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32 Cards in this Set
- Front
- Back
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HRT Estrogen Preparations
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Oral
Transdermal patches(less side effects, more expensive) Intravaginal Estrogen/Progesterone Combo: Oral |
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Benefits of HRT
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1. relief of vasomotor symptoms
2. prevention of urogenital atrophy 3. preventions of bone loss and fractures 4. prevention of colon cancer: only if using combo |
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Risks of HRT
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1. CV events
2. endometrial cancer 3. breast cancer: inc risk w/ estrogen and progesterone use 4. ovarian cancer: inc risk w/ estrogen use only |
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Current recommendations for HRT
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HRT for no more than 4 yrs, lowest dose. Women w/ intact uterus: take a combo estrogen and progesterone. Women who have had hysterectomy: estrogen only.
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Combo Contraceptive Meds MOA
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inhibit ovulation, thicken the cervical mucus, alter endometrium.
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Combo Contraceptive Meds AE
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thromboembolic disorders
HTN cancer(breast, if px has genetic predisposition) effects related to estrogen and progesterone imbalances |
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Combo Contraceptive Meds CI
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pregnancy
breastfeeding Hx of thromboembolic disorders/breast cancer smoking |
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Combo Contraceptive Meds DI
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P450 inducers
ABX: tetracycline, amipicillin warfarin insulin, oral hypoglycemic agents theophylline |
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Long-Acting Contraceptive agents: types
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Subdermal Implants: Norplant
Depot Injections: Depo-Provera |
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Norplant MOA
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contains levonorgestrel, a synthetic progestin. Six capsules, implanted on inside of arm-->release med over 5 yrs. Causes changes in the cervical mucous, affects the endometrium.
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Norplant AE
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menstrual irregularities
abdominal discomfort vaginitis breast discharge |
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Depo-Provera MOA
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same mechanism as OC. IM injections q 3 months.
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Depo-Provera AE
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menstrual irregularities
weightg gain abdominal bloating bone loss(BIGGEST concerm decr bone density= reason recommended not to use long-term, max 2 yr regimen) |
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Drugs that promote follicular maturation:
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Clomid
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Clomid MOA
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blocks receptors for estrogen in hypothalamus and pituitary. Pituitary gland compensates and releases LH and FSH--> stimulates ovaries.
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Clomid AE
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hot flashes
abdominal discomfort breast engorgement ovarian enlargement multiple births |
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Drugs that stimulate ovulation
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Human chorionic gonadotropin (hCG)
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(hCG) MOA
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functions like LH. Acts on ovaries to stimulate ovulation. Used in combo w/ meds that help follicle maturation(Clomid)
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(hCG) AE
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pain at injection site
CNS symptoms edema ovarian hyperstimulation syndrome( cysts can develop and rupture) |
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Drugs that affect uterine contractions:
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Tocolytics-Relaxants
a. magnesium sulfate Oxytocics-Stimulants a. Oxytocin |
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Magnesium Sulfate MOA
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inhibits Ach release at uterine NMJ.
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Magnesium Sulfate IND
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suppress preterm labor
seizures low doses-- replacement therapy laxative |
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Magnesium Sulfate AE
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maternal: therapeutic doses- hypotension, HA, dizziness
higher doses: pulmonary edema, muscle weakness, resp arrest infant: muscle weakness, sleepiness. |
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Magnesium Sulfate Nursing Considerations
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monitor magnesium levels
monitor urine output, renal function |
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Oxytocin MOA
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inc force, frequency, and duration of contractions
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Oxytocin IND
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induce labor for pregnacy near term or beyond term
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Oxytocin AE
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uterine rupture
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Oxytocin Nursing Considerations
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monitor contractions and maternal BP, HR
monitor fetal response to contractions, HR |
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Viagra MOA
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enhances vasodilation effects of nitric acid. Nitric oxide activates cyclic GMP. cGMP creates erection by relaxing smooth muscle and causing arterial vasodilation. cGMP gets broken down by PDE5. Viagra inhibits PDE5.
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Viagra IND
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ED
pulmonary arterial HTN |
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Viagra AE
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hypotension
priapism HA |
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Viagra DI
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nitrates
alpha blockers hepatic microsomal enzyme inhibitors |
