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Pharm 2 > Week One > Flashcards

Week One Flashcards

1
Q

Nuva Ring

A
  • 2 inch diameter ring inserted into upper 1/3 of vagina
  • placed for three weeks out for one week
  • placed during first five days of menstruation
  • use back up contraception for 5 days
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2
Q

Nexplanon

A
  • implanted under skin for 3 years
  • may not be effective in women with a BMI over 30, or on medications that induce liver enzymes
  • contains barium to be located
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3
Q

Medeoxyprogesterone acetate

A

Long acting injectable progestin

- injection every 3 months

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4
Q

Ortho-evra transdermal patch

A
  • patch is placed on skin of buttocks, upper putter arm, stomach, upper torso
  • does not work well in women above 198 lbs
  • do not place near breast because of estrogen
  • does not go through first pass effect
  • patch placed once a week for three weeks one week off for withdrawal bleeding
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5
Q

Period cycle

A
  • a woman get her period every 28 days

- if fertilization doesn’t occur estrogen and progestin drop causing shedding of uterine wall(bleeding)

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6
Q

Nonpharmacologic treatment of PMS

A
  • expression of empathy
  • family support
  • exercise
  • dietary changes(limit salty foods, alcohol, caffeine, and concentrated sweets
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7
Q

Herbal botanical and vitamin/mineral therapy for PMS

A
  • some experience symptom relief with vitamin B6

- increase calcium “food” intake(lowers risk of PMS)

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8
Q

Antidepressants and anti anxiety medication for PMS

A
  • Prozac and Zoloft are most common Selective Saratonin Reuptake Inhibitors
  • Xanax, Valium, Ativan most common for anti anxiety
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9
Q

Increased progestin

A

Causes thickening of endometrious mucous

“Hostile environment”

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10
Q

Increased estrogen

A
  • prevention of dominant follicle

- no estrogen or LH surges

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11
Q

Monophonic contraception

A

Set amount of estrogen and progestin throughout cycle

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12
Q

Biphasic contraceptive

A

Estrogen is same throughout cycle, progestin varies

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13
Q

Triphasic contraceptive

A

Varying levels of estrogen and progestin throughout cycle

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14
Q

First day start method

A
  • contraception is initiated on the 1st day of bleeding

- no backup method is needed when started on the 1st-5th day of menstruation

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15
Q

Sunday start

A
  • patient starts tab/patch on 1st Sunday after the 1st day of menstruation(if bleeding starts on Sunday start then)
  • if pt. starts her contraceptive later than 5 days after her menstruation, backup contraception should be used for 7 days
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16
Q

Quick start method

A

Patient starts the contraceptive the day she receives the prescription regardless of where she may be in here menstrual cycle
-back up contraceptive for 7 days

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17
Q

Extended cycle dosing

A
  • 24 days of active hormone, 4 days placebo

- more effective less withdrawal bleeding

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18
Q

Continuous dosing

A
  • 84 days of active hormone, seven days of placebo
  • 4 periods a year
  • seasonale(jolessa) seasonique
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19
Q

Lybrel (cont.dosing)

A

No interruption for withdrawal menses

-Sunday start

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20
Q

Antibiotics and birth control

A
  • may effect birth control especially tetracyclines

- use backup method of contraception during treatment and 7 days after treatment

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21
Q

ACHES

A 
Abdominal pain
Chest pain 
Headaches 
Eye disorders 
Severe leg pain/swelling(DVT)
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22
Q

Patient teaching

A
  • remind patient these drugs should only be used under watch of qualified practitioner
  • advise pt. certain drugs and herbs can decreases effectiveness and backup method should be used while being used
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23
Q

Patient safety

A
  • teach pt. smoking has many cardiovascular risks

- teach how to manage missed pills

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24
Q

One tablet missed

A

-take one tablet as soon as realized missed, then take next dose as scheduled

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25
Q

Two tablets missed

A
  • take two tablets as soon as realized, and two tablets the next day
  • use backup contraception the rest of cycle
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26
Q

