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Pharmacology II > REproductive System > Flashcards

REproductive System Flashcards

1
Q

Progesterone

A

Hormone of Pregnancy

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2
Q

Drugs for Female reproduction

A

Sex hormones
Estrogen receptor modulators
Fertility drugs
Uterine motility drugs

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3
Q

Estrogen

A

Estradiol (Estrace, Climara)
Conjugated estrogens (Premarin)
Esterified estrogen (Menest)
Estropipate (Ogen)

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4
Q

Indications for Estrogen

A

Hormone replacement therapy

Key for the development if the female reproductive system and secondary sex characteristics

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5
Q

Contraindications for estrogen

A 
Estrogen dependent cancer
Breast cancer
Idiopathic vaginal bleeding
Pregnancy and lactation
Smoker
HTN
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6
Q

Sex Hormones

Progestin

A 
Progesterone
Drospirenone
Etonogestrel
Lovenogestrel
Medroxyprogesternone
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7
Q

Indications for Progestin

A

Used as contraceptives
Maintain pregnancy and development of secondary sex characteristics
Used to treat primary and secondary amenorrhea and functional uterine bleeding

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8
Q

Contraindications for progestin

A 
High risk for embolic events
Pelvic inflammatory disease
Endometriosis
Pelvic surgery
Renal and hepatic disorders 
Migraine headaches
Cardiac dysfunction
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9
Q

Prototype Norethindrome Acetate

A

DVT!!

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10
Q

Adverse Effects of Sex Hormones

A 
Higher chance for embolic events
Change in menstrual flow
Peripheral edema
Increase risk for Breast Ca
Breakthrough bleeding
Delay conception for 3 mos after DC of progesterone
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11
Q

Estrogen Receptor Modulators

A

Stimulate specific estrogen receptors
Increase bone mass without stimulating the endometrium
Treatment of osteoporosis in postmenopausal women

Examples include:
Raloxifene (Evista)
Toremifene (Farestone

NEXT !!!
Are used to stimulate specific estrogen receptors to achieve therapeutic effects of increase bone mass without stimulating the endometrium and causing other less desirable effects. These stimulates the estrogen receptor in a body so that it could function to produce estrogen which is needed by the body for normal functioning

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12
Q

Contraindications

A

Venous thrombosis
Pregnancy
Lactation
Smoking

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13
Q

Adverse Effects

A 
Venous thromboembolism (know this!)
Hot flashes
Skin rash
Nausea 
Skin rash
Vomiting
Vaginal bleeding
Depression
Lightheadedness
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14
Q

Estrogen Receptor Modulators

Drug-to-drug interactions

A 
Warfarin
Cholestyramine
Diazepam (Valium)
Ibuprofen (Motrin)
Indomethacin (Indocin)
Naproxen (Naprosyn)

Cholesterol, NSAIDS, anti-anxiety, blood thinner

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15
Q

Prototype Estrogen Receptor Modulators

A

Raloxifene

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16
Q

Fertility Drugs

A

Cetrorelix
Chorionic gonadropin
Clomiphene
Menotropins

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17
Q

Actions

A

Work to stimulate ovulation
Stimulate the hypothalamus to increase FSH and LH levels
Follicle stimulating hormone and leutinizing hormone
By stimulating the foliicle stimulating hormone and leutinizing hormone
To stimulate ovulation

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18
Q

Contraindications

A 
Thromboembolic disease (DVT)
Presence of primary ovarian failure
Thyroid and adrenal dysfunction
Ovarian cyst
Pregnancy
Idiopathic uterine bleeding
Known allergies
Breast-feeding
Respiratory diseases
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19
Q

Adverse Effects

A 
Multiple pregnancies
Abdominal discomfort
Distention and bloating
Nausea and vomiting
Breast tenderness
Vasomotor flushing
Visual changes
Ovarian enlargement
20
Q

Uterine Motility Drugs

A

It stimulates uterine contraction
Labor (oxytocics)
Abortion (abortifacients)

Next is uterine motility drugs
It stimulates uterine contractions to assist labor OR to abort
Separated in two. Labor or abort

21
Q

Oxytocics

A

Stimulate contraction of the uterus
Help placenta delivery
Aid in post partum hemorrhaging
Methylgronovine (Methergine)
Oxytocin (Pitocin)
First is oxytocics, it mainly stimulates the contraction activity of the uterus
It can also help facilitate placenta delivery
And address post partum hemmorhaging
Ask me about placenta delivery or non delivery of the placenta in clinicals

22
Q

Actions

A

Directly affects neuroreceptors sites to stimulate contractions of the uterus
Effective in the Gravid uterus
Promotes milk ejection in lactating women
Prevents and treat uterine atony post delivery
It is not just for the contraction of uterus, but also for the milk ejection in lactating women.
Uterine atony,or failure of the uterus to contract following delivery, is the most common cause of postpartum hemorrhage.

