Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Women's Drugs !*
Women’s Health Drugs
| Question | Answer |
|---|---|
| Female Reproductive Functions | Female sex steroid hormones:Estrogens ProgestinsPituitary gonadotropin hormones Follicle stimulating hormone (FSH) Luteinizing hormone (LH) |
| Female Reproductive Functions (cont’d) | Development of primary and secondary sex characteristics. Menstrual cycle. |
| Estrogens | Three major endogenous estrogens: Estradiol (principal & most active) Estrone Estriol Synthesized from cholesterol in ovarian follicles. Basic chemical structure of a steroid. |
| Exogenous Estrogenic Drugs–Synthetic | Steroidal: Conjugated estrogens, estradiol transdermal, many others. Nonsteroidal: Chlorotrianisene, diethylstilbestrol diphosphate, others. These drugs no longer available in the United States. |
| Estrogens Required For | The development and maintenance of the female reproductive system. The development of female secondary sex characteristics. |
| Estrogens: Indications | Treatment of or prevention of disorders that result from estrogen deficiency. Atrophic vaginitis Hypogonadism Oral contraception (given with a progestin) Dysmenorrhea “Hot flashes” of menopause |
| Estrogens: Indications (cont’d) | Treatment of or prevention of disorders that result from estrogen deficiency (cont’d). Uterine bleeding. Palliative treatment of advanced breast and prostate cancer. Osteoporosis treatment and prophylaxis. Many other indications. |
| Estrogens: Indications (cont’d) | Continuous-combined hormone replacement therapy (CCHRT). Fixed estrogen/progestin combination products. Reduce complications, such as endometrial hyperplasia, that occur from using estrogen alone. |
| Estrogens: Contraindications | Any estrogen dependent cancer. Undiagnosed abnormal vaginal bleeding. Pregnancy. Active thromboembolic disorder or history. |
| Estrogens: Adverse Effects | Thrombolytic events—most serious. Nausea—most common. Hypertension, thrombophlebitis, edema. Vomiting, diarrhea, constipation, abdominal pain. May cause photosensitivity, chloasma. |
| Estrogens: Adverse Effects (cont’d) | Amenorrhea, breakthrough uterine bleeding. Tender breasts, fluid retention, headaches. Others |
| Progestins | Synthetic derivatives of progesterone: medroxyprogesterone (Provera) hydroxyprogesterone megestrol (Megace) Many others |
| Progestins: Indications | Treatment of functional uterine bleeding caused by: Hormonal imbalance, fibroids, or uterine cancer. Treatment of primary and secondary amenorrhea. |
| Progestins: Indications (cont’d) | Palliative treatment of some cancers and endometriosis Prevention of threatened miscarriage. Alleviation of symptoms of PMS. |
| Progestins: Indications (cont’d) | Megestrol:Adjunct therapy for treatment of breast and endometrial cancers.Also used for management of anorexia, cachexia, or unexplained weight loss in AIDS patients.Used to stimulate appetite and promote weight gain in patients with cancer |
| Progestins: Indications (cont’d) | Used with estrogen replacement therapy after menopause. |
| Progestins: Adverse Effects | Liver dysfunction - cholestatic jaundice. Thrombophlebitis, thromboembolic disorders, such as PE. Nausea, vomiting. Amenorrhea, breakthrough uterine bleeding, spotting. Edema, weight gain or loss Others |
| Contraceptive Drugs | Medications used to prevent pregnancy Oral medications: Monophasic, biphasic, and triphasic forms. Most contain estrogen-progestin combinations. |
| Contraceptive Drugs (cont’d) | Other contraceptive forms available: Long-acting injectable form of medroxyprogesterone (Depo-Provera) Transdermal contraceptive patch Intravaginal contraceptive ring |
| Contraceptive Drugs: Mechanism of Action | Prevent ovulation by inhibiting the release of gonadotropins and increasing uterine mucous viscosity, resulting in: Decreased sperm movement and fertilization of the ovum. Possible inhibition of implantation of a fertilized egg (zygote). |
| Contraceptive Drugs: Other Drug Effects | Improve menstrual cycle regularity. Decrease blood loss during menstruation. Decreased incidence of functional ovarian cysts and ectopic pregnancies. |
| Contraceptive Drugs: Indications | Primarily used to prevent pregnancy Other uses: Treatment of endometriosis and hypermenorrhea To produce cyclic withdrawal bleeding Postcoital emergency contraception |
