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Pharmacology > Women's Health > Flashcards

Women's Health Flashcards

1
Q

How long is an average menstrual cycle? How long does bleeding last?

A

Cycle: 21-35 days
Bleeding: 1-7 days

4 phases: Menstrual, Follicular, Ovulatory, Luteal

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2
Q

MCC of 2ndary dysmenorrhea?

A

Endometriosis

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3
Q

What is integrative therapy for dysmenorrhea?

A
  • Thermal therapy (heat), acupressure, acupuncture
  • TENS (electrical nerve stim)
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4
Q

When should NSAIDs be used for primary dysmenorrhea?

A

Begin day 1 of menses for 3 days and use around the clock; NOT PRN

Take with food
If one fails (Ibuprofen), try the other one (Naproxen)

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5
Q

Which 2 NSAIDs are preferred for primary dysmenorrhea?

A

Ibuprofen
Naproxen

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6
Q

distant places endometrial tissue can be found in endometriosis

A

lung pleura, lungs, brain

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7
Q

Pain control options for endometriosis

A
  • NSAIDs - safe and effective for pelvic pain -> Naproxen sodium (Aleve), Naproxen (Naprosyn), Ibuprofen (Motrin), Diclofenac (Voltaren)
  • Opioids
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8
Q

Pt with endometiosis is seeking tx after NSAIDs fails. options if preg is desired or not?

A

Preg not desired -> progestin, COC

Preg desired -> GnRH agonist, Laparascopy

GnRH agonists includenafarelin,leuprolide,buserelin,goserelin, andtriptorelin.

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9
Q

What are these:
nafarelin,leuprolide,buserelin,goserelin, andtriptorelin.

A

GnRH agonists
MOA: decr estrogen
USE: Endometriosis pain where NSAIDs, COCs, Progestins FAIL

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10
Q

Considerations for endometriosis therapies

A
  • Progestogens, GnRH agonists, and aromatase inhibitors decrease bone density
  • DXA monitoring is recommended
  • Depending on duration: potentially osteoporosis prescription medications
  • Surgery is the is an option for deep endometriosis
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11
Q

ACOG Guidelines for PMS/PMDD Tx

A
  1. carb diet, exercise, therapy, incr Calcium, spironolactone, vit B6
  2. SSRIs
  3. Hormonal ovulation suppression
  4. Hysterectomy + BSO
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12
Q

Wdyd if SSRIs fail for PMDD

A

Use anxiolytics

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13
Q

1st line for PMDD or MOD/SEVERE PMS

A

SSRIs:
Fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro)

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14
Q

PMS/PMDD Tx

_____ may be considered for 2nd line for augmentation of SSRI

A

Alprazolam

3-4days max

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15
Q

Med for PMS/PMDD Tx if SSRIs/Alprazolam FAIL & CI to contraceptives

A

GnRH Agonist (Lupron)

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16
Q

Which progesterone BC is Spironolactone derived?

A
  • 1st gen: norethindrone, ethynodiol diacetate
  • 2nd gen: norgestrel, levonorgestrel
  • 3rd gen: desogestrel, norgestimate
    * Spirinolactone derived: drospirenone
  • MOA: blocks ovulation; production of cervical mucous; contributes to atrophy of endometrium
17
Q

COC Contraindications

A
18
Q

Vaginal Ring May not be as effective in women with BMI > ___

A

30

Waterman thinks this is BS and the pharmacist was thinking the patch, not the ring

19
Q

BC option for pt who wants Better cycle control and decreased breakthrough bleeding compared to OC &
Lower systemic exposure to estrogens

A

Vaginal ring

20
Q

One injection of progestin (depo shot) suppresses ovulation for ____wks

A

12 - 13wks

21
Q

Nexplanon must be replaced in ___yrs

A

3

22
Q

Paragard (Copper IUD) is FDA approved for ____yrs

A

10

23
Q

Generic Plan B

A

Levonorgestrel
MOA: delays ovulation

24
Q

Drugs to avoid when on hormonal contraceptives

A
  • Anticonvulsants: phenytoin, carbamazepine, topiramate, oxcarbazepine
  • Anti-infectives: rifampin, griseofulvin
  • St. John’s wort
25
Q

do hormonal contraceptives decr your risk for endometrial and ovarian cancer?

A

yes

unsure if this is actually true

26
Q

MCC of infertility in women

A

PCOS

27
Q

PCOS 1st line Tx

A
  1. Lifestyle
  2. COCs
  3. Metformin
28
Q

Is PCOS infertility very common?

A

yes (75%)

29
Q

What is Clomiphene Citrate used for? MOA?

A

PCOS - 1st line Infertility Tx
MOA: hypothalamus action on estrogen receptor, increases pulsatile GnRH leading to increase FSH and LH causing follicle growth and rupture

30
Q

Infertility Tx for PCOS

A
  1. Comiphene Citrate
  2. Gonadotropins
  3. Aromatase Inhibitors
  4. Metformin + IVF to prevent hyperstimulation syndrome
31
Q

PCOS Tx options for
- Acne
- Alopecia
- Hirsutism

A
  • Acne -> Isotretinoid (acutane)
  • Alopecia -> Oral finasteride or cyproterone, Topical minoxidil
  • Hirsutism -> COCs, Metformin, Elfornithane, Antiandrogens (Spironolactone, Flutamide, Finasteride)
32
Q

Menopause Hormone replacement therapy (HRT)

therapy for women WITH UTERUS

A
  • Women w/intact uterus: estrogen + progestin
  • Women w/hysterectomy: unopposed estrogen

used to replace low estrogen levels

33
Q

names for synthetic
- Estrogen
- Progestin
- Testosterone

A
  • Estrogen -> Estradiol, equine estrogen, esterified estrogen
  • Progesterone -> Medroxyprogesterone, norethindrone, micronized progesterone
  • Methyltestosterone
34
Q

Phytoestrogens & botanical/herbals (Red clover, soy, black cohosh, etc) have effects of which hormone?

A

Estrogen
inconsistent results

35
Q

CI to estrogen replacement therapy

A
  • Abnormal, undiagnosed genital bleeding
  • Breast cancer (known, suspected, or history of)
  • History of DVT or PE
  • Estrogen-dependent neoplasia
  • Pregnancy
  • Stroke or MI in past year
  • Liver dysfunction or disease
36
Q

bone accumulates until age ____

A

30

37
Q

Osteopenia vs Osteoporosis DEXA T-scores

A

Osteoporosis: < -2.5
Osteopenia: -1.0 - -2.5

Pharmacology (14 decks)

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