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PHARM > Week 6 - Reproductive Drugs > Flashcards

Week 6 - Reproductive Drugs Flashcards

1
Q

What are teratogens?

A

Substances that can cause developmental abnormalities

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2
Q

Teratogens can result in characteristic set of ______. Exerts effects at _____________.

A

Teratogens can result in characteristic set of malformations. Exerts effects at a particular stage of fetal development.

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3
Q

Cigarette smoking effect on fetus (2)

A

Intrauterine growth restriction, still birth

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4
Q

Alcohol effect on fetus (2)

A

Neurocognitive delay, miscarriage

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5
Q

Drugs with significant teratogenic or other adverse effects

A

ACE inhibitors, amphetamines, acutane, androgens, busulfan, cocaine, diazepam, ethanol, heroin, metronidazole, phenytoin, smoking, thalidomide, tetracycline, warfarin

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6
Q

Tetracycline effect on fetus

A

Limb reduction

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7
Q

FDA pregnancy categories - A

A

No risk

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8
Q

FDA pregnancy category A example

A

Anti-emetics

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9
Q

FDA pregnancy categories - B

A

No fetal risk in animal studies - no risk assumed in humans

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10
Q

FDA pregnancy categories - C

A

Fetal risk in animal studies - weigh risk vs benefit

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11
Q

FDA pregnancy categories - D

A

Proven fetal risk in human studies - weigh risk vs benefit if life-threatening

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12
Q

FDA pregnancy categories - X

A

Proven fetal risk in humans studies - the risk is greater than benefit, AVOID in pregnancy

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13
Q

Therapeutic Uses of estrogen and progestin (4)

A
  • Menopausal hormone therapy
  • Issues with period irregularity and symptom relief
  • Anti-estrogen works against hormone responsive breast cancer, and can help with infertility
  • Anti-progestin can induce medical abortion (RA46 pill) - only for pregnancies less than 7 weeks
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14
Q

Combined Hormone Contraceptives (CHC) are made up of…

A

Synthetic version of estrogen (Ethinyl estradiol) and progestin (natural or synthetic progesterone)

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15
Q

Progestins ____ out the badass effects of ______

A

Progestins balance out the badass effects of estrogen

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16
Q

How are combined hormone contraceptives differentiated?

A

By the STRENGTH of the estrogen and TYPE of progestin

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17
Q

CHC routes

A

PO, transdermal, transvaginal

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18
Q

CHC mechanism

A

Produce drug-induced anovulatory cycles by suppressing pituitary secretion of FSH and LH through negative feedback system

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19
Q

Progestins change the uterine ____ to make it less favorable for ____ of a fertalized ovum

A

Progestins change the uterine endometrium to make it less favorable for implanatation of a fertalized ovum

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20
Q

Progestins change the _____ and ____ of the cervical mucus, making it thick and hostile to ___ _____

A

Progestins change the quantity and viscosity of the cervical mucus, making it thick and hostile to sperm penetration

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21
Q

Progestins alter the motility of the fallopian muscles and mucus to “plug” the cervix, preventing _______

A

Progestins alter the motility of the fallopian muscles and mucus to “plug” the cervix, preventing movement of the ovum and sperm

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22
Q

Estrogen _____ the uterine ______ to inhibit proliferation and secretory changes – this ______ irregular and or heavy bleeding

A

Estrogen stabilizes the uterine endometrium to inhibit proliferation and secretory changes. This decreases irregular and or heavy bleeding.

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23
Q

What is the most commonly prescribed category of contraceptive? Why? (3)

A

CHC - easy to use, high degree of effectiveness, relatively safe

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24
Q

Higher the dose of estrogen, ____ risk for (3)

A

Higher the dose of estrogen, increased risk for VTE, MI, and stroke

25
Q

Side effects of oral contraceptives (2)

A

Breakthrough bleeding - occurs during the active pill cycle

Withdrawal bleed - between cycles, not a real menstruation

26
Q

Dangerous side effects of oral contraceptives - ACHES

A 
A - abdominal pain 
C - chest pain/SOB
H - headache, dizziness, weakness, numbness, speech difficulty 
E - eye disorder
S - severe leg pain/swelling
27
Q

Oral contraceptives assessment (4)

A
  • Drug and herb use
  • Baseline BP and weight
  • Pregnancy status
  • History of contraindications especially smoking and HTN
28
Q

Monophasic

A

Fixed ratio every day

29
Q

Most common type of oral contraceptive

A

monophasic

30
Q

Biphasic

A

Fixed estrogen, progesterone amount varies

31
Q

Triphasic

A

Newest, low doses, few side effects - either the estrogen or progesterone varies throughout the cycle in different ratios during 3 phases

32
Q

Extended cycle

A

24 days of active therapy, 4 days of hormone free pills

33
Q

Continuous

A

Continuous active therapy

34
Q

What is drospirenone?