| Contraceptive Drugs: Adverse Effects | Drawbacks to the use of these drugs include: Hypertension Thromboembolism, possible PE, MI, stroke Alterations in lipid and carbohydrate metabolism Increases in serum hormone concentrations These effects are due to the estrogen component |
| Contraceptive Drugs: Adverse Effects (cont’d) | May also cause: Edema, dizziness, headache, depression, nausea, vomiting, diarrhea, increased appetite, increased weight, breast changes, many others. |
| Contraceptive Drugs: Interactions | Drugs that decrease effectiveness of oral contraceptive drugs: Antibiotics, barbiturates, isoniazid, rifampin, griseofulvin. |
| Contraceptive Drugs: Interactions (cont’d) | Drugs that may have reduced effectiveness if given with oral contraceptive drugs: Anticonvulsants, beta-blockers, hypoglycemic drugs, oral anticoagulants, theophylline, TCAs, vitamins, hypnotics. |
| Osteoporosis | Low bone mass. Increased risk of fractures. Primarily affects women. 20% of those with this condition are men. |
| Osteoporosis: Risk Factors | Caucasian/Asian descent Slender body build Early estrogen deficiency Smoking Alcohol consumption |
| Drug Therapy for Osteoporosis | Calcium supplements and vitamin D may be recommended for women at high risk for osteoporosis. |
| Drug Therapy for Osteoporosis (cont’d) | Bisphosphonates: alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) Selective estrogen receptor modifier (SERM) raloxifene (Evista) Hormone: calcitonin teriparatide (Forteo) |
| Drug Therapy for Osteoporosis (cont’d) | Biphosphonates: Work by inhibiting osteoclast-mediated bone resorption, thus preventing bone loss. SERMs: Stimulate estrogen receptors on bone and increasing bone density. |
| Drug Therapy for Osteoporosis (cont’d) | Calcitonin: Directly inhibits osteoclastic bone resorption Teriparatide: Only drug that stimulates bone formation Derivative of parathyroid hormone Action similar to natural parathyroid hormone |
| Drug Therapy for Osteoporosis: Indications | Bisphosphonates and calcitonin: Both prevention and treatment of osteoporosis. Biphosphanates also used for glucocorticoid-induced osteoporosis and Paget’s disease. |
| Drug Therapy for Osteoporosis: Indications (cont’d) | Raloxifene: Prevention of postmenopausal osteoporosis Teriparatide: Used for those with highest risk of fracture (prior history of fractures). |
| Drug Therapy for Osteoporosis Adverse Effects | SERMs: Hot flashes, leg cramps. Can increase risk of venous thromboembolism. Not used if patient is near age of menopause due to possible hot flashes. Leukopenia. |
| Drug Therapy for Osteoporosis Adverse Effects (cont’d) | Bisphosphonates: Headache, GI upset, joint pain. Risk of esophageal burns if medication lodges in esophagus before reaching the stomach. |
| Fertility Drugs | Various medical techniques used to treat infertility: Include: in vitro fertilization Medication therapy: ovulation stimulation |
| Fertility Drugs (cont’d) | clomiphene (Clomid, others) Nonsteroidal ovulation stimulant. Blocks estrogen receptors in the uterus and brain, resulting in a false signal of low estrogen levels. |
| Fertility Drugs (cont’d) | Mentropins (Pergonal); Standardized mixture of FSH and LH Stimulates development of ovarian follicles, leading to ovulation. May also be given to men to stimulate spermatogenesis. |
| Fertility Drugs (cont’d) | chorionic gonadotropin alfa (Ovidrel): Recombinant form of human chorionic gonadotropin. Causes rupture and ovulation of mature ovarian follicles, and maintenance of corpus luteum. Used to stimulate ovulation. |
| Fertility Drugs: Indications | Used primarily to induce ovulation in anovulatory patients. Also may be used to promote spermatogenesis in infertile men. |
| Fertility Drugs: Adverse Effects | Tachycardia, phlebitis, DVT . Dizziness, headache, flushing, depression, anxiety, nervousness, fatigue. Nausea, bloating, constipation, others. Ovarian hyperstimulation, multiple pregnancies, blurred vision, breast pain, others. |
| Uterine-Active Medications | Medications used to alter uterine contractions: Used to: Promote labor Prevent the start or progression of labor. Postpartum use: to reduce the risk of postpartum hemorrhage. |
| Uterine Stimulants | Also called oxytocics Ergot derivatives Prostaglandins Progesterone antagonist oxytocin (hormonal drug) |
