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22 Cards in this Set
- Front
- Back
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Vitamins for PMS (4)
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1.) Calcium
2.) Magnesium 3.) Vitamin E 4.) Multivitamin |
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Calcium
a.) dosing b.) effect on PMS c.) caution |
a.) 1200mg/day or 600mg twice daily
b.) decreases DEPRESSION, bloating, pain, fatigue, insomnia, food cravings c.) can cause constipation, so avoid people with kidney stones |
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Magnesium
a.) dosing b.) effect on PMS c.) ADR |
a.) 200-400 mg daily
b.) decreased bloating, breast tenderness c.) DIARRHEA |
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Vitamin E
a.) dosing b.) effect on PMS |
a.) 400 IU during luteal phase
b.) mood, breast tenderness |
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Naproxen
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220-250mg q6-8 hours
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Ibuprofen
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200-400mg q4-6 hours
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Acetaminophen dosing
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500-1000mg q4-6 hours
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First line for bloating
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Sodium restriction
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2nd line for bloating
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Pamabrom, a diuretic. Seen in pamprin, midol, etc
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3rd line for bloating
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Spironolactone diuretic
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Oral contraceptives: Which is preferred?
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Those that have drospirenone (Yaz, Yasmin, Beyaz, Safyral) bc it helps with mood (ant-androgen) and bloating (diuretic). Use biphasic or triphasic for 3-6 cycles
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Danazol
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Restrict use to SEVERE pms only. This causes amenorrhea
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Leuprolide acetate
a.) class b.) indication |
a.) This is a GnRH agonist
b.) severe PMS (can worsen mood. dont use >6months). endometriosis |
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PMDD
a.) defining characteristic b.) duration before defining c.) when does it occur |
a.) severe decreased mood that interferes with daily activity
b.) need to have symptoms (5+) for a year or more c.) before your period (last week luteal) |
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1st line PMDD
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SSRI's (PFS: Paroxetine, Fluoxetine, Sertraline), taken as needed (before period) or continuously
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2nd line options (2) for PMDD
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1.) SNRI (venlafaxine) or TCA (chlomipramine/anafranil)
2.) Birth control: Yaz & Beyaz. Other birth controls in general won't work for PMDD because birth control can worsen mood |
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Primary dysmenorrhea
a.) when does it occur? b.) MOA c.) risk factors |
a.) this is painful period, so occurs DURING menstruation day 1
b.) too much prostaglandin release, resulting in stronger contractions, ischemia, sensitive nerves c.) started early, heavy periods, long periods, smoking/alcohol, obesity |
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Primary dysmenorrhea- 1st line (2)
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1.) NSAIDS: Ibuprofen 200-400mg q4-6h; Naproxen 225-250mg q8-12h
2.) Birth control |
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Secondary dysmenorrhea
a.) what b.) symptoms |
a.) This is dysmenorrhea due to an underlying disease (endometriosis, tumors, etc)
b.) very heavy bleeding than normal and lasts longer, no response to NSAIDs. refer to doctor |
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Endometriosis
a.) what b.) risk factors |
a.) When the endometrium grows outside of the uterus. Very painful periods or obstruction of periods, infertility
b.) never had kids, genetics, early start |
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Treatment for endometriosis - Nonpharm
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SURGERY. Depends if patient wants to get pregnant or not. If she does want to get pregnant some day, do a conservative surgery, where they laproscopically remove the lesions. If she does not want to get pregnant, do a definitive surgery and take out the uterus or ovaries
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Treatment for endometriosis - Pharm
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NSAIDS or oral contraceptives (just like dysmenorrhea)
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