A

Progestin derived from spironolactone (instead of testosterone)

35
Q

Drospirenone is used in combination with

A

Ethinyl Estradiol

36
Q

Drospirenone can increase ____

A

Potassium

37
Q

Drospirenone contraindications (9)

A

Kidney/liver/adrenal disease, NSAIDs, potassium-sparing diuretics, ACE inhibitors, potassium supplementation, Angiotensin II Receptor Antagonists (ARBs), heparin

38
Q

What should you always check when giving Drospirenone

A

Serum potassium levels

39
Q

Yasmin - classification, type, route

A

Estrogen Combined with DRSP, monophasic, oral BCP

40
Q

Yaz - classification, type, route

A

Estrogen Combined with DRSP, extended cycle (24 days of active hormonal therapy)

41
Q

Beyaz - classification, type route

A

Estrogen Combined with DRSP, extended cycle (24 days of active hormonal therapy + 4 days of hormone free pills); during the active pill cycle, contains folic acid to promote healthy folic acid levels

42
Q

Hormone Therapy improves ____ symptoms and vaginal ___, _____ risk of _____ and ____ ______

A

Hormone therapy improves vasomotor symptoms and vaginal dryness, decreases risk of osteoporosis and osteoporotic fractures

43
Q

HT boxed warning: HT should only be used only for the ____ of menopausal symptoms at the ____ dose possible for the ____ duration possible (usually less than ____ years)

A

HT should only be used for the treatment of menopausal symptoms at the lowest dose possible for the shortest duration possible (usually less than 5 years)

44
Q

Estrogen-Progestin Therapy (EPT) should be used in women with…

A

An intact uterus

45
Q

Estrogen Therapy (ET) should be used in women…

A

Who have had a hysterectomy (surgical removal of uterus) because estrogen thickens the uterine lining

46
Q

Contraindications to HT (9)

A

Pregnancy, history of endometrial or breast cancer, history of thromboembolic disorders, active liver disease/chronic impaired liver function, active gallbladder or pancreatic disease, CAD, undiagnosed vaginal bleeding, endometriosis

47
Q

Osteoporosis

A

Progressive, debilitating skeletal disease that affects the elderly

48
Q

Is HT recommended for treatment of Osteoporosis?

A

NO

49
Q

HT can be used as a preventative measure of osteoporosis in who?

A

Postmenopausal women who are at risk

50
Q

What kind of medications can be used osteoporosis (2)? Mechanism?

A
  • Biphosphates slow bone resorption

- Selective estrogen receptor modulators (SERMs)

51
Q

Other methods of preventing osteoporosis

A

Vitamin D, calcium, weight baring exercise, fall prevention

52
Q

What category of drugs is used for sexual dysfunction?

A

Phosphodiesterase

53
Q

Phosphodiesterase mechanism

A

cGMP increases vasodilation and relaxation of smooth muscle to increase blood flow and strengthen erection (works mainly on corpus cavernosa)

54
Q

Sildenafil (Viagra) - classification, onset, contraindications (6)

A

Phosphodiesterase

  • 60 - 120 minutes onset of action
  • Contraindicated if on nitrates (potentiates hypotensive effect), CHF, cardiomyopathy, CAD, anatomic deformities, conditions predisposing to priapism
55
Q

Sildenafil side effects (5)

A

*H/A, flushing, dyspepsia (GI distress), nasal congestion, diarrhea

56
Q

Sildenafil rare side effects (4)

A

Blurred vision, photosensitivity, changes in color perception (blue and green), urinary tract symptoms (frequency, painful urination, cloudy/bloody urine)

57
Q

What is unique about Cialis?

A

It is longer acting

58
Q

What are essentially important to monitor in transgender on HT (3)?

A

BP, vascular status, lipids

PHARM (11 decks)

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