Women's Health Drugs Flashcards

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1
Q

Alendronate (Fosamax)

Chemical Classification

A

Bisphosphate

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2
Q

Alendronate (Fosamax)

Mechanism of Action

A

Decreases rate of bone resorption and may directly block dissolution of hydroxyapatite crystals of bone, inhibits osteoclast activity

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3
Q

Alendronate (Fosamax)

Uses

A

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

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4
Q

Alendronate (Fosamax)

Contraindications

A

Hypersensitivity to bisphosphonates, delayed esophageal emptying, inability to sit or stand for 30 min, hypocalcemia

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5
Q

Alendronate (Fosamax)

Side Effects

A

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

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6
Q

Alendronate (Fosamax)

Nursing Considerations

A

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)
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7
Q

Dinoprostone (Cervidil)

Functional Classification

A

Oxytocic, abortifacient

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8
Q

Dinoprostone (Cervidil)

Chemical Classification

A

Prostaglandin E2

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9
Q

Dinoprostone (Cervidil)

Mechanism of Action

A

Stimulates uterine contractions, causing abortion; acts within 30hr for complete abortion

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10
Q

Dinoprostone (Cervidil)

Uses

A

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

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11
Q

Dinoprostone (Cervidil)

Contraindications

A

Hypersensitivity, C-section, surgery

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12
Q

Dinoprostone (Cervidil)

Side Effects

A

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

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13
Q

Dinoprostone (Cervidil)

Nursing Considerations

A

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
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14
Q

Methylergonovine (Methergine)

Functional Classification

A

Oxytocic

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15
Q

Methylergonovine (Methergine)

Chemical Classification

A

Ergot alkaloid

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16
Q

Methylergonovine (Methergine)

Mechanism of Action

A

Stimulates uterine, vascular, and smooth muscle, thereby causing contractions; decreases bleeding; arterial vasoconstriction

17
Q

Methylergonovine (Methergine)

Uses

A

Treatment of hemorrhage postpartum or postabortion, uterine contractions

18
Q

Methylergonovine (Methergine)

Contraindications

A

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

19
Q

Methylergonovine (Methergine)

Side Effects

A

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

20
Q

Methylergonovine (Methergine)

Nursing Considerations

A

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
21
Q

Oxytocin (Pitocin)

Functional Classification

A

Hormone

22
Q

Oxytocin (Pitocin)

Chemical Classification

A

Oxytocic, uterine-active agent

23
Q

Oxytocin (Pitocin)

Mechanism of Action

A

Acts directly on myofibrils, thereby producing uterine contraction; stimulates milk ejection by the breast; vasoactive antidiuretic effect

24
Q

Oxytocin (Pitocin)

Uses

A

Stimulation, induction of labor, missed or incomplete abortion; postpartum bleeding

25
Q

Oxytocin (Pitocin)

Contraindications

A

Hypersensitivity, serum toxemia, cephalopelvic disproportion, fetal distress, hypertonic uterus, prolapsed umbilical cord, active genital herpes

26
Q

Oxytocin (Pitocin)

Side Effects

A

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

27
Q

Oxytocin (Pitocin)

Nursing Considerations

A

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
28
Q

Alendronate (Fosamax)

Functional Classification

A

Bone-resorption inhibitor