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32 terms

50BFinal Reproductive Drugs

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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