23
Q

Contraindications

A 
Allergies
Cephalopelvic disproportion
Complete uterine atony
Early pregnancy
CAD
HTN
Previous cesarian section
Hepatic and renal impairment
24
Q

Adverse Effects

Severe H2O intoxication

A 
Uterine rupture
Painful contractions
Cardiac arrythmias
HTN
Fetal bradycardia
N/V
Pelvic hematoma
Uterine hypertonicity
Severe H2O intoxication
Uterine hypertonicity- especialiy if we have an OD of oxytocic agent
So it would stimulate or over stimulate the uterus
Has antidiuretic effects
Watch for neuro changes since it messes with electrolytes
25
Q

Oxytocin (Pitocin)

A

Monitor contractions
Less than 60 secs
Every 2-3 mins
Stop infusion if it is longer
Monitor maternal and fetal BP and pulse
Magnesium can be used to relax the uterus
If a patient is having contractions for 90 secs, that is too long. Oxytocin should be DC’ed
Mag to counter the oxytocin by relaxing the uterus

26
Q

Prototype Oxytocics

A

Oxytocin

27
Q

Abortifacients

Used to evacuate uterine content
Used to induce abortions

A 
Carboprost
Dinoprostone
Mifepristone
On the flipside, aborificients are Used to evacuate uterine content via intense uterine contractions
Abortion drug
We are going to focus on these 3 drugs
28
Q

Action of Abortifacients

A

Stimulate uterine activity

Dislodging any implanted throphoblast and preventing fertilization of egg

29
Q

Contraindications

A 
Allergies
Active PID
Acute CV, hepatic, renal, or pulmonary diseases
Lactation
Scarred uterus
Acute vaginitis
30
Q

Adverse Effects

A 
Uterine rupture
Uterine or vaginal pain
Headache
Paresthesia
Hypotension
Vomiting
Diarrhea
Chills
Diaphoresis
Backache fever
31
Q

Tocolytics
Drugs to slow uterine activity
Terbutaline

A

Before we end the drugs affecting the female reproductive system.
We gotta talk about tocolytics
It is a drug that slows uterine activity. it is for pre-term labor
Terbutaline will delay arrival time of the baby
Delays, but not prevent labor

32
Q

Terbutaline

A

Other uses
COPD
Asthma

Side Effects
Tachycardia
Angina
Restlessness
Tremors
33
Q

Terbutaline

Contraindication

A

Gestation >34 weeks
Cervical dilation > 6 cm
Because the delivery of the baby is inevitable from that point

34
Q

Other tocolytics

Nifedipine (Ca channel blocker)
Magnesium
Given IV at this stage

A

Watch for magnesium toxicity
Calcium gluconate antidote for Mag toxicity
Endomethacine (NSAIDS)
Nifedipine to suppress contraction. Watch out for orthostatic hypotension since it is mainly used to lower BP.
Watch for magnesium toxicity
Decreased DTR, U/O <30 ml/hr, respiratory depression
Too much mag lowers these things
Endomethacine – blocks prostaglandin syhnthesis which suppresses labor

35
Q

Drugs affecting the male reproductive system

A

Androgens
Anabolic steroids
Drugs for penile erectile dysfunction

36
Q

Androgens

Male sex hormones
Testosterone
Androgens

A 
Examples
Testosterone
Danazol
Fluoxymesterone
Methyltestosterone 
Anadrol-50
Androderm
Androgel
Android
Androxy
Axiron
Danocrine
DHEA
First-Testosterone
Testosterone – produced in the testes. Responsible for male characteristics before puberty
Androgens – produced in the adrenal glands, sustains male characteristics after puberty
Testosterone in the drug name
37
Q

Actions

A

Responsible for the grown the development of male sex organs
Maintenance of secondary male characteristics
Increase protein anabolism
Decrease protein catabolism

38
Q

Contraindications

A 
Allergies
Pregnancy and lactation
Prostate or breast Ca
Liver dysfunction
High potential for abuse

Cardiovascular disease

39
Q

Adverse effects

A 
Sleep disorders
Fatigue
Androgenic effects
Acne
Deepening of voice
Oily skin
Hepatocellular carcinoma
Hypercholesterolemia
Polycythemia
Premature epiphyseal closure

Cardiovascular disease
In women, they become manly with deep voice and hair growth

40
Q

Anabolic Steroids

A

Analogous of testosterone
Developed to produce tissue building effects

Drugs
Oxandrolone
Oxymetholone

The second drug that affetcts the male reproductive system is anabolic steroids
Developed to produce tissue building effect with led androgenic effect

41
Q

Actions

A

Promote body tissue building process
Reverse catabolic process
Increase Hgb and RBC mass

Indication
Anemia
Cancer (give to cancer pt to increase muscle mass)
Angioedema
Weight gain
Tissue repair
42
Q

Contraindications

A 
Allergies
Pregnancy
Lactation
Prostate or breast Ca
Liver dysfunction
CVD
Same as androgens
43
Q

Adverse effects

A

Virilization – development of male characteristics

?

44
Q

Drugs for penile erectile dysfunction

These are vasodilators

A

Drugs
Slidenafil (Viagra)
Tadalafil (Cialis)
Verdenafil (Levitra)

What is penile erectile dysfunction?
A condition in which the corpus cavernosum does not fill with blood to allow for penile erection.
Results from aging process and in vascular and neurological condition.

45
Q

Actions

A

Acts locally to relax smooth muscle and allow filling of corpus cavernosum

It would allow for sustained erection

46
Q

Contraindication

Which one is the double whammy vasodilator taken with viagra?
Nitrates

Caution: this combo will drop blood pressure

A 
Priapism
Penile implants
Bleeding disorders
CAD
Severe HTN
Severe hepatic and renal disorder
Nitrates

Prolonged unwanted erection. Really bad, it hurts, may need drainage
Use in caution in CAD patients as it increases the risk for MI
Vasodilators X2, double whammy in the ER

47
Q

Adverse Effects

A

Priapism - unwanted erection that will not go away, last for hours, too much blood flow, and it is painful!

Increased risk for MI

Pharmacology II (6 decks)

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