Women's Health

Question 1

o Clomiphene (Clomid)

Answer 1

• Pregnancy category X
• Ovulation stimulant; for female infertility
• Headache, depression; DVT; n/v, constipation; birth defects, spontaneous abortions; rash, dermatitis
• Liver function tests; serum progesterone, urinary excretion of pregnanediol; pelvic exam; endometrial biopsy may be done in women over 35 to rule out endometrial carcinoma
• Give after dc estrogen therapy; give at same time daily; begin on 5th day of menstrual cycle
• Multiple births common; report low abdominal pain; double dose if missed; response usually occurs 4-10 days after last tx

Question 2

o Danozol (Danocrine)

Answer 2

• Pregnancy category X; children, lactation
• Androgen, anabolic steroid
• Used for endometriosis, prevention of hereditary angioedema, fibrocystic breast disease
• Lability; cholestatic jaundice, weight gain; amenorrhea, decreased breast size; acneiform lesions, hirsutism
• Assess for pain before and after tx; monitor potassium, blood, urine glucose; assess breast for fibrocystic nodules; daily weight; mental status; signs of virilization: deepening of voice, decreased libido, facial hair
• Do not break, crush, or chew
• Start tx during menstruation in endometriosis, fibrocystic breast disease; provide ROM for immobile patient; give with food or milk
• Do not dc medication; nonhormonal contraceptive measures are needed during tx; report menstrual irregularities; use sunscreen or stay out of the sun to prevent burns

Question 3

o Fluconazole (Diflucan)

Answer 3

• Pregnancy category B; lactation
• Antifungal
• Hepatotoxicity; Stevens-Johnson syndrome
• Assess for infection; hepatotoxicity
• Take with food; shake oral suspension before each use; give after diluting according to package directions; run at 200 mg/hr or less; do not use plastic containers in connections

Question 4

o Estrogens, conjugated (Premarin)

Answer 4

• Pregnancy category X
• Needed for adequate functioning of female reproductive system
• Seizures; thromboembolism, stroke, pulmonary embolism, MI; nausea, cholestatic jaundice, hepatic adenoma; gynecomastia, testicular atrophy, impotence, increased risk of breast, endometrial cancer
• Monitor blood glucose; BP, I&O; liver function studies; assess edema, HTN, cardiac symptoms, jaundice; mental status; female patient for intact uterus

Question 5

o Medroxyprogesterone (Provera)

Answer 5

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Question 6

o Valacyclovir (Valtrex)

Answer 6

• Pregnancy category B; lactation
• Antiviral; tx or suppression of herpes zoster, recurrent general herpes, herpes labialis
• Dizziness, headache, weakness; dysmenorrhea; n/v, diarrhea, abdominal pain, constipation; rash
• Assess for infection; C&S before drug therapy, repeat after tx; bowel pattern; skin eruptions; allergies; thrombocytopenia purpura, hemolytic uremic syndrome, may be fatal
• Take as prescribed; if dose is missed, take as soon as remembered up to 2 hr before next dose; do not double dose; drug does not cure infection

Question 7

o Levonorgestrel (Plan B)

Answer 7

• Emergency contraceptive; prevents ovulation; also causes changes in the cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus
• Nausea, diarrhea, or stomach pain; dizziness, tired feeling
• Not for women 17 or younger

Question 8

o Alendronic acid (Fosamax)

Answer 8

• Pregnancy category C; children, lactation
• Bone-resorption inhibitor; bisphosphonate
• Tx of osteoporosis
• Hormonal status; bone density testing; renal; hypercalcemia: paresthesia, twitching, laryngospasm, Chvostek’s, Trousseau’s signs; phosphate level
• Give PO for 6 mo to be effective in Paget’s disease; 8 oz water 30 min before first food, beverage, or medication of the day; patient remain upright for 30 min after to prevent esophageal irritation

Question 9

o Ibandronic acid (Boniva)

Answer 9

• Bisphosphonate
• It alters the cycle of bone formation and breakdown in the body; slows bone loss while increasing bone mass, which may prevent bone fractures; used to treat or prevent osteoporosis in women after menopause
• Bladder pain, bloody or cloudy urine, chest pain, cough producing mucus; difficult, burning, or painful urination; difficulty with breathing; fever or chills; frequent urge to urinate; lower back or side pain, nervousness, pounding in the ears; shortness of breath, slow or fast heartbeat, sneezing, sore throat

Question 10

o Synthetic estrogen and progestin

Answer 10

a variety of contraceptive brands