Women's Health Drugs Flashcards
Alendronate (Fosamax)
Functional Classification
Bone-resorption inhibitor
Alendronate (Fosamax)
Mechanism of Action
Decreases rate of bone resorption and may directly block dissolution of hydroxyapatite crystals of bone, inhibits osteoclast activity
Alendronate (Fosamax)
Uses
Treatment and prevention of osteoporosis in postmenopausal women, treatment of osteoporosis in men, Paget’s disease, treatment of corticosteroid-induced osteoporosis in postmenopausal women in receiving estrogen and in men who are on continuing corticosteroid treatment with low bone mass
Alendronate (Fosamax)
Contraindications
Hypersensitivity to bisphosphonates, delayed esophageal emptying, inability to sit or stand for 30 min, hypocalcemia
Alendronate (Fosamax)
Side Effects
CNS: headache
CV: ATRIAL FIBRILLATION
GI: abdominal pain, constipation, nausea, vomiting, esophageal, ulceration, acid reflux, dyspepsia, ESOPHAGEAL PERFORATION, diarrhea, ESOPHAGEAL CANCER
META: hypophosphatemia, hypocalcemia
MS: bone pain, osteonecrosis of the jaw, bone fractures
SYST: ANGIOEDEMA, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS
Alendronate (Fosamax)
Nursing Considerations
ASSESS:
- Serious reactions: angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, atrial fibrillation
- Hormonal status if a woman, before treatment
- FOR OSTEOPOROSIS: bone density test before and during treatment
- FOR PAGET’S DISEASE: increased skull size, bone pain, headache; decreased vision, hearing
- Electrolytes; BUN/creatinine; calcium, phosphorous, magnesium, potassium
- FOR HYPERCALCEMIA: paresthesia, twitching, laryngospasm; Chvostek’s, Trousseau’s signs
- Alk phos levels, baseline and periodically, 2 x upper limit of normal is indicative of Paget’s disease
- Dental status: regular dental exams should be performed; dental extractions (cover with antiinfectives before procedure)
Dinoprostone (Cervidil)
Functional Classification
Oxytocic, abortifacient
Dinoprostone (Cervidil)
Chemical Classification
Prostaglandin E2
Dinoprostone (Cervidil)
Mechanism of Action
Stimulates uterine contractions, causing abortion; acts within 30hr for complete abortion
Dinoprostone (Cervidil)
Uses
Abortion during 2nd trimester, benign hydatidiform mole, expulsion of uterine contents in fetal deaths to 28 wk, missed abortion, to efface and dilate the cervix in pregnancy at term
Dinoprostone (Cervidil)
Contraindications
Hypersensitivity, C-section, surgery
Dinoprostone (Cervidil)
Side Effects
CNS: Headache, dizziness, chills, fever, flushing
CV: hypotension, DYSRHYTHMIAS, DIC
EENT: blurred vision
SYST: ANAPHYLACTOID SYNDROME OF PREGNANCY
FETAL: bradycardia (i.e., deceleration)
GI: Nausea, Vomiting, Diarrhea
GU: vaginitis, vaginal pain, vulvitis, vaginismus
INTEG: rash, skin color changes
MS: Leg Cramps, Joint Swelling, weakness
GEL: uterine contractile abnormality, GI side effects, back pain, fever
INSERT: uterine hyperstimullation, fever, nausea, vomiting, diarrhea, abdominal pain
SUPPOSITORY: UTERINE RUPTURE, ANAPHYLAXIS
Dinoprostone (Cervidil)
Nursing Considerations
ASSESS:
- CERVICAL RIPENING: dilation, effacement of cervix and uterine contraction, fetal heart tones, check for contractions over 1 min
- For fever that occurs 1/2hr after suppository insertion (abortion)
- Respiratory rate, rhythm, depth; notify prescriber of abnormalities, pulse, BP, temp
- VAGINAL DISCHARGE: check for itching, irritation; indicates vaginal infection
Methylergonovine (Methergine)
Functional Classification
Oxytocic
Methylergonovine (Methergine)
Chemical Classification
Ergot alkaloid
Methylergonovine (Methergine)
Mechanism of Action
Stimulates uterine, vascular, and smooth muscle, thereby causing contractions; decreases bleeding; arterial vasoconstriction
Methylergonovine (Methergine)
Uses
Treatment of hemorrhage postpartum or postabortion, uterine contractions
Methylergonovine (Methergine)
Contraindications
Pregnancy, hypertension, PID, respiratory/cardiac disease, peripheral vascular disease, angina, arteriosclerosis, CAD, dysfunctional uterine bleeding, eclampsia, MI, neonates, Raynaud’s disease, sepsis, stroke, Buerger’s disease, thrombophlebitis, hypersensitivity to ergot preparations
Methylergonovine (Methergine)
Side Effects
CNS: Headaches, Dizziness, SEIZURES
CV: HYPOTENSION, chest pain, palpitation, HYPERTENSION, DYSRHYTHMIAS, CVA (IV)
EENT: tinnitus
GI: Nausea, Vomiting
GU: cramping
INTEG: sweating, rash, allergic reactions
RESP: dyspnea
Methylergonovine (Methergine)
Nursing Considerations
ASSESS:
- BP, pulse, character and amount of vaginal bleeding; watch for indications of hemorrhage
- Uterine relaxation; observe for severe cramping
- ERGOT TOXICITY: tinnitus, hypertension, palpitations, chest pain, nausea, vomiting, weakness; cold, numb extremities
Oxytocin (Pitocin)
Functional Classification
Hormone
Oxytocin (Pitocin)
Chemical Classification
Oxytocic, uterine-active agent
Oxytocin (Pitocin)
Mechanism of Action
Acts directly on myofibrils, thereby producing uterine contraction; stimulates milk ejection by the breast; vasoactive antidiuretic effect
Oxytocin (Pitocin)
Uses
Stimulation, induction of labor, missed or incomplete abortion; postpartum bleeding
Oxytocin (Pitocin)
Contraindications
Hypersensitivity, serum toxemia, cephalopelvic disproportion, fetal distress, hypertonic uterus, prolapsed umbilical cord, active genital herpes
Oxytocin (Pitocin)
Side Effects
CNS: SEIZURES, TETANIC CONTRACTIONS
CV: hypo/hypertension, dysrhythmias, increased pulse, bradycardia, tachycardia, PVC
FETUS: dysrhythmias, jaundice, hypoxia, INTRACRANIAL HEMORRHAGE
GI: anorexia, nausea, vomiting, constipation
GU: ABRUPTIO PLACENTAE, DECREASED UTERINE BLOOD FLOW
HEMA: increased hyperbilirubinemia
INTEG: rash
RESP: ASPHYXIA
SYST: water intoxication of mother
Oxytocin (Pitocin)
Nursing Considerations
ASSESS:
- I&O ratio
- BP, pulse; watch for changes that may indicate hemorrhage
- Respiratory rate, rhythm, depth; notify prescriber of abnormalities
- Length, intensity, duration of contraction; notify prescriber of contractions lasting >1 min or absence of contractions; turn patient on her side; discontinue oxytocin
- FHTs, fetal distress; watch for acceleration, deceleration; notify prescriber if problems occur; fetal presentation, pelvic dimensions; turn patient on left side if FHT change in rate, give O2
- WATER INTOXICATION; confusion, anuria, drowsiness, headache
Alendronate (Fosamax)
Chemical Classification
Bisphosphate
