Module 2: Chapter 52 Drugs Affecting Women's Health and Sexuality

Question 1

what are the female sex hormones responsible for

Answer 1

producing female sex characteristics
developing the female reproductive systme
maintaining pregnancy

Question 2

what are the two types of female sex hormones

Answer 2

estrogen

progestin

Question 3

true or false: both female sex hormones are not steroidal compounds

Answer 3

false: they are steroidal

Question 4

when are female sex hormones produced and where

Answer 4

ovaries begin to secrete at puberty and the placenta secretes during pregnancy
adrenal cortex also secretes estrogen and progestin but in much smaller amounts

Question 5

how does the menstral cycle work

Answer 5

low estrogen and progesterone levels cause stimulation
GnRH is produced
release of FSH and LH
ovulation
development of corpus luteum
estrogen and progesterone levels rise to high levels
fertilization or non fertilization

Question 6

what are the three options that occur in the menstral cycle when their are high estrogen and progesterone levels

Answer 6

fertilization
no fertilization
suppression and indirect shutoff of FSH and LH (negative feedback)

Question 7

what happens if fertilization occurs

Answer 7

production of progesterone and estrogen by placenta
high levels of estrogen and progesterone maintained
suppression and indirect shutoff of FSH and LH (negative feedback)

Question 8

what happens if no fertillization occurs

Answer 8

disintigration of corpus luteum
drop in levels of progesterone and estorgen
low levels cause stimulation and cycle repeats

Question 9

will a women who is deficient in endogenous sex hormones can she still experience normal sexual development

Answer 9

no

Question 10

what happens to a womans estrogen levels during menopause

Answer 10

estrogen levels drop and woman experiences several changes

Question 11

in postmenopausal women the loss of estrogen contribute to the development of what

Answer 11

osteoporosis

Question 12

what is osteoporosis characterized by

Answer 12

low bone mineral density

Question 13

what is the leading cause of osteoporosis

Answer 13

deficiency of sex hormones

Question 14

is there many different types of exogenous estrogen that differ in terms of indications, route of administration and pharmacokinetics

Answer 14

yes

Question 15

what are the different routes of administration for exogenous estrogens

Answer 15

oral
IM
transdermal
topcial (vaginal creams)

Question 16

what are most of these estrogens used for

Answer 16

correction of low endogenous estrogen or in birth control products combined with progestins

Question 17

what is the prototype drug for estrogen

Answer 17

conjugated estrogen (premarin)

Question 18

conjugated estrogen is primarily used in what

Answer 18

hormone replacement therapy

Question 19

where is conjugated estrogen metabolised

Answer 19

liver

Question 20

where is conjugated estrogen excreted

Answer 20

kidneys

Question 21

what does conjugated estrogen do

Answer 21

stimulates the development of the female sex organs and secondary female sexual characteristics

Question 22

what are the contraindications for conjugated estrogen

Answer 22

black box warning for increase of risk of cardiovascular events

Question 23

what are some adverse effects for conjugated estrogen?

Answer 23

incr. risk for stroke and heart disease
breakthrough bleeding
headache
N/V
bloating
abdominal cramps
chloasma (brown patches on the skin)

Question 24

what should be assessed for when giving conjugated estrogen

Answer 24

assess BP and breast fr any masses

check pts age

Question 25

why is the environment important when giving conjugated estrogen

Answer 25

causes photosensitiviity

Question 26

how can the therapeutic effects of conjugated estrogen be maximized

Answer 26

administer conjugated estrogen cyclically

Question 27

how can adverse effects of conjugated estrogen be minimized

Answer 27

monitor for signs of thrmobophlebitis and thromboembolus | monitor uterus for risk of endometrial cancer with the combination of estrogen and progestin

Question 28

True or False: The women's health initiative (WHI) found that menopausal women who had moderate-to-severe vasomotor symptoms had benefirt from estrogen therapy

