Womens Health Drugs Flashcards
What is the first phase of the ovarian cycle?
Follicular phase
What are the first 2 phases of the uterine cycle?
Menses
Proliferation phase
What is the 2nd phase of the ovarian cycle?
Luteal phase
What is the 3rd phase of the uterine cycle?
Secretory phase
What phase contains the highest levels of progesterone levels?
Luteal/secretory phase
What phase is estrogen increasing?
Follicular/Proliferation phase
What causes LH and FSH to increase at the beginning of follicular phase?
Slow rise in estrogen
What is the MOA of BC how does it effect ovulation?
Large dose of estrogen and progesterone cause a negative feedback to LH and FSH…causing no ovulation
What are the 6 major effects of estrogen on the body?
Increase risk for VTE Increase bone retention Increase in female body contours Cervical mucus thinning Increase risk for endometrial cancer Increase risk for breast cancer
What are the 5 major effects of progesterone on the body?
Increase risk for VTE Increase bone retention Thickening of cervical mucus Increase in alveolar growth Inhibition of uterine contractions
What is RU 486? what is it used for?
Progesterone agonist
Used to abort fetus
What is the major estrogen that comes from the body?
Estradiol
What does the body use to make estrogen and progesterone? What is the basically chemical structure of the sex hormones considered? How does it cross the cell membrane?
Cholesterol
Steroid
Simple diffusion
What are the good factors from taking exogenous estrogen? Bad factors?
Decreases hot flashes
Increases bone retention
Increases cancer risk
Increases VTE risk
What are the indications for Estrogen(7)?
Atrophic vaginitis Hypogonadism BC uterine bleeding Hot flashes Osteoporosis Ovary removal
What is dyspareunia?
Pain during intercourse
What is atrophic vaginitis?
Shrinkage of vagina
What is hypogonadism?
Decrease in the production of estrogen
What are the contraindications for estrogen(5)?
Allergy Estrogen dependent cancer Abnormal vaginal bleed Pregnant VTE risk
What are ADR of estrogens?
VTE N/V chloasma Amenorrhea HA Fluid retention Tender breasts
Which pts are not recommended for estrogen HRT?
Pts with endometrial cancer or breast cancer
What must be assessed in pts who have had several years use of estrogen HRT?
Bone mineral density
What do progestin drugs have in their name?
-gest- or nor-
What are the indications for progestins?
Uterine bleeding Amenorrhea Uterine cancer BC prevention of threatened miscarriage PMS Sx
What can uterine bleeds be caused by?
Hormone imbalance
Fibroids
Uterine cancer
What are fibroids?
Non cancerous growth in uterus
What are the ADRs of Progestins?
Cholesterol jaundice VTE N/V Amenorrhea Edema
What is cholestatic jaundice? What Sx does it cause?
Bile duct gets blocked which increases bilirubin deposited in skin
Causes severe itching
What effect does hypocalcemia cause on nerves?
Increases the frequency of AP
How does Calcitonin effect Ca2+ in the blood?
Decreases Ca2+ in the blood
How does PTH effect Ca2+ in the blood?
Increases Ca2+ in the blood
What effect do osteoclasts have on Ca2+ in the blood?
Increase Ca2+ in blood
What I needed for Ca2+ to be reabsorbed in the kidneys and be absorbed in the intestines?
Vitamin D
What conditions can cause hypocalcemia(6)?
Vit D deficiency Calcitonin secreting thyroid tumors Dialysis Diarrhea Pregnancy Hypoparathyroidism
Why does dialysis and diarrhea cause hypocalcemia?
Because you poop and pee out Ca2+
Why does pregnancy cause hypocalcemia?
Because creating a skeleton inside of you requires increased demand for Ca2+
Why does hypoparathyroidism cause hypocalcemia?
Because of the decreased production of PTH which increases Ca2+ in the blood
What are the 2 Tx options for hypocalcemia? What are their ADR?
Calcium supplements
Vit D
Lead to kidney stones
What syndrome can be caused by hypocalcemia? How can you Tx this condition?
Carpopedal syndrome
Ca2+ IV
What causes hypercalcemia?
Renal dysnfunction
Multiple myeloma
Parathyroid tumor
How does renal dysfunction cause hypercalcemia?
Causes too much reabsorption of Ca2+
How does multiple myeloma cause hypercalcemia?
Multi myeloma causes cytokines to be released to increase osteoclasts activity
Why does parathyroid tumor cause hypercalcemia?
Because the tumor secretes increased amounts of PTH
What does a RANKL and RANK interaction cause?
Increase in osteoclasts activity
What holds RANKL? What holds RANK? What does it activate and turn it into?
Osteochondral progenitor/osteoblast
Osteoclasts precursor
RANKL and RANK interaction activate NFKB in precursor cell and turn it into a osteoclast
What prevents RANKL and RANK interactions?
OPG binds to RANKL to prevent RANK from binding
What increases OPG production? Decreases?
Increases
- mechanical strain
- sex hormones
Decreases
- PTH
- Glucocorticoids
What increases RANKL expression? Decreases?
Increases
- PTH
- glucocorticoids
Decreases
-sex hormones
What is osteoporosis? How many SD away <30yo? What comes before osteoporosis? How many SD away <30yo?
Decreased BMD
-1 SD
Osteopenia
-2.5 SD
What is the female athlete triad?
- decreased food intake
- Increased number calories being burned
- decreased body weight which decreases Estrogen levels
Pain in osteoporosis is associated with what?
Pain is associated with fractures
What are common fractures for pt with osteoporosis(5)?
Hip Vertebrae Pelvis Humerus Distal radius
What are personal characteristics that can lead to osteoporosis(5)?
Increased age Female White or Asian Low body weight Postmenopausal
What are lifestyles that can increase risk for osteoporosis?
Sendentary
Ca2+/vit D deficiency
What drugs/diseases can cause osteoporosis?
Corticosteroids/cushings disease
Celiac disease
Anorexia nervosa
How does celiac disease cause osteoporosis?
Because it decreases the bodies ability to absorb Ca2+
Before giving a uterine stimulant, what should be assessed? How can this effect the fetus
Mother and fetus vitals
Can increase fetal HR
What are uterine stimulants called?
Oxytocics
What are uterine relaxants called?
Tocolytics
What are Sx of hypercalcemia?
N/V
constipation
Lethargy
Muscle weakness
What is the #1 drug to Tx osteoporosis?
Bisphosphonate
What is the synthetic version of oxytocin?
Pitocin
What is a common ADR of OCPs?
N/V
