Drugs for UTI & Oral Contraceptives Flashcards
(95 cards)
0
Q
Urinary antiinfectives
A
Nitrofurantoin (furadantin, macrodantin)
1
Q
Bacteriostatic, bactericidal
A
Urinary antiinfectives Sulfonamides Fluoroquinolones Penicillins Third generation cephalosporins
2
Q
Sulfonamides
A
Trimethoprim-sulfamethoxazole (bactrim)
3
Q
Fluoroquinolones
A
Nalidixic acid (NegGram) ciprofloxacin (cipro)
4
Q
Third generation cephalosporins
A
Cefixime (maxipime)
5
Q
Treats gram positive and negative
A
Nitrofurantoin (macrobid)
6
Q
What does nitrofurantoin (macrobid) inhibit?
A
Bacterial enzymes and metabolism
7
Q
Side effects of nitrofurantoin (macrobid)
A
Dizziness, HA, drowsiness, rust colored or brown urine, rash, pruritus, GI distress, superinfection, peripheral neuropathy, hepatotoxicity, Steven Johnson syndrome, blood dyscrasias
8
Q
Nursing interventions for nitrofurantoin (macrobid)
A
Take with food, avoid antacids, don’t crush or open capsules, shake liquid suspension, rinse mouth after taking, don’t drive or operate dangerous equipment, INCREASE Fluids, cranberry juice, plums, protein, and vit C
9
Q
Urinary antiinfective that treats chronic UTI and is bacteriocidal
A
Methenamine hippurate (hiprex)
10
Q
What is methenamine hippurate (hiprex) effective for?
A
Pseudomonas and E. coli
11
Q
Caution for methenamine hippurate (hiprex)
A
Not to be taken with sulfonamides because it may cause crystalluria
12
Q
Client teaching for methenamine hippurate (hiprex)
A
Consume acidic foods and fluids
13
Q
Urinary analgesic, relieves pain, burning sensation, frequency, urgency
A
Phenazopyridine (pyridium)
14
Q
Side effects of phenazopyridine (pyridium)
A
GI upset, red-orange urine, blood dyscrasia, nephrotoxicity, hepatotoxicity
15
Q
Urinary stimulant / treat hypotonic bladder
A
Bethanechol (urecholine)
16
Q
Action of bethanechol (urecholine)
A
Increases bladder tone of detrusor muscle
17
Q
Contraindication of bethanechol (urecholine)
A
Peptic ulcer
18
Q
Side effect of bethanechol (urecholine)
A
GI distress, dizziness, fainting
19
Q
Urinary antispasmodic
A
Oxybutynin (ditropan)
20
Q
Action of oxybutynin (ditropan)
A
Direct action on smooth muscles to relieve spasms
21
Q
Side effects of oxybutynin (ditropan)
A
Drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth, constipation
22
Q
Caution for oxybutynin (ditropan)
A
Avoid in narrow-angle glaucoma, cardiac, renal, hepatic, prostate problems
23
Q
Urinary antimuscarinics
A
Tolterodine tartrate (detrol)
24
Action of tolterodine tartrate (detrol)
Control overactive bladder
25
Side effects of tolterodine tartrate (detrol)
Drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth, constipation
26
Caution for tolterodine tartrate (detrol)
To be avoided of client has narrow angle glaucoma or cardiac, renal, hepatic, prostate problems
27
PDE5 inhibitors
Levitra, cialis, Viagra
28
Taken for erectile dysfunction/improves blood flow to penis
PDE5 inhibitor
29
When do you take PDE5 inhibitor
30 min prior to sex, lasts several hours
30
Caution PDE5 inhibitor
Not for pts taking nitrates
31
Side effect of PDE5 inhibitor
Stuffy nose and headache
32
A client with a lower UTI has been prescribed nitrofurantoin. What side effect would nurse teach client to expect?
Brown, discolored urine
33
A client entering the med clinic has been diagnosed with overactive bladder. Which med would nurse expect to be ordered?
Tolterodine tartrate (detrol)
34
Combined hormone contraception
Contain a synthetic version of estrogen and a compound known as progestin
35
Most commonly used estrogen
Ethinyl estradiol
36
Older form of estrogen found in higher dose oral combination products
Mestranol
37
Derivative of the steroid testosterone and have progesterone like effects
Progestin
38
What dose do you use for contraception?
The lowest effective dose that successfully prevents conception should be used
39
What is the action of the estrogen component of combined hormone contraceptive?
Inhibits ovulation by preventing the formation of a dominant follicle which inhibits stimulation of luiteinizing hormone.
40
Action of progestin component
Suppresses LH surge, makes cervical mucus thick and hostile to sperm penetration. Ovulation inhibited, pregnancy does not occur.
41
Oral contraception absorption and metabolized
Ingested daily, absorbed by gastrointestinal tract and metabolized by liver
42
Combined oral contraceptive effective rate
98% accounting for user error
43
Increased estrogenic activity side effects
Cyclic breast changes, dysmenorrhea, menorrhagia (heavy periods), chloasma (hyper pigmentation of skin), and VTE, nausea, vomiting, edema, leg cramps, hypertension
44
Side effects of decreased estrogenic activity
Amenorrhea and spotting, dyspareunia (painful sex) and nervousness
45
Side effects of increased progestational activity
Breakthrough bleeding (BTB) and headaches, increased appetite, weight gain, oily skin and scalp, acne, excess hair growth, decreased breast size
46
When does Breakthrough bleeding occur?
