. combined hormone contraception pills
2. Plan B (Progestin levonorgestrel )
3. copper intrauterine devices
116
How do combined hormone contraception pills work as an emergency contraceptive?
1. Raises estrogen and progestin levels to delay or prevent ovulation
2. Interfere with tubal transport of the embryo, egg, or sperm
3. Changes uterine lining
117
How does Plan B (Progestin levonorgestrel ) work as an emergency contraceptive?
1. Progestin levonorgestrel (0.75mg each)
| 2. Most effective if first dose is taken within 72 hours of intercourse
118
Menopause is termed the "__ __ __" event
It is a continuum from __ __ to __ __. IT is a permanent end of menstruation caused by decreased __ __ function .
Average age is around __.
"change of life"
no difficulty ; severe difficulty
ovarian function
50
119
Symptoms of menopause:
```
Irregular menstruation vasodilation
hot flashes
sweating
“heat” to upper chest, neck and head; flushing
chills
loss of sleep
tachycardia
Vaginal alterations: dryness and thinning. Decreased bone mass: Osteoporosis
```
120
__ is a stage when the body adapts to a new hormonal environment
Postmenopause
121
During post menopause, production of __ and __ from the ovaries decrease
estrogen; progesterone
122
Hormonal Therapy (HT) improves __ __ and __ __ . It also decreases the risk of __ and __ __.
vasomotor symptoms
vaginal dryness
osteoporosis
osteoporotic fractures
123
What is the BOXED WARNING for Hormone Therapy (HT)?
HT should be used only for the treatment of menopausal symptoms, at the lowest dose possible, for the shortest duration possible, usually less than 5 years.
124
HT includes __ and __
EPT ; ET
125
What is EPT?
Estrogen-progestin therapy for use with women have an intact uterus
126
What is ET?
Estrogen therapy (ET) for use with women who have had a hysterectomy
127
What is a hysterectomy?
surgical removal of the uterus
128
What are the contraindication to Hormone Therapy?
```
Pregnancy
History of endometrial cancer
Personal history of breast cancer
History of thromboembolic disorders
Acute liver disease or chronic impaired liver function
Active gallbladder or pancreatic disease
Coronary artery disease (CAD)
Undiagnosed vaginal bleeding
Endometriosis
```
129
Osteoporosis is a __ debilitating skeletal disease that affects __ men and women
progressive
older
130
HT is no longer recommended for the treatment of __ but should be considered as a __ measure in postmenopausal women who are at risk
osteoporosis
preventive
131
What slows bone reposition?
Biphosphonates
132
What is used to treat osteoporosis in postmenopausal women?
Selective estrogen receptor modulators (SERMs) - such as raloxifene
133
How do you prevent osteoporosis?
1. Calcium
2. Vitamin D
3. Weight-bearing exercises
4. Fall prevention
134
What medications are used for treating osteoporosis?
(Bisphosphonates)
1. Alendronate (Fosamax)
2. Ibandronate sodium (Boniva)
3. Risedronate (Actonel)
135
Name 4 types of male reproductive agents
1. Androgens: Testosterone being primary
2. Anabolic Steroids
3. Drugs for Sexual Dysfunction
4. Masculinization: FTM (transmale)
136
What is the main androgen?
testosterone
137
Where is testosterone synthesized?
primarily in the testes and lesser extent in adrenal cortex
138
What are the physiologic effects of androgens?
1. Male sex hormones
2. Sexual processes
3. Accessory sexual organs
4. Cellular metabolism (↑ RBC production)
5. Bone and muscle growth (protein anabolism)
139
What are the uses for testosterone?
1. Hypogonadism
2. Constitutional growth delay
3. Treatment of refractory anemia
4. Masculinization: FTM Transgender (transmale)
140
What are the side effects of testosterone?
1. Abdominal pain
2. Nausea
3. Constipation
4. ↑ or ↓ libido
5. Insomnia
6. Headache
7. Aggressive behavior
8. Weakness
9. Dizziness
10. Pruritus
11. Mouth soreness
141
What are adverse reactions of testosterone?
```
Acne
Hirsutism
Masculinization
Irregular menses
Urinary urgency
Gynecomastia
Priapism
Jaundice
Allergic reaction
Na+ & water retention
Depression
Habituation
Oily skin/hair
Testicular atrophy
Emotional lability (when used by women)
```
142
What are 4 life-threatening reactions of testosterone?
1. Hepatic necrosis
2. Hepatitis
3. Hepatic tumors (risk for liver cancer)
4. Respiratory distress (and coughing)
143
__ __ are testosterone derivatives that maximize __ and __ effects
Anabolic steroids
anabolic; androgenic
144
There is an abuse potential of Anabolic steroids among
athletes and trainers
| gay and bisexual adolescent boys
145
Where can anabolic steroids be purchased? (5)
1. grocery stores
2. health food markets
3. sports stores
4. underground
5. through internet
146
What are the three types of erectile dysfunctions?
1. organic
2. psychogenic
3. mixed
147
What are the 4 types of ejaculation/orgasm disorders
1. anejaculation
2. dysorgasmia (painful orgasm)
3. anorgasmia/retarded orgasm
4. premature
148
What are the two types of sexual incontinence
1. arousal incontinence
| 2. climacturia
149
What is climacturia?
when a man leaks urine as he ejaculates
150
What is hirsutism?
unwanted, male-pattern hair growth in women like facial hair and chest hair
151
What is gynecomastia?
enlarged breasts in men
152
What is priapism?
when erect penis does not return to its flaccid state
153
What is habituation?
the diminishing of a physiological or emotional response to a frequently repeated stimulus
154
What is emotional lability?
a tendency to laugh or cry unexpectedly at what might seem the wrong moment
155
What is the type of drug for sexual dysfunction? (erectile dysfunction)
Phosphodiesterase reuptake inhibitors
156
What is one component of phosphodiesterase reuptake inhibitors?
cGMP
157
What are 3 examples of phosphodiesterase reuptake inhibitors?
