Women's Health Drugs Flashcards
Estrogens are responsible for…
Development and maintenance of the female reproductive system
Development of female secondary sex characteristics
Shaping of body contours and development of the skeleton
Indications for Estrogens
Treatment of
Atrophic vaginitis Hypogonadism Oral contraception Uterine bleeding Vasomotor spasms of menopause Osteoporosis Breast or prostate cancer Ovarian failure or castration
Contraindications for Estrogens
Drug allergy Any estrogen-dependent cancer Undiagnosed abnormal vaginal bleeding Pregnancy Active thromboembolic disorder
Adverse Effects of Estrogens
THROMBOEMBOLYTIC EVENTS (MOST SERIOUS)
HYPERTENSION, THROMBOPHELBITIS
Progestins
MEDROXYPROGESTERONE (PROVERA, DEPOPROVERA)
MEGESTROL (MEGACE)
Indications for Progestins
Treatment of functional uterine bleeding caused by hormonal imbalance, fibroids, uterine cancer
Treatment of primary and secondary amenorrhea
Indications for Progestins
Alone or in combination with estrogens to prevent conception
Prevention of threatened miscarriage
Adverse Effects of Progestins
Liver dysfunction
Thrombophlebitis
Nausea, vomiting
Amenorrhea, spotting
Medroxyprogesterone
Used to treat uterine bleeding, secondary amenorrhea, endometrial cancer, renal cancer
Antineoplastic action against endometrial cancer
Mechanism of Action of Contraceptive Drugs
Prevent ovulation by inhibiting the release of gonadotropins and increasing uterine mucus viscosity, resulting in decreased sperm movement and possible inhibition of implantation of a zygote
Improves menstrual cycle regularity
Decreases blood loss during menstruation
Decreases incidence of functional ovarian cysts and ectopic pregnancies
Adverse Effects of Contraceptive Drugs
Hypertension
Thromboembolism, PE, MI
Alterations in lipid and carbohydrate metabolism
Increases in serum hormone concentrations
Contraindications of Contraceptive Drugs
Pregnancy
Known high risk for or history of thromboembolic events such as MI, venous thrombosis, PE, or stroke
Risk Factors for Osteoporosis
Slender body build
Early estrogen deficiency
Smoking
Alcohol consumption
Low calcium diet
Sedentary lifestyle
Family history
Drug Therapy for Osteoporosis
BIPHOSPHONATES (ALENDRONATE [FOSAMAX])
SELECTIVE ESTROGEN RECEPTOR MODIFIERS (SERMS) (RALOXIFENE, TAMOXIFEN)
HORMONES (CALCITONIN)
Biphosphonates
Work by inhibiting osteoclast-mediated bone resorption, which enhances bone mineral density
Selective Estrogen Receptor Modulators
Stimulate estrogen receptors on bone and increase bone density
Adverse Effects of SERMs
HOT FLASHES, LEG CRAMPS
INCREASED RISK OF VENOUS THROMBOEMBOLISM
Adverse Effects of Biphosphonates
GI UPSET, JOINT PAIN
RISK OF ESOPHAGEAL BURNS
Alendronate (Fosamax)
Oral biphosphonate
Inhibits or reverses osteoclast-mediated bone resorption
Raloxifene
SERM
Used to prevent postmenopausal osteoporosis
Adverse effect is hot flashes
Adverse Effects of Fertility Drugs
Tachycardia, hypovolemia, DVT
Dizziness, headache, flushing, depression, restlessness, anxiety, nervousness, fatigue
Nausea, bloating, constipation
Uterine Stimulants
Also called oxytocics
Prostaglandins
Ergot derivatives
Prostaglandins
Natural hormones
Used to induce labor by softening the cervix and enhancing uterine muscle tone
Misoprostol (Cytotec)
Ergot Alkaloids
Increase force and frequency of uterine contractions
Used after delivery of the infant and placenta to prevent postpartum uterine atony ad hemorrhage
Methylergonovine (Methergine)
Adverse Effects of Uterine Stimulants
Hypotension or hypertension, chest pain
Headache, dizziness, fainting
Nausea, vomiting, diarrhea
Vaginitis, vaginal pain, cramping
Tocolytics
Uterine relaxants
Indomethacin
NSAID
Inhibits prostaglandin activity
Nifedipine
Calcium channel blocker
Inhibits myometrial activity by blocking calcium influx
Estrogens and Progestins Nursing Implications
Take the smallest dose needed
Give IM doses deep in large muscle masses and rotate sites
Give oral doses with meals to reduce GI problems
Increased susceptibility to sunburn may occur
Instruct patients to report weight gain
Bisphosphonates Nursing Implications
Instruct patients to take medication upon rising in the morning with a full glass of water
Sit upright for at least 30 minutes after taking the medication
Nursing Implications for SERMs
Instruct patients that the medication will need to be discontinued 72 hours before and during any prolonged immobility