Reproduction Drugs Flashcards
(65 cards)
1
Q
What is menarche?
A
when hormones begin cycling
2
Q
Estrogen is responsible for
A
- Uterine lining build up
- Decreased libido
- Impaired thyroid fx and blood sugar
- Mood/Depression/PMS
- Water retention
- Increases risk for breast/endometrial cancer
3
Q
Progesterone is responsible for
A
- Maintaining uterine lining to allow pregnancy
- Decreasing uterine motility to increase implantation
- Maintenance of pregnancy
- Thickening cervical yucas (prevents bacteria from entering)
- Increasing blood sugar for embryo, anti insulin effect
4
Q
When is progesterone released into circulation?
A
After ovulation
5
Q
What organ releases GnRH and when?
A
Hypothalamus releases GnRH at puberty
6
Q
Role of GnRH
A
Stimulates follicles to grow
- Follicles produce Estrogen (automatically released into circulation) & Progesterone (stays in follicle until ovulation)
- High estrogen = inc in LH (released by anterior pituitary)
- LH surge = burst follicle and ovum release = ovulation = progesterone release
7
Q
What is the corpus luteum?
A
ruptured follicle that turns into endocrine gland after ovulation
8
Q
Explain relationship between corpus luteum and estrogen/progestrone production
A
Corpus Luteum continues producing estrogen/progestrone for 10-14 days after ovulation, unless pregnancy occurs
If pregnant, will continue producing estrogen and progesterone until the placenta develops and becomes functional
9
Q
Relationship between light and reproductive hormones
A
Inc light levels = LH/FSH release = early sexual maturation
Dec light = puberty/sexual development at later ages
10
Q
What is menopause?
A
Women’s body no longer produces estrogen/progesterone
11
Q
The loss of estrogen/progesterone leads to
A
- Dry vaginal tissues (Increased UTI, painful sex)
- Decreased bone density
- Vasospasms which cause hot flashes
12
Q
When is a patient considered to be in menopause?
A
18 months are menstruation stops
13
Q
What are the risks for hormone replacement therapies for menopause?
A
- Estrogen Only: inc risk for endometrial/breast cancer
2. Estrogen+Progesterone Combo: Increases the risk of CV disease, stroke, DVT
14
Q
Function of Vas Deferens
A
- Stores sperm
2. Carries sperm from testes to be ejaculated
15
Q
Function of Prostate Gland
A
produces enzymes to stimulate sperm maturation
16
Q
Seminiferous tulles produce
A
sperm
17
Q
Leydig cells produce
A
testosterone
18
Q
What happens when FSH is released in males?
A
- Stimulates seminiferous tubules to produce sperm (spermatogenesis)
- stimulates Sertoli cells in seminiferous tubules to produce estrogens providing a negative feedback to pituitary and hypothalamus = decrease in release of GnRH, FSH and LH
19
Q
Purpose of negative feedback in males
A
prevents overproduction of sperm in testes
20
Q
What is andropause?
A
Atrophy of seminiferous tubules & interstitial cells leading to loss of testosterone effects
21
Q
What is estrogen used for?
A
- Stimulate ovulation in women with hypogonadism
- Prevent conception
- Replace hormones after menopause
22
Q
Contraindications of Estrogen Use
A
- Smoking (increase risk of clot)
- Grapefruit (inhibits metabolism = increase levels)
- St. Johns Wort (decrease effectiveness of BC with estrogen)
- Corticosteroids (toxic effects)
23
Q
What is Estradol?
A
Is a potent endogenous female sex hormone, responsible for estrogen effects on the body
24
Q
What is Estradol used for?
A
- Menopause
- Prevent osteoporosis in postmenopausal women
- Ovarian failure
- Inoperable breast/ prostatic cancer (inhibits growth of hormone sensitive tissue)
25
Adverse effects of Estradol
1. Corneal changes
2. Cholasma
3. Hepatic Adenoma (liver tumor)
4. Peripheral edema
5. Photosensitivity
6. GI Symptoms
7. Change in menstrual flow (breakthrough bleeds, dysmenorrhea)
26
What is Cholasma?
1. Large brown patches on skin, mainly on face
| 2. Temporary condition due to hormone changes
27
Purpose of Norethindrone Acetate
1. Inhibits secretion of pituitary FSH and LH
2. Prevent ovulation
3. Inhibits uterine contractions
4. Makes a proliferative endometrium into a secretory endometrium
28
What is Norethindrone Acetate used for?
1. Amenorrhea (no period) treatment
2. Abnormal uterine bleeding from hormonal imbalance
3. Treatment of endometriosis
4. Component of hormonal contraceptives
29
Proliferative Endometrium vs Secretory Endometrium
Proliferative: cells are multiplying and spreading = rise in estrogen = thick endometrium
Secretory: lining is prepared for pregnancy or sloughed if not pregnant
30
Adverse Effects of Norethindrone Acetate
1. Venous thromboembolism
2. Diplopia or loss of vision
3. Migraine headache
4. Breakthrough bleeding or spotting
5. Amenorrhea
6. Fluid retention – weight increase
7. Edema
8. Cholasma
31
Teaching for Oral Contraceptives
1. Need other protection against sexually transmitted diseases
2. Avoid smoking
3. Oral contraceptives need to be taken daily
4. Adverse effects she may experience
32
Purpose of Estrogen Receptor Modulators
Used to stimulate specific estrogen receptors to achieve therapeutic effects of increased bone mass without stimulating the endometrium
33
What are the Estrogen Receptor Modulators?