| Uterine Stimulants (cont’d) | Ergot alkaloids: Increase force and frequency of uterine contractions Used after delivery of the infant and placenta to prevent postpartum uterine atony and hemorrhage methylergonovine (Methergine) |
| Uterine Stimulants (cont’d) | Prostaglandins: Natural hormones Cause potent contraction of myometrium, smooth muscle fibers of the uterus. Used to induce labor by softening the cervix and enhancing uterine muscle tone. dinoprostone (Prostin E2) and misoprostol (Cytotec) |
| Uterine Stimulants (cont’d) | Progesterone antagonist mifepristone (Mifeprex) RU-486, the “abortion pill” Stimulates uterine contractions to induce abortion. Given with a prostaglandin drug for elective abortions. |
| Uterine Stimulants: oxytocin (Pitocin) – Synthetic Form | Used to induce labor at or near full-term gestation, and to enhance labor when contractions are weak and ineffective. |
| Uterine Stimulants: oxytocin (Pitocin) - Synthetic Form (cont’d) | Other uses: Prevent or control postpartum uterine bleeding. Complete an incomplete abortion (after miscarriage). Promote milk ejection during lactation. |
| Uterine Stimulants: Adverse Effects | Hypotension or hypertension, chest pain. Headache, dizziness, fainting. Nausea, vomiting, diarrhea. Vaginal pain, cramping. Leg cramps, joint swelling, chills, fever, weakness, blurred vision. |
| Uterine Relaxants: Tocolytics | Used to stop labor that begins before term to prevent premature birth. Generally used after the 20th week of gestation. |
| Uterine Relaxants: Tocolytics (cont’d) | Uterine contractions that occur between the 20th and 37th weeks of gestation are considered premature labor. Nonpharmacologic measures: Bedrest, sedation, hydration |
| Uterine Relaxants | ritodrine (Yutopar) and terbutaline (Brethine):Beta-adrenergic drugs Stimulation of beta2-adrenergic receptors on the uterine smooth muscle.Results in relaxation of the uterus, thus stopping premature contractions. |
| Uterine Relaxants | “Off-label” use Magnesium sulfate IV also used to stop labor |
| Uterine Relaxants: Adverse Effects | Palpitations, tachycardia, hypertension, others Tremors, anxiety, insomnia, headache, dizziness, others Nausea, vomiting, anorexia, bloating, diarrhea, constipation Hyperglycemia, hypokalemia Dyspnea, hyperventilation, others |
| Nursing Implications | Assess baseline VS, weight, blood glucose levels, renal and liver function studies . Assess whether the patient smokes. Assess history and medication history. Assess contraindications, including potential pregnancy. |
| Nursing Implications (cont’d) | Before giving any uterine stimulants, assess the mother’s vital signs and fetal heart rate. Uterine relaxants are used when premature labor occurs between the 20th and 37th weeks of gestation. |
| Nursing Implications (cont’d) | For biphosphonates, ensure that the patient has no esophageal abnormalities and can remain upright or in a sitting position for 30 minutes after the dose. |
| Nursing Implications (cont’d) | Estrogens and progestins: 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. Teach patient about correct self-administration and what to do if a dose is missed. |
| Nursing Implications (cont’d) | Estrogens and progestins (cont'd): Increased susceptibility to sunburn may occur -advise patient to wear sunscreen or avoid sunlight. Patients should report weight gain. Annual follow-up exams should be completed, including PAP smear and breast exam. |
| Nursing Implications (cont’d) | Follow specific administration guidelines carefully for IV administration of uterine relaxants or stimulants. Monitor the patient’s vital signs and fetal condition during therapy. |
| Nursing Implications (cont’d) | Instruct patient taking fertility drugs to take the medication as ordered. Recommend the patient keep a journal while on fertility drugs. |
| Nursing Implications (cont’d) | Biphosphonates: Instruct patient to take medication upon rising in the morning, with a full glass of water, and 30 minutes before eating. Emphasize that the patient should sit upright for at least 30 minutes after taking the medication. |
| Nursing Implications (cont’d) | SERMs: Instruct patient that the medication will need to be discontinued 72 hours before and during any prolonged immobility (such as surgery or a long trip). |
| Nursing Implications (cont’d) | Monitor for therapeutic responses. Monitor for adverse effects. |
Created by:
LauraHall
Popular Nursing sets