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estrogen used to tx menopause, dysmenorrhea, atrophic vaginitis (weakening of vaginal wall), turner syndrome (failure of ovary development), cancers of the prostate and breast, suppresses postpartum milk production, acne, prophylaxis for osteoporosis, and oral contraceptives adverse effects of estrogen nausea like morning sickness contraindications for estrogen avoid in pregnancy and thrombolytic disorders increases risk of embolism if pt smokes, is over 35 and with high doses conjugated estrogen clinically used in menopause, cyclic use on 21 day, and 7 days off and has increase risk of endometrial cancer. (can be prevented by cyclic use or use w/progestin diethylstilbestrol (DES) nonsteroidal synthetic estrogen. use to be used as post coital contraceptive but not anymore, now used for inoperable prostate cancer precaution for DES avoid in pregnancy progestins medroxyprogesterone and norethindrone clinical uses for progestins used as an oral contraceptive, Tx of dysfunctional uterine bleeding w/estrogens, dymenorrhea w/estrogens, premenstrual tension, endometriosis w/estrogens, endometrial cancers, and suppression of lactation adverse effects of progestins congenital defects, hyperglycemia, fluid retention, HA, and visual disturbances contraindications of progestins hx of thromboembolism, breast and genital cancer medroxyprogesterone injectable progestin, adverse effect is fluid retention (diuretics and low sodium diet used to tx it) norethindrone causes loss of bone density oral contraceptives four types: combination, mini-pill, morning after and implantable combination pill ethyl estradiol, contains estrogen and progestin adverse effects of ethyl estradiol thrombophlebitis, thromboembolism (age>35 and smokers), hypertension, possible risk of cancer (endometrial and breast), melasma (freckling when exposed to sun), and depression. mini pill contains no estrogen but small amounts of progestin, less effective Morning after pill large dose of estrogen (DES), must administer 24 hours but not more than 72 hours after intercourse. adverse effect is nausea and vomiting selective estrogen receptor modulator (SERMS) raloxifene, used for prevention of osteoporosis in post menopausal women. decreases LDL cholesterol, adverse effects of raloxifene hot flashes and leg cramps precaution for raloxifene must discontinue use 72 hours prior to and during prolonged immobilization and avoid in pregnancy toxemia of pregnancy preclampsia (hypertensive state) and eclampsia (coma and seizures as sequel to preclampsia) drug Tx for toxemia of pregnancy IV infusion of Magnesium sulfate (monitor for signs of toxicity and also contraindicated for heart block or kidney impairment), Hydralyzine (alternative), and valium®/diazepam (for seizures) oxytocin used to induce labor, stimulates milk production, and uterus, can also be used to stop hemorrhage adverse effects of oxytocin monitor mother and fetus every 10 minutes to prevent uterine tetany, rupture, amniotic fluid embolism, or cervical laceration, can cause decrease in uterine placental placental blood flow and postpartum uterine atony. contraindications of oxytocin severe preclampsia, fetal distress, fetal abnormal presentation, and 1st stage of labor. Androgens important for growth, reproduction, and masculinization and spermatogenesis. testosterone methyltestosterone is drug used to Tx hypogonadism, impotence, suppress lactation in women and inoperable breast tumors in women. adverse effects of testosterone masculinization in women, cholestatic hepatitis, salt and fluid retention, adverse effects of anabolic steroids roid rage, psychotic reactions, increase risk of CAD, liver toxicity, testicular atrophy, gynecomastia, hair loss, sperm abnormalities, prostate enlargement, and change in libido sildenafil use to Tx erectile dysfunction but is not an aphrodisiac. unlabeled used in pulmonary hypertension. adverse effects of sildenafil color vision disturbances (blue haze or brightness), HA and hearing problems DDI of sildenafil all organic nitrates (NTG, nitroprusside), cimetadine, erythromycin, and ketoconazole