1. Raloxifene
| 2. Toremifene
34
Therapeutic use for Raloxifene
1. Used to prevent and treat osteoporosis in postmenopausal women
35
What does Raloxifene do?
Increase bone mineral density without stimulating the endometrium
36
Adverse Effects of Raloxifene
1. Venous thromboembolism
2. Hot flashes
3. Skin rash
4. N/V
5. Vaginal bleeding
6. Depression
7. Lightheadedness
8. Headaches
37
Patient Education for Raloxifene
1. Take with food to decrease GI upset
2. Take analgesics for headaches as needed
3. Strongly recommend smoking cessation
4. Monitor for swelling and fluid retention
5. Monitor for changes in vision
6. Monitor LFT’s and renal function
38
What is Clomiphene?
Fertility drug
39
What is Clomiphene used for?
To stimulate functioning ovaries or to stimulate increased FSH and LH levels by hypothalamus by binding available estrogen sites in women
40
What is necessary before Clomiphene is administered?
1. Normal liver function
| 2. Normal endogenous estrogens
41
What is the off-label use for Clomiphene?
treats male sterility
42
Adverse effects of Clomiphene
1. Vasomotor flushing
2. Abdominal discomfort
3. Distention and bloating
4. N/V
5. Ovarian enlargement
6. Breast tenderness
7. Ovarian overstimulation
8. Multiple pregnancies
9. Increased risk birth defects
43
What is Oxytocin used for?
to stimulate labor and improve uterine contractions and control postpartum bleeding
44
Before administering Oxytocin, what should a nurse do?
Check history of cesarean prior to use - could compromise previous scar tissue
45
Adverse Effects of Oxytocin
1. cardiac arrhythmias
2. hypertension
3. fetal bradycardia
4. uterine hypertonicity/spasm and possible rupture
5. N/V
6. pelvic hematoma
7. Severe water intoxication when used for prolonged periods
46
How does oxytocin cause water intoxication?
ADH released in response to oxytocin activity, causing fluid retention by the kidney.
47
Nursing Interventions for Oxytocin
1. Fetal Status
2. Monitor neurological statys
3. Monitor for HTN
4. Assess for adventitious sounds
5. Assess for labor pattern
6. Monitor bleeding
48
What does Dinoprostone do?
Stimulate uterine activity dislodging any implanted trophoblasts and preventing implantation of any fertilized egg; abortion pill
49
What is Dinoprostone used for?
1. Pregnancy termination from 12-20 weeks
| 2. Uterus evacuation for missed abortions or or intrauterine fetal death
50
Adverse Effects of Dinoprostone
1. Headache
2. N/V
3. paresthesias
4. hypotension
5. uterine pain or rupture
6. backache
7. chills
8. fever
9. diaphoresis
51
What are trophoblasts?
Layer of tissue that nourishes embryo and forms major part of placenta
52
What is testosterone used for?
1. Inoperable breast cancer
| 2. Replacement therapy in hypogonadism
53
Actions of Testosterone
1. Growth and development of male sex organs
2. Maintenance of secondary sex characteristics
3. Stimulates RBC production
4. Increases protein anabolism
54
Adverse Effects of Testosterone
1. Dizziness
2. Sleep disorders
3. Androgenic effects (acne, deepening voice, oily skin, hirsutism)
4. Hypoestrogenic effects (flushing , sweating, vaginitis, nervousness, emotional lability)
5. Polycythemia
6. Nausea
7. Rash
8. Fatigue
9. May cause decreased thyroid function
10. Hepatocellular cancer
11. Increased creatinine
55
What labs should a nurse monitor when administering Testosterone?
1. CBC
2. Thyroid Fx
3. Liver Fx
4. Creatinine Clearance
56
What is Oxandrolone?
testosterone analogues with more anabolic or protein building effects than androgenic effects
57
What is Oxandrolone used for?
1. Used to promote tissue building effects and tissue repair in debilitated patients
2. Promote weight gain – reverses catabolic processes
3. HIV related cachexia and wasting
4. Increase hematocrit
58
Adverse Effects of Oxandrolone
1. Development of manly features (deep voice, penis grows, hair) in pre pubertal males
2. Change in libido, baldness, painful erection in post pubertal males
59
Effects of Oxandrolone in women
1. Hirsutism
2. Hoarseness
3. Clitoral enlargement
4. Baldness.
5. Menstrual irregularities
60
Oxandrolone Off Label Use
1. Cardiomyopathy
2. Hepatic carcinoma
3. Personality changes
4. Sexual dysfunction
61
Contraindications of Oxandrolone
interact with oral anticoagulants and antidiabetic agents which may not be metabolized normally
62
What is Sildenafil used for?
1. To treat erectile dysfunction in the presence of sexual stimulation
2. Treatment of pulmonary arterial hypertension
63
How does Sildenafil work?
Relaxes smooth muscle to allow blood flow into penis - lasts 4 hrs
64
Adverse Effects of Sildenafil
headache, flushing, dyspepsia, UTI, rash
65
Contraindications of Sildenafil
1. Structural Abnormalities in Penis
2. Bleeding Disorders
3. Coronary Artery Disease
4. Congenital prolonged QT
5. Hepatic/Renal Disorders
6. Hypotension/Severe Hypertension
