Women's Health Drugs

Question 1

Oral contraceptives

Answer 1

E/P or P only; monophasic, biphasic or triphasic
Suppresses FSH/LH via negative feedback thus inhibiting follicular development and ovulation, thickens cervical mucus and decreases ovus motility
Reduces risk of ovarian cysts, cancer, endometrial cancer benign breast disease
Fewer ectopic pregnancies
Fewer menstrual symptoms
Iron def. with RA
Ameliorates acne and hirsutism

AE: mild: HA, nausea, mastalgia, edema, bleeding, migraine, withdrawal bleed
Moderate: bleeding (P only), wt gain, acne, hirsutism, bacteriuria, amenorrhea, and galactorrhea after cessation
Severe: DVT, MI, cerebrovascular dz, GI d/o, depression

Contraindication: CVD, migraine, HTN, DM, Lyme, Asthma

Question 2

Transdermal patch

Answer 2

4 week cycle with 1 patch/ wk until week 4
AE: rash, HA, nausea, psych, breast pain, painful menses
No in: DVT, liver, breast ca, migraine, HTN, DM, smoker

Question 3

Ring

Answer 3

4 week cycle with 1 ring/ wk until week 4
AE: vaginal irritation, HA, N+V, d/c, breast tenderness, painful menses
No in: DVT, liver, breast ca, migraine, HTN, DM, smoker

Question 4

Subdermal implants

Answer 4

Rod in upper arm, lasts 3 yrs, remove then
AE: bleeding, HA, mood, wt gain, acne, breast tenderness, painful menses
No in: DVT, liver, breast ca, migraine, HTN, DM, smoker

Question 5

IUDs

Answer 5

Thicken cervical mucus, prevents sperm from traveling, lasts for 3-5 yrs
AE: menstrual irregularities, pain, expulsion, ovarian cysts (typically regress)
Worse: PID, perforation of uterus
No in: multiple partners, immune issues, IVDA

Question 6

Injectable

Answer 6

IM Q3months
AE: menstrual irregularity, HA, mood, wt gain, acne, breast tenderness, loss of bone density
No in: DVT risk, liver, breast ca., migraine, HTN, DM, osteoporosis

Question 7

Mifepristone

Answer 7

Progesterone-R antagonist
Luteolytic
Post-coital contraceptive
AE: Vomiting, diarrhea, pain

Question 8

Levonorgestrel

Answer 8

Progestin agonist to proliferate cervical mucus and decreasing motility to prevent implantation
AE: N+V, HA, breast tenderness, abdominal and leg cramps

Question 9

Clomiphene

Answer 9

Selective estrogen receptor modulator (SERM) partial E-agonist
Inhibits stronger estrogens, increases gonadotropins and estrogens by mitigating negative feedback
Induces ovulation
AE: hot flashes, multiple preg.
Also: heavy flow, N+V, nervous tension, depression, fatigue, breast soreness, wt gain

Question 10

Leuprolide

Answer 10

GnRH-R agonist
Increase FSH/LH when pulsatile
Anovulation failing clomiphene, usually in COH
AE: pain, hot flashes, fatigue, cramps, myalgias, vaginal dryness, reduced libido