Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
18 Cards in this Set
- Front
- Back
|
What is Step 1(PMS) treatment?
|
-institiute lifestyle changes, supplements, diuretics
-calcium (as calcium carbonate) |
|
|
___________should be recommended for women with PMS symptoms since it is well tolerated and provides relief with mood and somatic symptoms
|
calcium supplementation
|
|
|
What is Step 2 (PMDD) treatment?
|
-SSRIs or anxiolytics
|
|
|
_____are the first line therapy for PMDD
|
SSRIs
|
|
|
actions of SSRIs in the treatment of PMDD
|
-effective for mood disorder; decrease iffitability, depressed mood, dysphonia, and anxiety
-also improve physical Sx: bloating, breast tenderness, appetite changes |
|
|
SSRI DOC is _________ for PMDD
|
fluoxetine
|
|
|
onset of SSRI in PMDD compared with major depressive disorders
|
-partial response occurs within 1st cycle
-quicker onset in PMDD |
|
|
What is the Step 3 (alternative agents for PMDD) treatment?
|
-oral contraceptives to suppress ovulation (YAZ)
-GnRH agonists to suppress ovulation ("medical oophorectomy") |
|
|
YAZ (drospirenone and ethinyl estradiol) for use in PMDD
|
-24 days active tabs/4 placebo tabs
-FDA approved for PMDD pts who wish to use oral contraceptives -considered alternative tx for pts who failed SSRI tx or those who do not want antidepressant therapy |
|
|
MOA of GnRH agonists
|
-continual stimulation desensitizes the GnRH receptors
-results in decreased release of LH/FSH -subsequent drop in estrogen and progesterone similar to values in postmenopausal women -"medical oophroectomy" |
|
|
indications of GnRH agonists in treatment of PMDD
|
-eliminates many of emotional and physical Sx
-Sx may be exacerbated during 1st month until down-regualtion occurs -reserve for pts who have failed all other tx or who are severely debilitated -HIGH COST |
|
|
GnRH agonist products (2)
|
-nafarelin nasal spray
-leuprolide daily or depot injection |
|
|
ADR of GnRH agonists
|
-menopausal Sx
-hypoestrogenic effects cause decreased bone mineral density making long-term use inadvisable |
|
|
Pathogenesis of primary dysmenorrhea
|
-increased PG secretion induces more powerful uterine contraction, decreased uterine blood flow, and hypoxia
-these changes cause the cramping and pain |
|
|
the primary pharmacological therapy for primary dysmenorrhea is?
|
NSAIDs: naproxen, ibuprofen, and mefenamic acid are all approved for PD
|
|
|
comparison of NSAIDs used in treatment of primary dysmenorrhea
|
-naproxen allows for less frequent dosting than ibuprofen
-ibuprofen and naproxen are available OTC -no significant difference in efficacy |
|
|
Is ASA used in the tx of primary dysmenorrhea?
|
No-it has slightly less efficacy to other NSAIDs and is not approved for this indication
|
|
|
If a 2-3 month trial of one NSAID in the treatment of primary dysmenorrhea is unsuccessful, ______________ may be tried.
|
switching to an NSAID from a different class
|
