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pharm ch 27
| Question | Answer |
|---|---|
| Diaphragms | associated with risk of UTI and toxic shock syndrome a shallow, dome-shaped, flexible cup made of latex or silicone. It is inserted into the vagina before intercourse to cover the cervix. |
| hormone-releasing IUDs (Levonorgestrel) | Jaydess, Kyleena, Mirena contraceptive that reduces menstrual bleeding, making it useful for the treatment of menorrhagia |
| copper-releasing IUD | Flex-T 300, Flex-T 380, Nova T prevents the sperm from reaching the egg and the egg from attaching to the uterus |
| IUD MOA | Prompts the release of leukocytes and prostaglandins by the endometrium • Hostile to sperm and eggs |
| Progestin-releasing IUDs | prevent ovulation and thicken cervical mucus, preventing the sperm from reaching the egg. |
| IUD - Adverse drug reactions | risk of pelvin inflammatory disease 20 days after insertion |
| Oral Contraceptives | Initiate negative feedback inhibition of FSH and LH secretion: ⮚ Mature follicles do not develop ⮚ Ovulation does not occur preventing preg |
| Monophasic | fixed dose of estrogen and progestin ⮚ 21- or 28-day package - helps with fluctuating hormones |
| Biphasic | Same estrogen dose ⮚ Less progestin in first half of cycle, increased progestin in second half of cycle |
| Triphasic | ⮚ Estrogen is the same or varies throughout cycle; progestin amount varies mimics natural fluctuating hormones |
| Progestins only oral contreceptive | ⮚ Medroxyprogesterone (Depo-Provera) INJ ⮚ Etonogestrel (Nexplanon) IMPLANT / prevents pregnancy for up to 4 years ⮚ Prevent ovulation, ⮚ Thicken cervical mucus to inhibit the passage of sperm, ⮚ Maintain the endometrium |
| NuvaRing- hormonal vaginal ring | ⮚ Inserted for 3 weeks and removed for 1 week. |
| Evra -transdermal patches | ⮚ Applied once a week for 3 weeks, followed by 1 patch-free week. The hormones in the patch inhibit ovulation by suppressing follicle-stimulating hormone (FSH) and luteinizing hormone (LH). They also thicken cervical mucus, |
| Levonorgestrel (Plan B) | EMERGENCY contraceptive 75% to 85% effective when taken as soon as possible ⮚ most effective if taken within the first 72 hours |
| Ulipristal (Ella) | emergency contraceptive / effective if taken within 5 days of unprotected intercourse. ⮚ delays ovulation and prevents implantation of a fertilized egg. percription only |
| Menopause | diagnosed when no period for one year Symptoms may last from a few months to years and vary from hardly noticeable to severe. ⮚ The long-range effects of lower estrogen levels are osteoporosis and atherosclerosis |
| Atrophic vaginitis | postmenopausal thinning and dryness of the vaginal epithelium related to decreased estrogen levels causes burning pain during intercorse |
| Hormone Replacement Therapy | restores integrity of vaginal epithelium |
| Hormone Replacement Therapy: Adverse Reactions | breast/endometrial cancer breast tenderness weight gain migraine cardiovascular disease |
| SSRI (paroxetine) | can be used to treat symptoms of menopause such as hot flashes and mood changes and PMDD |
| Premenstrual syndrome | Collection of symptoms that regularly occur in women prior to menstruation. ⮚ headache, mood changes, fatigue, weight gain, sleep changes, and other problems that limit activity and affect personal relationships |
| Dysmenorrhea | Painful menstruation 85% of women TREATED WITH NSAIDS (ibuprofen / naproxen/ ketoprofen) ⮚ Severe lower abdominal cramping and back pain accompanied by headache, nausea, and vomiting |
| Primary dysmenorrhea | ⮚ Last from hours to days - adolescents and young women ⮚ Vary in severity from cycle to cycle |
| Secondary dysmenorrhea | • Menstrual-related pain caused by a pelvic pathological condition/ treat underlying disorder |
| Amenorrhea | Absence of normal menstruation - |
| Primary amenorrhea | failure of menstruation cycles to begin |
| Secondary amenorrhea | -slows to three or four cycles per year - excessive weight loss, disease , menopause |
| treatment for amenorrhea | ⮚ Bromocriptine - dopamine receptor agonists ⮚ Oral contraceptives |
| Dysfunctional Uterine Bleeding (DUB) | Irregular or excessive uterine bleeding resulting = disruption of blood supply. affects 1/3 women can cause life threatening anemia can be caused by fibroids Treatment ⮚ NSAIDs, ⮚ low-dose birth control pills ⮚ hysterectomy remains |
| Azithromycin (antibiotics) | treats Chancroid and chlamydia |
| menorrhagia | excessive bleeding |
| Amoxicillin, azithromycin, cefpodoxime, ceftriaxone, cefixime, cefuroxime, spiramycin (Canada only), doxycycline, tetracycline (antibiotics) | used to treat goneorhea |
| Infertility | Failure to conceive after 1 year of regular unprotected intercourse |
| Hypogonadism | caused infertility - Sex glands produce little or no hormones |
| treatment for infertility | Antiestrogens / SERM: ⮚ Clomiphene |
| Gonadotropins (treatment for infertility ) | Follitropin-alpha, follitropin-beta, urofollitropin, human chorionic gonadotropin, human menopausal gonadotropin |
| Clomiphene moa | tricking pituitary gland to make FSH AND LH causing ovulation |
| Gonadotropins moa | hmg - acts like FSH / follicular growth hcg- acts like LH producing ovulation stimulates superovulation |
| Treatment of Hypogonadism female | ⮚ Lutropin alfa, estrogens |
| Endometriosis | endometrial tissue outside of the uterus: ⮚ Causes infertility, dysmenorrhea, and severe pain |
| Treatment of Hypogonadism male | ⮚ Methyltestosterone, testosterone |
| Danazol | androgen steroid treats Endometriosis- Suppresses pituitary output of FSH and LH ⮚ Causes atrophy of normal and ectopic endometrial tissue should be taken with food |
| Gonadotropin-releasing hormone analogs | synthetic agnosits used to treat enfometriosis Inhibits gonadotropin secretion |
| Danazol adverse reactions | Masculinity effects; gastrointestinal distress, diarrhea, or jaundice; menstrual irregularities |
| Gonadotropin-releasing hormone analogs adverse reactions | ⮚ Headache, tumor flare, gynecomastia, breast swelling and tenderness, postmenopausal symptoms, vaginal spotting, breakthrough bleeding, decreased libido, impotence, bone pain, and bone loss |
| Treatment of Androgen Deficiency in Men | Androgens used as hormone replacement therapy/ Testosterone is the primary androgen ⮚ Secreted by the anterior pituitary gland and small amount by adrenal gland ⮚ Responsible for masculinization |
| Androgen agonists = synthetic drugs that closely resemble testosterone | ⮚ Fluoxymesterone ⮚ Methyltestosterone ⮚ Oxandrolone ⮚ Testosterone |
| Testoderm scrotal patch | designed to treat male hypogonadism (low testosterone levels). It delivers testosterone through the skin directly into the bloodstream. |
| where to apply androderm | Apply to arm, abdomen, back, or thigh |
| testosterone and anabolic steroids are | controlled substances |
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