Active pill cycle of combined oral contraceptives (COC). More common at start of COC use and when women changes COC type of pill
47
What do majority of women on COC products experience
Shorter, lighter periods, decreased blood loss, decreased uterine cramps, elimination of mittelschmerz, reduces incidence if pelvic inflammatory disease
48
Three types of COC
Monophasic, biphasic, and triphasic
49
Fixed ratio of estrogen to progestin throughout cycle
Monophasics
50
Amount of estrogen is fixed but amount of progestin varies
Biphasics
51
Reduced in first half to provide proliferation of endometrium and increased in second half to promote secretory development of endometrium.
Biphasic, this simulates normal process of menstruation with no ovulation.
52
Newest COC/amount of either estrogen or progesterone varies throughout cycle in different ratios during three stages.
Triphasic
53
How are COC packaged?
21 day or 28 day tablet packs
54
21 days of active pill followed by 7 pill free days
21 day pack
55
21 days of active pill followed by 7 days of inert or counter pills
28 day package
56
When is pseudomenstruation or withdrawal bleeding?
During hormone free period while taking counters or during 7 day pill free period
57
What is withdrawal bleeding caused by?
Level of estrogen and progestin decreases allowing for breakdown of endometrial lining
58
Continuous dosing COC products
91 day regimen/84 days active pill, and 7 days of inert pills
59
For continuous COC how often is there withdrawal bleeding?
4 times a year
60
Who may benefit from continuous COC?
Women with menstrual disorders such as menorrhagia (heavy period), metrorrhagia (irregular bleeding between periods), endometriosis, dysmenorrhea, PMS, and ovarian cyst formation.
61
What increases the risk of circulatory disorders?
Estrogen component
62
First day start method
Contraception product initiated first day of menstruation. No backup method needed (condoms or diaphragm)
63
Sunday start method
Start contraception on Sunday following first day of menstruation or on Sunday if menstruation starts that day. Use backup if started after day 5 of menstruation.
64
Quick start method
Start day receive prescription. Use back up method for 7 days if started after day 5 of menstruation.
65
Miss one tablet of COC product
Take tablet as soon as realized
| Take next pill as scheduled
66
Miss two tablets of COC
Take 2 tabs for 2 days with next tab as scheduled
| Use back up method of contraception for rest of cycle
67
Miss 3 tab of COC
Discontinue present pack and allow for withdrawal bleeding. Start a new pkg of tablets 7 days after the last tab was taken. Use another form of contraception until tabs have been taken for 7 consecutive days.
68
Miss one or more tabs of progestin only products
Take tab as soon as realized and follow with next tablet at regular time, PLUS use backup method for 48 hrs
69
Contraception with no estrogen
Progestin-only contraception
70
Advantages of progestin only
Safe, ease of use, spontaneity of sexual intercourse and reversibility.
71
Disadvantages to progestin only
Higher incidence of irregular bleeding and spotting and possibility of depression, mood changes, and fatigue.
72
Progestin only oral contraceptive pill four mechanisms of action
1) alteration in cervical mucus, making thick and viscous, blocking sperm
2) interference with the endometrial lining, making implantation difficult
3) decreased peristalsis in Fallopian tubes, slowing transport of ovum
4) in 50% of cycles, interference with LH surge inhibiting ovulation
73
Side effects of progestin deficiency
Dysmenorrhea, bleeding late in cycle, heavy menstrual flow with clots, or amenorrhea
74
How long should a women in transitional period of menopause take contraceptives?
Until menstruation has ceased 1 year
75
Natural alternatives for menopause
Soy, isoflavones from soy, Actaea racemosa or black cohosh, vitamin E, evening primrose
76
What do natural alternatives treat for menopause?
Menopause symptoms especially hot flashes
77
Bioidentical hormone therapy for menopause
Estrogen-like compounds that have been derived from plants. Most common is soy and Mexican yam root.
78
What are the most commonly commercially available compounds?
Estrone, estradiol, estriol, testosterone, and micronized progesterone
79
Benefits of bioidentical hormones
Limited side effects, reduced risk of exacerbating the growth of bread cancer cells, equal osteoporosis prevention benefits, decrease in cardiovascular effects
80
Two commonly prescribed bioidentical products
Tri-est and Bi-est
81
What do estrogen and progestin do in hormone therapy
Estrogen relieves symptoms of menopause while progestin protects uterine endometrium from hyperplasia
82
What forms are hormone therapy available?
Oral preparations, transdermal applications, and vaginal preparations
83
Types of vaginal preparations
Creams, suppositories, pellets, or rings. Only secrete estrogen
84
Three types of estrogen used in hormone therapy
Natural, conjugated equine estrogens (CEE) and synthetic
85
Where is estrogen absorbed and metabolized?
Absorbed in GI tract and metabolized by liver necessitating daily doses when oral products are nonesterified
86
Drug used for benign prostate hyperplasia
5-alpha-reductase inhibitors and alpha-adrenergic blocking agents
87
Side effects of 5-alpha-reductase inhibitors
Decreased libido and erectile dysfunction
88
Side effects of alpha-adrenergic blocking agents
Hypotension, dizziness, fatigue
89
What must you consider before giving an alpha-adrenergic blocking agent to a client?
It also is used to control blood pressure, so to prevent hypotension ask client for list of their meds before adding another antihypertensive drug
90
Drug to treat poly cystic ovarian syndrome
Metformin. It treats insulin resistance, regulates menstrual period and increases possibility of ovulation
91
Pharmacological management of endometriosis
Combined hormone contraceptive products, progestational products, gonadotropin inhibitors and Gn-RH agonists,
92
Herbal treatment of PMS
Vitamin B6 and increased calcium and chaste berry
93
Antidepressants and anti anxiety Meds for PMS
SSTI Meds: Prozac, Zoloft, Paxil, and celexa
For severe: Xanax, Valium, BuSpar, and Ativan
94
Hormonal therapy for PMS
Progesterone, medroxyprogesterone acetate,
| Long term: orthoevra and nuvaring
