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TN Gyneco > 20. Common medications > Flashcards

20. Common medications Flashcards

1
Q

Describe this medication: acyclovir (Zovirax®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action:
    • Antiviral; inhibits DNA synthesis and viral replication
  • Dosing:
    • First Episode: 400 mg PO tid x 7-10 d
    • Recurrence: 400 mg PO tid x 5 d
  • Indications: Genital herpes
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: headache, GI upset
    • D/I: zidovudine, probenecid
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2
Q

Describe this medication: bromocriptine (Parlodel®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action:
    • Dopaminomimetic, agonist at D2R and antagonist at D1R; acts directly on anterior pituitary cells to inhibit synthesis and release of prolactin
  • Dosing:
    • Initial: 1.25-2.5 mg PO qhs with food. Then: increase by 2.5 mg every 2-7 d as needed until optimal therapeutic response
    • Usual Range: 1.5-15 mg OD
    • For IVF:
      • Initial: 1.25 mg/d PO between days 4-6 of follicular phase
      • Then: 2.5 mg/d until 3 d after onset menstruation
  • Indications:
    • Galactorrhea + amenorrhea
    • 2° to hyperprolactinemia
    • Prolactin-dependent menstrual disorders and infertility
    • Prolactin-secreting adenomas (microadenomas, prior to surgery of macroadenomas)
    • IVF
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: N/V, headache, postural hypotension, somnolence
    • C/I: uncontrolled HTN, pregnancy-induced HTN, CAD, breastfeeding
    • D/I: domperidone, macrolides, octreotide
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3
Q

Describe this medication: clomiphene citrate (Clomid®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Increases output of pituitary gonadotropins to induce ovulation
  • Dosing: 50 mg OD x 5 d

Try 100 mg or 160 mg OD
If ineffective 3 courses: adequate trial

  • Indications: Patients with persistent ovulatory dysfunction (e.g. amenorrhea, PCOS) who desire pregnancy
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: Common: hot flashes, abdominal
      discomfort, exaggerated cyclic ovarian enlargement, accentuation of Mittelschmerz
      Rare: ovarian hyperstimulation syndrome,
      multiple pregnancy, visual blurring, birth defects
    • C/I: pregnancy, liver disease, hormone-dependent tumours, ovarian cyst, undiagnosed vaginal bleeding
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4
Q

Describe this medication: clotrimazole (Canesten®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Antifungal; disrupt fungal cell membrane
  • Dosing:
    • Tablet: 100 mg/d intravaginally x 7 d or 200 mg/d x 3d or 500 mg x 1 dose
    • Cream (1 or 2%): 1 applicator intravaginally qhsx3-7d
    • Topical: apply bid x 7 d
  • Indications: Vulvovaginal candidiasis
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I): S/E: vulvar/vaginal burning
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5
Q

Describe this medication: danazol (Cyclomen® [CAN]) (Danocrine® [US])

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Synthetic steroid: inhibits pituitary gonadotropin output and ovarian steroid synthesis Has mild androgenic properties
  • Dosing:
    • 200-800 mg in 2-3 divided doses
    • Use for 3-6 mo
    • Biannual hepatic U/S required if >6 mo use
  • Indications:
    • Endometriosis
    • 1° menorrhagia/DUB
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: weight gain, acne, mild hirsutism, hepatic dysfunction
    • C/I: pregnancy, undiagnosed vaginal bleeding, breastfeeding, severely impaired renal/hepatic/cardiac function, porphyria, genital neoplasia, thromboembolic disease
    • D/I: warfarin, carbamazepine, cyclosporine, tacrolimus, anti-hypertensives
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6
Q

Describe this medication: doxycycline

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Tetracycline derivative; inhibit protein synthesis
  • Dosing: 100 mg PO bid x ≥7 d
  • Indications: Chlamydia, gonococcal infection, syphilis
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: GI upset, hepatotoxicity
    • C/I: pregnancy, severe hepatic dysfunction
    • D/I: warfarin, digoxin
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7
Q

Describe this medication: fluconazole (Diflucan®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Antifungal; disrupt fungal cell membrane
  • Dosing: 150mgPOx1dose
  • Indications: Vulvovaginal candidiasis unresponsive to clotrimazole
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: headache, rash, N/V, abdominal pain, diarrhea
    • D/I: terfenadine, cisapride, astemizole, hydrochlorothiazide, phenytoin, warfarin, rifampin
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8
Q

Describe this medication: leuprolide (Lupron®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Synthetic GnRH analog; induces reversible hypoestrogenic state
  • Dosing:
    • 3.75 mg IM q1mo or 11.25 mg IM q3mo
    • Usually ≤6 mo, check bone density if >6 mo
    • Retreatment with Lupron® alone not recommended because of effects on bone density
  • Indications:
    • Endometriosis
    • Leiomyomata
    • dysfunctional uterine bleeding (DUB)
    • Precocious puberty
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: hot flashes, sweats, headache, vaginitis, reduction in bone density, acne, GI upset
    • C/I: pregnancy, undiagnosed vaginal bleeding, breastfeeding
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9
Q

