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wvc gyn pharm
wvc gyn pharm Linda Visser
| Question | Answer |
|---|---|
| Treatment for yeast infection | – “conazoles” cream, suppositories, oral (Diflucan –fluconazole) |
| Trichomoniasis -Trichomonas | Metronidiazole (Flagyl) ; Tinidazole (Tindamax) |
| hcirt lgalf galf | Trich flagl flag |
| Chlamydia trachomatis -CT Treatment – | azithromycin (Zithromax) OR doxycycline (Doxy) |
| Gonorrhea Treatment | Commonly co-infected with chlamydia, so treat for both CT and GC;… Ceftriaxone (Rocephen) IM X1 (avoid fluoroquinolones in drug resistant gonorrhea//ciprofloxacin; ofloxacin, levofloxicn) |
| Syphilis Treatment | Benzathine Peniclin G IM X1 |
| Meds for HSV | – po Acyclovir –(Zovirex) / Famiclovir – (Famvir) / Valacyclovir – (Valtrex )hsv Creams (acyclovir) are not effective but are sold |
| TSS Treatment | Antibiotics – Penicillin, vancomycin if allergic to penicillin |
| Plan B –Emergency contraception | 2 tablets–levonorgestrel 0.75 mg. po. Take w/in 72 hours of first unprotected intercourse act |
| Medical abortion | Mifepristone (RU486) (Mifeprex)po. FDA approved in 2000. Use with Misoprostol (Cytotec) oral or vag. suppository. |
| DXA | - Normal > - 1.0; Osteopenia is -1.0 to -2.5…Osteoporosis is -2.5 or less |
| Biphosphonates- | Aledronate (Fosamax), risedronate (Actonel), ibandronate (Boniva) –treatment and prevention Decreases hip and vertebral fxs by 50%... |
| Aledronate (Fosamax) – | Take on empty stomach with water, without other fluids or food for 30 to 60 minutes, sitting up, after fasting. Even with perfect compliance, it is still poorly absorbed. (can cause problems in the esophagus) |
| SERMs (selective estrogen receptor modulators) | (allows more estrogen to make it in) Evista is an example of this drug class. Evista (raloxifene) Used to prevent breast cancer in high risk females. |
| Calcitonin Treatment only - | Inhibits osteoclast, bone mass increases 8 – 10% in one year, then plateaus; Does NOT decrease hip fx rate; DRAWBACK to all treatment – once medication stops, bone loss rates resumeL |
| Progesterone Only birth control | medroxyPROGESTERone (Depo Provera); Acetate (woman gets every 3 months); –etnogestril (Implanon) (implanted for three years) ; OC – norethindrone (Micronor) –; - levonorgestril (IUS –Mirena)(progesterone only placed in uterus) |
| IUD | Paragard – copper coil – 10 years; Mirena – progesterone -5 years |
| Consider efficacy and drug interactions of hormonal birth control- | PCN, Rifampin (makes BC ineffective), Phenobarb. (reduces effectiveness of phenobarb.) , Phenytoin (reduces effectiveness of phenytoin) |
| Danazol (danocrine)& Lupron | “reversible medication oophorectomy”. Antigonadatrophin |
| Treatment of ectopic pregnancy | –medical – methotrexate ( Trexall/ Rheumatrex)to “dissolve” pregnancy if early enough |
| Hypermenorrhea/ Menorrrhagia | too much flow |
| Hypomenorrhea | decresed flow |
| Oligomenorrhea | menses more than 40 days apart, usually irregular. |
| Polymenorrhea | menses closer than 22 days. Regular or irregular pattern. |
| Metromenorrhea | normal amount of menses at irregular intervals. |
| Menometrorrghia | excessive amount at irregular intervals |
| DUB - treatment | Hormonal –medroxyPROGESTERone (Depo Provera), OCs, Mirena IUS (67% can avoid surgery with this IUD) |
| Gardasil Vaccine (HPV) | – Series of 3 vaccines for use in females age 9 -26, preferably before onset of intercourse. Protects against HPV types 6, 11, 16, and 18 that cause about 70% of cervical cancers. |
| Bacterial Vaginitis Treatment | Metronidiazole (Flagyl) ; Metronidiazole gel apply to vagina daily X5 days; Clindamycin cream 2% one applicator to vagina q HS X7 days (never mix flagyl & alcohol) (contain the normal flora) |
| DES (diethylstilbestrol) | a tetraogen in utero (was used to prevent mischarage) raises risk for cervical cancer. |
| Treatment for yeast infection | – “conazoles” cream, suppositories, oral fluconazole (Diflucan) |
| Trichomoniasis Treatment | .; metronidazole (Flagyl ); Tinidazole (Tindamax) |
| Syphilis Serological markers | RPR (rapid plasma regain) & VDRL –Venereal Disease Research Lab |
| HPV treatment | Podofilox –(pt. applied); Cryotherapy – liquid nitrogen |
| Bleeding assessment | 1 pad Q 4hrs |
| Breast tumors Benign vs. cancerous | benign= sudden, bi-lateral, may or may not be painful, mobile…cancer= slow growing, uni-lateral, not painful, Non mobile – attached/fixed with dimple and color changes |
| ovulation cycle (Page 226, McKinney for phases ) | a V in estrogen signals hypothal. to produce GnRH; stimulates ant. pit. to release FSH to begin follicle maturation & estrogen sec. Est. stimulates LH to produce ovulation & progesterone which inhibits GnRH. If no conception, estr. V & cycle starts again. |
| Hormones and Menstrual Cycle Estrogen –Estradiol- is responsible for: | Secondary sex characteristics; Endometrial regeneration in uterus; ^ Vit D metabolism to ^ Ca absorption; ^HDL and decreases LDL; Maintains tissue suppleness; Enhances nerve impulse conduction (memory) |
| Progesterone Secreted by the corpus luteum –responsible for | Endometrial thickening; Suppresses FSH and LH and prevents further ovum maturation in the cycle; Promotes sleep; Decreases anxiety |
| estrogens estrone and estradiol | 3 types of estrogen |
| clomid | used to treat amenorrhea |
| tamoxifen | reduces risk of breast cancer |
| implanon | progesterone on birth control implanted into the arm, lasts 3 years |
| spironolactone | anti androgen & potassium sparring diuretic |
| provera | treatment for amenorrhea |
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