1. Sildenafil (Viagra)
2. Tadalafil (Cialis)
3. Vardenavil (Levitra)
158
What does cGMP do?
helps to relax smooth muscle which increases vasodilation and increases blood flow
159
What does cGMP stand for?
cyclic guanosine monophosphate
160
Sildenafil (Viagra) is a potent and selective reuptake inhibitor of __ in __ __
cGMP
corpus cavernosa
161
Sildenafil (Viagra) restores __ __ . Onset of action is __ - __ min.
erectile response
60-120
162
Sildenafil (Viagra) - potentiates __ __ of nitrates
hypotensive effects
163
Sildenfail (Viagra) should be contraindicated if using any __
nitrates
164
Contraindications of Sildenafil (Viagra) :
1. CHF, cardiomyopathy, coronary artery disease
2. Anatomic deformities
3. Conditions predisposing to priapism
165
What are the side effects of Sildenafil (Viagra)
1. Headache (most common)
2. Flushing
3. Dyspepsia – GI distress
4. Nasal congestion
5. Diarrhea
*Report these promptly to HCP
166
What are rare side effects of Sildenafil (Viagra)?
1. Blurred vision
2. Photosensitivity
3. Changes in color perception
Esp. blue & green
4. Urinary tract symproms
Frequency
Painful urination
Cloudy or bloody urine
167
To achieve congruence with gender identity, hormones may be used to “____-___". There are therapies called __ __ __ therapies ( __, __)
trans-gender
cross sex hormone
FTM, MTF
168
Feminizing/masculinizing interventions have a __ spectrum of possibilities
wide
169
MTF (transfemale) who take feminizing hormones may be at increased risk of __ __ compared to __ __ but significantly decreased risk compared to __ __
breast cancer
natal males
natal females
170
It is important to monitor __ , ___ __, and ___ for people on cross sex hormone therapies
BP
vascular status
lipids
171
What are the effects of hormone therapy for female to male: testosterone?
1. Deepening of the voice
2. Genital changes
3. Irregular menses cessation of menses
4. Clitoral enlargement
5. Atrophic vaginitis (thinning/shrinking of the tissues, decreased lubrication)
6. Increased libido
7. Redistribution of fat from hips to waist
8. Increased upper body strength (with exercise)
9. Integument
Male-pattern facial and body hair growth
Male-pattern hair loss
10. Psychological sense of well-being
172
What are side effects of hormone therapy - FTM: testosterone?
1. Acne
2. headaches
3. weight gain
4. fluid retention
173
What are risks of FTM hormone therapy (testosterone) ?
1. Polycythemia (overproduction of red blood cells)
2. hepatotoxicity (chemically driven liver damage)
3. worsening of lipid profile (risks of coronary heart disease) and increased homocysteine (amino acid in blood related to heart disease) level
4. emotional changes
5. infertility
6. insulin resistance
7. osteoporosis
174
What are the effects of male to female (MTF) hormone therapy? (estrogens & anti-androgens)
1. Breast development
Magnitude of enlargement is highly variable;
size beyond B cup is uncommon
Maximum effect after two years
2. Integument
Body hair diminishment
Slowing, stopping, or reversal of androgenic hair loss
Softening of the skin
3. Fat redistribution (smaller waist, wider hips)
4. Reduction in upper body muscle mass and strength
May result in loose skin for a short time
5. Psychological sense of well-being
6. No effect on beard hair
Electrolysis
175
What are the genital changes of MTF hormone therapy (estrogen & anti-androgens)?
1. Testicular atrophy
2. Reduction in penis size
3. Decrease in frequency and strength of erections
4. Decrease in volume and content of semen
5. Reduction in prostate size
176
Is there an effect on the prominence of the larynx (adam's apple) for a person on MTF hormone therapy?
NO
177
Is there an effect on pitch and resonance of voice for a person on MTF hormone therapy?
NO
178
What are the risks of MTF hormone therapy?
1. thromboembolism (DVT)
2. increased risk of breast cancer
3. high levels of prolactin/tumors in pituitary gland
4. liver damage
5. cardiovascular risk
6. infertility
7. anxiety/depression
8. gallstones
9. hypertension
10. osteoporosis
179
What are the two types of drugs used for benign prostatic hypertrophy (BPH)?
1. Alpha 1 blockers
| 2. 5-alpha-reductase inhibitors
180
What is the mechanism of action for alpha 1 blockers?
relaxes the muscles around the prostate = less pressure on the urethra improving urinary flow.
Dilates arterioles and veins and relaxation of sympathetic effects on the bladder and urinary tract.
181
What are the side effects of alpha 1 blockers?
1. GI distress
2. stuffy nose
3. headache
4. dizziness
5. fatigue
6. orthostatic hypotension
182
What are 4 examples of alpha 1 blockers?
1. Cardura/doxazosin
2. Flomax/tamsulosin
3. Uroxatral/alfuzosin
4. Hytrin/terazosin
183
What is the mechanism of action for 5-alpha-reductase inhibitors?
inhibits enzymes that converts testosterone to a potent androgen dihydrotestosterone (DHT), which the prostate glad need for its development.
“Shrinks” the prostate.
184
What are the side effects of 5-alpha-reductase inhibitors?
↓ libido, impotence (due to ↓ DHT)
185
What are two examples of 5-alpha-reductase inhibitors?
1. Avodart/dutasteride
| 2. Proscar/finasteride)
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What is important to note for a person who is taking 5-alpha-reductase inhibitors?
Restrict blood donation for 6 months after last dose to prevent exposure of recipients
