Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Pharma > Women's health > Flashcards

Women's health Flashcards

1
Q

teratogenic list of meds

A

-warfarin
-phenytoin
-valproic acid
-carbamazepine
-lithium
-ace inhibitors/ARBs
-thalidomide
-ethanol
-statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

combined oral contraception

A

choose a formula based on fertility goals, pt preference, discussion of risk/benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

risk of oral contraceptives

A

cancer, CV events/HTN, VTE, drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

VTE abbr

A

venous thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

concomitant use of antibiotic with oral contraceptive may result

A

in decreased contraceptive efficacy; however, this is category 1 under US MEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

concomitant use of P450 enzyme inducers (rifampin, phenytoin, carbamazepine, phenobarbital) may result in

A

decreased contraceptive efficacy

-if use COC, use higher doses (at least 35mcg EE) + high progestin, shorten hormone-free interval to 4 days or less
-avoid low progestin - the patch POP
-consider additional or alternative of birth control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

concomitant use of anti-HIV protease inhibitors can

A

either increase or decrease serum levels of estrogens and progestins
(may need back up method)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

drospirenone can cause

A

kyperkalemia if used with other agents that can increase K+ (ACEIs, heparin, aldosterone antagonists, etc).

benefits: on bone, menstrual effects, improved acne, PMDD, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

estrogen

A

excess: N/V, cervical mucorrhea, HTN, headache, breast tenderness, edema, melasma, bloating

def: early or mid-cycle breakthrough bleeding, increased spotting, hypomenorrhea, vasomotor sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

progestin

A

excess: breast tenderness, headache, fatigue, changes in mood
def: late breakthrough bleeding, hypermenorrhea, dysmenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

androgen

A

excess: inc appetite, wt gain, acne, oily skin, hirsutism, dec libido, inc breast size, breast tenderness, inc LDL, dec HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

amenorrhea

A

rule out other causes; can inc to more estrogenic formulation or to triphasic formulation to decrease amenorrhea
-not a concern if pt is happy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acne/oily skin/hirsutism

A

rule out of causes; switch to less androgenic formulation of progestin (or decrease progestin content)

3rd generation: desogestrel, norgestimate
4th generation: drospirenone
dienogest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gi typically resolved in

A

1-3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

decrease estrogen component will help with

A

nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

decrease progestin component to help with

A

bloating and constipation

17
Q

bleeding/spotting

A

common 30-50% when first initiated; often resolved by 3rd or 4th cycle

rule out causes inc medications (that increase metabolsim)

18
Q

if spotting or bleeding before completing active cycle (late cycle (10-21d)

A

increase progestin to enhance endometrial support

-monophasic w/ higher progestin or triphasic with ing progestin

19
Q

if spotting after withdrawl bleeding (early cycle (1-9d)

A

increase estrogen or decrease progestin in the early pills (triphasic)

20
Q

if mid-cycle spotting/bleeding

A

increase both estrogen/progestin midcycle

21
Q

if headaches start or worse after starting OC, need to rule out

A

other causes (take BP, ask about headache, any focal neurologic symptoms)
-if treated to OC use and are not serious, discontinue OC, lower estrogen dose, lower progestin, eliminate pill free interbal (only if HA occur during pill free interval)

22
Q

decreased libido

A

ask about depressing
-if due to decrease in vag lubrication, switch to vag ring contraception
-inc estrogen

23
Q

HTN

A

COC can cause small increase (6-8mmHg) in BP, regardless of estrogen dosage

-low dose: COC is acceptable in women younger than 35 years with well controlled and freq monitored HTN
-discontinuing COC usually restored BP to pretreatment values w/i 3-6 months

24
Q

VTE

A

estrogen increases hepatic production of factor VII, factor X and fibrinogen in the coagulation cascade thus increasing the risk of thromboembolic events

25
Q

progestins

A

newer 3rd & 4th generation - greater effect on procoagulant, anticoagulant, and fibrinolytic pathways

-increased resistance to the anticoagulant effect activated by protein C
-higher levels of sex hormone binding globulin

26
Q

for women at high risk of thromboembolism consider

A

low-dose oral estrogen contraceptives containing older progestins or Progestin only contraceptive

27
Q

Situations when Progestin Only oral contraceptives suitable?

A

-Breastfeeding (post-partum phase)
-Older women who cant take estrogen

***failure is higher than other progestin-only methods or COCs
-effectiveness is lowered when taken as little as a few hours late

28
Q

T1& T2 DM in pregnancy tx

A

-ADA diet
-insulin:
regular insulin or NPH, insulin lispro (Humalog)
aspart (Novolog)

insulin req increase beginning around 28 wks gestation & continues to increase due to placental hormones

increasing data on the safety of insulin glargine in pregnancy

29
Q

T1& T2 DM in pregnancy 2nd line tx

A

oral agents (metformin/glyburide)

30
Q

HTN

A

SBP reaches 160/DBP reaches 110

con’t tx when multiple HTN’s were req before pregnancy or when end-organ damage is present

methyldopa, labetalol, nifedipine ER 1st line

31
Q

hypothyroidism

A

levothyroxine - DOC

-attain normal thyrotropin concentrations
- women who received thyroid replacement prior to pregnancy can expect an increased dosage requirement of 25-50% during pregnancy

32
Q

depression

A

classified as severe unipolar major tx w/ antidepressants prior to pregnancy should generally receive the same drug during pregnancy

-have not been tx’ed w/ antidepressants, selective serotonin reuptake inhibitors (SSRIs) as initial tx

33
Q

psychotic drugs examples approved by FDA during pregnancy and lactation

A

none

34
Q

1st line for depression

A

psychotherapy (not always an option)

35
Q

SSRIs

A

avoid paroxetine (D) during 1st trimester (CV malformations)

fluoxetine (C), citalopram (c), sertraline (C)&raquo_space;>best options during pregnancy

36
Q

risks w/ SSRIs during pregnancy

A

after 20 wks, PPHTN

risk of neonatal withdrawwal or adaptation syndrome 1

d/c 2 wks before term

37
Q

TCAs for depression

A

literature is reassuring
possible withdrawal sxs

38
Q

atypical antidepressants

A

limited data

39
Q

dyslipidemia

A

women who are on statin and anticipate becoming pregnant should stop statins 3 months prior to attempting to conceive
-maternal consumption of fish and marine omega-3 fatty acid supplement is an active area of investigation bc of potential favorable effects on pregnancy and offspring otucome

Advanced Pharma (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions