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Women's Health
Estrogens and Progestins
| Term | Definition |
|---|---|
| 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
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