Answer 28

True: small benefit in sleep quality with 3 years of estrogen-progestin therapy

Question 29

What do progestins consist of

Answer 29

progesterone and its derivatives

Question 30

how do progestins work

Answer 30

through stimulation or inhibition regulate secretion of pituitary gonadotropins inhibit spontaneous uterine contractions

Question 31

what is the prototype drug for progestins

Answer 31

progesterone (prometrium, crinone)

Question 32

what is the desired therapeutic effect of progesterone

Answer 32

help produce normal menstrual cycle

Question 33

how is progesterone administered

Answer 33

oral or IM

Question 34

where is progesterone metabolized

Answer 34

liver

Question 35

where is progesterone excreted

Answer 35

kidneys

Question 36

does exogenous progesterone affect the body in ways similar to endogenous progesterone

Answer 36

yes

Question 37

are there any contraindications or precautions for progesterone

Answer 37

hypersensitivity

Question 38

what are some adverse effects of progesterone

Answer 38

may increase the risk of breast and ovarian cancer when given in combination with estrogen in postmenopausal women

Question 39

are there any known drug interactions with progesterone

Answer 39

no

Question 40

what pregnancy category is progesterone

Answer 40

B

Question 41

what is important about environment regarding progesterone

Answer 41

caution pts about exposure to UV light

Question 42

how can you maximize therapeutic effects for progesterone

Answer 42

dosing schedule dependent n the clinical indication for using progesterone

Question 43

how can you minimize adverese effects for progesterone therapy

Answer 43

don't give to pts with contraindications to therapy

Question 44

what do you need to educate patients on that are receiving progesterone therapy

Answer 44

teach patients how to perform breast self-examination

Question 45

what patients should you monitor closely during progesterone therapy

Answer 45

premenopausal women taking progesterone for return of normal menstral flow and cessation of abnormal bleeding

Question 46

why is progesterone also added to postmenopausal HRT (hormone replacement therapy)

Answer 46

decrease the risk of endometrial cancer

Question 47

what hormones do oral contraceptives contain

Answer 47

estrogen and progesterone or just progesterone

Question 48

what is the purpose of oral contraceptives

Answer 48

to prevent pregnancy

Question 49

hwo do oral contraceptives work

Answer 49

inhibit ovulation by suppressing the gonadotropins FSH and LH

Question 50

oral contraceptives should be prescribed with the ______ effective dose of estrogen possible

Answer 50

smallest

Question 51

oral contracetpives are known to interact with what two classes of drugs

Answer 51

penicillins and tetracyclines

Question 52

what class of drugs affects normal and abnormal bone reabsorption

Answer 52

bisphosphonates

Question 53

what is the prototype drug for bisphosphonates

Answer 53

alendronate (fosamax)

Question 54

what is alendronate used for

Answer 54

to treat and prevent osteoporosis

Question 55

how is alendronate administered

Answer 55

orally

Question 56

how is alendronate excreted

Answer 56

kidneys

Question 57

how does alendronate work

Answer 57

inhibits both normal and abnormal bone resorption

Question 58

what are the contraindications and precautions for alendronate

Answer 58

hypocalcemic or hypersensitivity

Question 59

what are the adverse effects of alendronate

Answer 59

``` musculoskeletal pain flatulence acid regurgitation esophageal ulcer gastritis headache erythema ```

Question 60

are there any known drug interactions for alendronate

Answer 60

recommended to wait at least 30 minutes after taking alendronate before taking any other drug

Question 61

what pregnancy category is alendronate

Answer 61

category C

Question 62

what race of women are at risk for ostoporosis

Answer 62

asian and white

Question 63

how can you minimize adverse effects for alendronate

Answer 63

take measures to correct preexisting hypocalcemia before treatment monitor electrolytes during therapy

Question 64

what are two key pieces of patient teaching you should do when teaching about alendronate therapy

Answer 64

take alendroante at least 30 mins before eating patients should swallow the medicine with 6-8ox (180-240mL) of plain water

Question 65

what ongoing assessment should you monitor when a patient is taking alendronate

Answer 65

make sure patient is not experiencing hypocalcemia or other adverese effects