Three tablets missed

A
  • discontinue present pack and allow for withdrawal bleeding
  • start new package 7 days after last tablet taken
  • use backup contraception until tablets have been taken 7 days consecutively
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27
Q

Progestin only tablet missed

A
  • take tablet as soon as realized and follow with next tablet at regular time
  • backup method for 48 hours
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28
Q

Spermicides

A
  • chemical agents that inactivate sperm before they can travel to the cervix and into the upper genital tract
  • the sponge(nonoxynol-9)
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29
Q

Combined hormone contraception pills

Emergency contraception

A
  • raises both estrogen and progestin to delay or prevent ovulation
  • yuzpe is the original type
  • 75% effective
  • should be taken within 72 hours
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30
Q

Plan B pill

A
  • progestin only pill that can be taken by anyone of childbearing age
  • must be over 17 Y/O to get OTC
  • should be taken by 72 hours after but can be effective up to 120 hours after
  • if taken within 24 hours it’s 95% effective
31
Q

Paragaurd copper IUD

A
  • may be inserted within 5 days of unprotected sex

- may stay in place up to 10 years as method of backup contraception

32
Q

Menopause

A
  • documented after permanent cessation of menstruation after a full year
  • should use backup contraception for full year after cessation
  • women who experience menopause before age 40 are said to have premature ovarian failure
33
Q

S/S of menopause

A 
Hot flashes 
Mood changes 
Decreased libido
Vaginal dryness 
Insomnia
Irregular the cessation of bleeding
34
Q

Side effects of estrogen being depleted

A

Vaginal bleeding
Oligomenorrhea
Nervousness
Dyspareunia(painful intercourse)

35
Q

Dude effects of progesterone being depleted

A

Dysmenorrhea

  • bleeding late in cycle
  • heavy flow with clots
36
Q

Hormone replacement therapy

A
  • used only to treat menopausal symptoms, at lowest dose, for shortest time possible(usually no more than 5 years)
  • without uterus women can do estrogen only pills
37
Q

Contraindications of HRT

A
  • DVT,CAD, liver disease
  • HX of endometrious or breast cancer
  • people with diabetes use HRT with caution
38
Q

Osteoporosis

A

Amy disease process that results in reduction in the mass of bone

39
Q

HT to prevent osteoporosis

A
  • showed 35% decrease in hip and vertebral FX, but had too many adverse reactions
  • no longer recommended for osteoporosis treatment
40
Q

Estrogen receptor modulator

A

Raloxifene(Evista)

-stimulates estrogen receptors without estrogen being around

41
Q

Osteoporosis prevention

A
  • 1200 mg of calcium+Vitamin D daily
  • regular weight bearing exercise
  • no smoking
42
Q

The Deontae’s for osteoporosis

A

Alendronate(Fosamax)

-must be taken with 6oz. Of water 30 min before meals, and patient must remain upright for 30 min

43
Q

Teriparatide for osteoporosis

A
  • stimulates parathyroid hormone to increase Ca levels
  • subcut injection
  • for men and women with multiple risk factors for FX especially osteoporosis
44
Q

Androgens

A

Male sex hormones that control the development and maintenance of sexual processes, accessory sexual organs, cellular metabolism, and bone and muscle growth

45
Q

Testosterone

A

Class: androgen
AR: masculinization, urinary urgency,gynecomastia, priapism(prolonged erection), allergic reaction
-drug interactions: increases effects of anticoagulants, decreases effects of barbiturates,phenytoin, and corticosteroids
-lab interactions: lowers blood glucose in diabetics, increases serum cholesterol, thyroid, liver function hematocrit
-inserted: IM
-excreted in urine and bile
- pregnancy category X

46
Q

Anabolic steroids

A
  • increases protein synthesis within cells, which results in a build up of cellist tissue, especially in muscle.
  • developed to maximize anabolic effects of androgens
  • athlete abuse can result in 30X TD
  • older teens heaviest users
47
Q

Anti-androgens

A
  • block synthesis/actions of androgens
  • used in treatment of BPH, advanced prostatic cancer, and HT
  • SE: hypotension
48
Q