Describe this medication: menotropin (Pergonal®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Human gonadotropin with FSH and LH effects; induce ovulation and stimulate ovarian follicle development
  • Dosing: 75-150 U of FSH and LH IM OD x 7-12d, then 10,000 U HCG 1 d after last dose
  • Indications: Infertility
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: bloating, irritation at injection site, abdominal/pelvic pain, headache, N/V, multiple pregnancy
    • C/I: primary ovarian failure, intracranial lesion (e.g. pituitary tumour), uncontrolled thyroid/adrenal dysfunction, ovarian cyst (not PCOS), pregnancy, undiagnosed uterine bleeding
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10
Q

Describe this medication: metronidazole (Flagyl®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Bactericidal; forms toxic metabolites which damage bacterial DNA
  • Dosing: 2 g PO x 1 dose or 500 mg PO bid x 7 d
  • Indications: Bacterial vaginosis, trichomonas vaginitis
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: headache, dizziness, N/V, diarrhea, disulfiram-like reaction (flushing, tachycardia, N/V)
    • C/I: pregnancy (1st trimester)
    • D/I: cisapride, warfarin, cimetidine, lithium, alcohol, amiodarone, milk thistle, carbamazepine
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11
Q

Describe this medication: oxybutinin (Ditropan®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Anticholinergic; relaxes bladder smooth muscle, inhibits involuntary detrusor contraction
  • Dosing:
    • 5 or 10 mg/d PO
    • May increase doses by 5 mg weekly to a max of 30 mg/d
  • Indications: Overactive bladder (urge incontinence)
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: dry mouth/eyes, constipation, palpitations, urinary retention, dizziness, headache
    • C/I: glaucoma, GI ileus, severe colitis, obstructive uropathy, use with caution if impaired hepatic/renal function
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12
Q

Describe this medication: tolterodine (Detrol®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Anticholinergic
  • Dosing: 1-2 mg PO bid
  • Indications: Overactive bladder (urge incontinence)
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: anaphylaxis, psychosis, tachycardia, dry mouth/ eyes, headache, constipation, urinary retention, chest pain, abdominal pain
    • C/I: glaucoma, gastric/urinary retention, use with caution if impaired hepatic/renal function
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13
Q

Describe this medication: tranexamic acid (Cyklokapron®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Anti-fibrinolytic; reversibly inhibits plasminogen activation
  • Dosing:
    • 1-1.5 g tid-qid for first 4 d of cycle
    • Max 4 g/d
    • Ophthalmic check if used for several wk
  • Indications: Menorrhagia
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: N/V, diarrhea, dizziness, rare cases of thrombosis, abdominal pain, MSK pain
    • C/I: thromboembolic disease, acquired disturbances of colour vision, subarachnoid hemorrhage, age <15 yr
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14
Q

Describe this medication: ulipristal acetate (Fibristal®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: Selective progesterone receptor modulator (SPRM)
  • Dosing: 5 mg PO OD for max 3 mo; first tablet taken anytime during first 7 d of menstruation
  • Indications: Leiomyoma (pre-operative)
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: headache, hot flushes, constipation, vertigo, endometrial thickening
    • C/I: pregnancy, undiagnosed vaginal bleeding, any gynecological cancer
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15
Q

Describe this medication: urofollitropin (Metrodin®)

  • Action
  • Dosing
  • Indications
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
A
  • Action: FSH
  • Dosing: 75 U/d SC x 7-12d
  • Indications: Ovulation induction in PCOS
  • Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I):
    • S/E: ovarian enlargement or cysts, edema and pain at injection site, arterial thromboembolism, fever, abdominal pain, headache, multiple pregnancy
    • C/I: primary ovarian failure, intracranial lesion (e.g. pituitary tumour), uncontrolled thyroid/adrenal dysfunction, ovarian cyst (not PCOS), pregnancy, abnormal uterine bleeding
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16
Q

Describe this medication: combined oral contraceptive pill (OCP)

  • Action
  • Indications
A
  • Action:
    • Ovulatory suppression by inhibiting LH and FSH
    • Decidualization of endometrium
    • Thickening of cervical mucus to prevent sperm penetration
  • Indications:
    • Contraception
    • Disorders of menstruation
17
Q

Describe this medication: intrauterine device (IUD) copper IUD (Nova-T®) progesterone-releasing IUD (Mirena®, Jaydess®)

  • Action
  • Dosing
  • Indications
A
  • Action:
    • Copper IUD: mild foreign body reaction in endometrium, which is toxic to sperm and alters sperm motility
    • Progesterone-releasing IUD: decidualization of endometrium and thickening of cervical mucus, may suppress ovulation
  • Dosing: Contraceptive effects last 3 yr (Jaydess®); up to 5 yr (Copper IUD, Mirena®)
  • Indications:
    • Contraception
    • Disorders of menstruation

TN Gyneco (20 decks)

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