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Women's Health

Estrogens and Progestins

Selective Estrogen Receptor Modulators (SERMs) active in some tissue and block estrogen receptors selectively in others, provide benefits of estrogens w/o side effects
Tamoxifen blocks some ERs adn activates others, used for breast CA, inhibits cell growth in the breast, protect against osteoporosis
Tamoxifen side effects hot flashes, increase risk for endometrial CA and thromboembolism
Raloxifene similar to tamoxifen but does not activate estrogen, protects against breast CA and osteroporosis and promotes thromboembolism and hot flashes
Duavee (conjugated estrogens/bazedoxifene) bazedoxifene component reduces risk of excessive growth of uterine lining, decreased risk for endometrial CA
Progestin Adverse Effects teratogenic effects, gynecologic effects, breast CA, depression, breast tenderness, bloating
Progestin uses postmenopausal HRT, dysfunctional uterine bleeding, amenorrhea, infertility, prematurity prevention, endometiral CA and hyperplasia
Menopausal Hormone Therapy (MHT) benefits provides relief of vasomotr symptosm, mgmnt of urogential atrophy, prevent osteopoorsis, cardioprotection, prevent colorectal CA, positive effect on wound healing, tooth rentention, glycemic control
Menopausal Hormone Therapy (MHT) risks MI, stroke, PE, DVT, endometrial CA, breast CA, Ovarian CA, gallbladder disease, dementia, urinary incontinence
Estrogen & Progestin therapy inhibits ovulation by suppressing release of FSH and LH, thickens cervical mucous and alter endometrium making conditions unfavorable for implantation
Monophasic OC dose of hormones remain constant
Multiphasic OC dose of hormones vary
Adverse effects of OC thromboembolic disorders, HTN, CA, stroke, teratogenic effects, abnl uterine bleeding, benign hepatic adenoma, glucose intolerance
Antibiotics that interact with OC rifampin, ampicillin/amoxicillin, tetracycline, erythromycin
Antifungals that interact with OC griseofulvin
Antiepileptics that interact with OC phenytoin, carbamazipine, phenobarbitol
Other drugs that interact with OC theophylline, st. John's wort
Progestin-only OCs Camila, Errin, Heather, Jolivette, Ortho Micronor, Nor-QD, and Nora-BE
Effects of Progestin-only OCs do not cause thromboemoblic disorders, HA, nausea, safer than combo therapy, less-effective, may cause irregular bleeding
Estrogen preparations Ethinyl estradiol, mestranol and estradiol valerate
Drospireone progestin that antiandrogen action
Levonorgestrel & Norgestrel progestins that have greater androgenic effects
Leveonorgestrel progestin only emergency contraceptive, taken w/in 72hrs, act before fertilization and implantation to delay or stop ovulation
Ullipristal Acetate (Ella) emergency contraceptive works by preventing conception by suppressing ovulation, remains effective up to 5 days
Mifepristone (Ru 486) w/misoprostol used for medical abortion, blocks uterine progesterone receptors, utltimately results in expulsion of conceptus
Mifepristone (Ru 486) w/misoprostol adverse effects bleeding, cramping, nausea, vomiting, diarrhea, HA
Mifepristone (Ru 486) w/misoprostol Contraindications ectopic pregnancy, hemorrhagic disorder, use of anticoagulant drugs, and adrenal insufficiency
Prostaglandins act like local hormones and cause uterine stimulation and cervical softening
Uses for prostaglandins induction of abortion, cervical ripening before induction of labor, and control of postpartum hemorrhage
Prostaglandin agents misoprostol (cytotec), Carboprost (Hemabate), Dinoprostoine (Cervidil)
Clomiphene (Clomid) used to promote follicular maturation and ovulation, blocks receptors for estrogen
Menotropins (Repronex, Meopur) used in conjunction with hCG to promote follicular maturation and ovulation in anovulatory patients, causes ovarian hyperstimulation syndrome and multiple births
Gosrelin (Zoladex) used to thin the endometrium
Bromocriptine (Parlodel) & Cabergoline (Dostinex) used to correct amenorrhea and infertility, activates dopamine receptors, inhibits prolactin release, normalization of menstrual cycle
Follitropins used in infertility tx, promote follicular maturation, stimulate ovulation
Adverse effects of Clomiphene (clomid) hot flashes, nausea, bloating, abd pain, breast engorgement, blurred vision, multiple births
Adverse effects of Follitropins HA, abd pain, nausea, breast pain, ovarian enlargement, ovarian hyperstimulation syndrome
Human chorionic gonadotropin (hCG) polypetide hormone produced by the placenta, used to promote follicular maturation and ovulation, promotes spermatogenesis
Adverse effects of Human chorionic gonadotropin (hCG) ovarian hyperstimulation syndrome, edema, injection site pain, HA, irritability, restlessness, fatigue
Danazol (Danocrine) reduce symptoms of endometriosis
Magnesium Sulfate used as a uterine relaxant, to prevent PTL
Terbutaline (Brethine) beta adrenergic agonist, used to prevent PTL, can cause edema, hypotension, and tachycardia- in mom and fetus
Nifedipine (Procardia, Adalat) uterine relaxant can cause transient tachycardia in mom
Indomethacin (Indocin) uterine relaxant used for very early labor, risk to the neonate
Hydroxyprogesterone caproate used to prevent PTL in women with a single pregnancy and hx of at least one preterm birth
Oxytocin (Pitocin) peptide hormone, increased the frequency, force, and duration of contx, caution: uterine rupture may occur, caution with active genital herpes
Ergot alkaloids: Ergonovine and methylergonovine used for postpartum bleeding and augmentation of labor
Oxytocin, misoprostol (cytotec), carboprost (hemabate) all used in tx of postpartum hemorrhage
Biophosphonates used to tx osteoporosis, decrease bone turnover, prevent bone resorption, inhibit osteoclasts, orally can cause esophogitis (sore throat)
Oral Biophosphonates Aldendronate (Fosamax), Tiludronate, Risendronate (Actonel), Ibandronate (Boniva),
Zolendronate (Zometa) IV biophosphonate, infusion given 1x/yr, can cause bone osteronecrosis
Created by: julzbanks