Drugs for BPH

A
  • tamulosin(Flomax)

- doxazosin(coders)

49
Q

5-Alpha refuctase inhibitors

A

Finasteride(Proscar)

Dustaride(avodart)

50
Q

Hypogonadism

A

-given male androgens for TX

51
Q

Constitutional growth delay

A
  • Given androgens to boost long bone growth
  • not given before age 14
  • typically given between 15 and 17 before growth plates shut
52
Q

Finasteride(Proscar)

A
  • women should prepare with gloves on
  • cannot be taken by pregnant women
  • women who are/may be pregnant should not handle broken or crushed tabs d/t risk for fetal abnormalities
53
Q

Drugs that cause ED

A 
Anticholinergics 
Antidepressants 
Antihistamines 
Anti hypertensives
Antipsychotics 
Sedatives/recreational drugs 
Antiulcer drugs
54
Q

Causes of ED

A
  • blood flow(atherosclerosis)
  • nerve impairment(neuropathy)
  • pharmacological agents
  • low testosterone
55
Q

The afils ED meds

A

Phosphodieaterase inhibitors end in afil

56
Q

Sildenafil citrate(viagra)

A

Onset:30-60 min

-lasts 4 hours

57
Q

Vardenafil(levitra)

A

Onset:25-30 min

-lasts 4-5 hours

58
Q

Tadalafil(Cialis)

A

Onset:15 minutes

Lasts 36 hours

59
Q

Chest pain: the afils and nitroglycerin

A
  • cannot use Sidenafil citrate(viagra) within 24 hours of recieving NTG, Cialis must wait 36 hours or longer depending on age
  • SE of afils: blue vision, headaches, GERD
60
Q

Endometriosis

A

Abnormal location of endometrial tissue outside of uterus, that tissue is known as ectopic endometrial implants

-it’s a common cause of dysmenorrhea, pelvic pain associated with menstrual cycle, and infertility

61
Q

Pharmacological management of endometriosis

CHC products

A

-suppress Gn-RH release,prevent ovulation, and cause atrophy of uterine lining(actions thought to relieve pelvic pain by causing a regression of the endometrial implants

62
Q

Pharmacological management of endometriosis

Progestinal products

A
  • suppress ovulation and cause long term endometrial atrophy
  • suppress Gn-RH release
  • overtime progestins can shrink or eliminate endometrial implants

-Provera: 70-90% feel relief, causes bone density loss
Injection given every 11-13 weeks

63
Q

Pharmacological management of endometriosis

Gn-RH Agonists

A
  • pregnancy category C
  • gives negative feedback to have body no longer make LH or FSH
  • given 4-6 months at a time and puts woman in hypoestrogen state, at risk for osteoporosis
  • leupride acetate:IM injection monthly for up to 6 months
  • should be initiated in the first 3 days of menstrual cycle
  • nafarlin(nasal spray) one spray in one nostril in morning and one spray in other nostril at night for up to 6 months
64
Q

Primary infertility

A

Woman has never conceived

65
Q

Secondary infertility

A

Woman has conceived at some point

66
Q

Clomiphene Citrate( Clomid)

A

Class: Ovulation stimulant
SE: hot flashes,cyst formation, ovarian enlargement, weight gain,GI disturbances, multiple gestation
TE: stimulates the release of pituitary gonadotropins:FSH,LH
- readily absorbed in the GI TRACT
-half life is 5 days

67
Q

Nursing process for infertility

A
  • be aware of social/psychological issues it can cause on a couple
  • can be uncomfortable, expensive, with no garuntee of pregnancy
68
Q

PID SHUFFLE

A

Pelvic inflammatory disease

69
Q

Metronidazole(Flagyl)

A

Used for trichomoniasis

-do not use alcohol

70
Q

Ceftriaxone(Rocephin)

A

Used for ghonorrhea

71
Q

Penicillin G

A

Used for cyphilis

72
Q

Azithromycin (Zithromax)

A

Used for chlamydia

73
Q

Acyclovir(Valtrex)

A

Used for herpes

Pharm 2 (21 decks)

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