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Pharmacy > Women's Health > Flashcards

Women's Health Flashcards

0
Q

PK changes in pregnancy

A

Increased AUC
Increased Vd, increase loading doses

Increased 3A4, 2D6

Increased gastric pH
Decreased albumin

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1
Q

G4P2113

TPAL

A

Gravidity: # of pregnancies
Parity: # reaching 20 weeks gestation

1) term deliveries
2) premature deliveries
3) aborted pregnancies
4) living children

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2
Q

Estrogens

A

Estradiol
Mestranol

Inhibit ovulation suppress LH FSH

Protective effects in ovary/vagina via hormone suppression

Causes nausea, contacts fit

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3
Q

Progestins

A

Levonorgestrel (most androgenic)
Norethindrone
Dienogest
Drosperinone

Some suppression of LH

Hair loss , fatigue
Inhibit sperm penetration and maturation

Increase appetite, weight gain, acne mostly due to androgenic effects
PEA activity

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4
Q

Monophasic

A

Constant dose of estrogen and progestin

Flexible

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5
Q

Multiphasic

A

Minimize breakthrough bleed

Less estrogen
More progestin

More confusing, harder to rectify AE

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6
Q

Ortho-Evra

A

Patch

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7
Q

Nuva ring

A

Stable for 4 months EXP date

Vaginal insertion

Risk for DVT

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8
Q

Depo provera DMPA

A

Medroxyprogesterone IM q 12 weeks

No menses, no cramps

Not readily reversible takes more than 3 months

Use if heavy smoker, progestin only

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9
Q

Inserted and removed by healthcare professional

A

Skyla: intrauterine 3 years
Mirena: IUD 5 years

Implanon - Subdermal 3 years

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10
Q

Long term risks

A

Decreased risk of endometrial, ovarian cancer

Increased risk of cervical cancer

Mild BP increase

Estrogen Increases clotting factors 2,7,9,10 and thromboembolic disorders
Drosperinone, desorgestrel may increase DVT

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11
Q

Drugs that decrease effectiveness of OC

A

Rifampin
Phenytoin, phenobarbital, carbamazepine
SJW
Protease inhibitors -avir

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12
Q

Seasonique

A

Placebo pills contain estrogen

Menses every 3 months

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13
Q

DC OC if ACHES

A 
Abdominal pain (gallbladder pancreas)
Chest pain (SOB PE)
Headache (severe)
Eye problems (blurry vision)
Severe leg pain (DVT)
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14
Q

OC contraindications

A 
Thromboembolic disease (stroke)
Coronary artery disease
Breast cancer
Abnormal uterine bleeding 
Pregnancy
Heavy smoker (use progestin only or DMPA)
Hepatic tumor
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15
Q

Vasomotor Menopausal Nonpharmacological

A

Dress in layers
Reduce spicy/hot foods & drinks
Use fans

Diet: phytoestrogens in soybeans, seeds, and grains

16
Q

Vasomotor Menopausal pharmacological

A

Paroxetine: risk suicide, osteoporosis

Escitalipram: less hot flashes

Venlafaxine: fatigue

Estradiol: more satisfaction, insomnia
Clonidine if can’t take estrogens

17
Q

Vasomotor Menopausal hormone therapy

A

Give both estrogen and progestin if intact uterus

Combo Not for history of breast cancer, heart disease, venous thromboembolism

Conjugated estrogen better if HF or breast cancer

3 year duration

18
Q

Ovulation

A

Surge of LH

19
Q

Corpus luteum

A

Remnants of follicle

Increase progesterone&endometrium

20
Q

Increased BP with OC

A

Estrogen and drosperinone (spironolactone analog)

21
Q

Due date

A

Last menstrual period + 1 week minus 3 months

22
Q

FDA pregnancy category C

A

Most dangerous because of unknown risk

23
Q

Pregnancy vitamins and minerals

A

Iron
Calcium
Folic acid

24
Q

Morning sickness

A

Light snack before getting out of bed

Pharm:

1) doxylamine/pyridoxine (Vit B6) diclegis
2) meclizine, diphenhydramine
3) metoclopramide
4) rectal phenothiazine (AE sedation)

25
Q

GERD

A

Nonpharmacological

2) antacid
3) H2RA
4) PPI

26
Q

Cold and cough

A

Don’t give anything

27
Q

Rhinitis

A

Diphenhydramine, meclizine
First gen

2) budesonide, beclamethasone

28
Q

Acute pain

29
Q

Hypertension >140/90 after 20 weeks

Especially if diastolic >100

A

1) Labetalol
2) nifedipine

NOT ACE/ARB

30
Q

Pre-eclampsia

A

HTN plus proteinuria>300
Risk: hemolysis, Elevated LFT, low platelets

Prevention 81 aspirin

31
Q

Severe preeclampsia

A

Immediate delivery

Betamethsdone, dexamethasone for lung maturation

IV labetalol if BP>160/110
Alternative: IV hydralazine
Keep diastolic 90-100

IV mag sulfate for seizure prevention

32
Q

Gestational DM

A

USA 2 step

50g >130

OGTT>200
Or 2 levels >140

Give NPH/regular insulin
Increase in 2/3 trimesters
Can use metformin

33
Q

Coagulation disorder

Increased 2,7,9,10
Decrease antithrombin

A

Give heparin, reversal with protamine
Alternative: LMWH (less osteoporosis risk)

NOT warfarin X!

34
Q

Drug excretion to breast milk

A

Nonionized cross membranes

Weak bases become trapped in milk

Take dose @night HS
Minimize exposure with short half life drugs,
Short term: pump and dump
Pump and store clean milk

35
Q

Pregnancy vitals

A 
Increase cardiac output 
Decrease blood pressure
Increase O2 intake
Increase renal blood flow, GFR
Decrease Scr
Increase pH, less acidity 
Decrease albumin
36
Q

Drug transfer

A

Weak acids and bases with pKa 4.3-8.5

37
Q

Constipation

A

Dietary fiber

1) Psyllium
2) docusate

38
Q

Congestion

A

Saline nasal spray

Pseudoephedrine

Pharmacy (63 decks)

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