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Pharmacy Professionalism & practice > RTS- women's health > Flashcards

RTS- women's health Flashcards

(43 cards)

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1
Q

treatments for dysmenorrhoea (periods pain)

A
  1. NSAIDS
    (a) ibuprofen 200-400mg TDS - neurofen, feminax
    (b) Naproxen 250mg tabs- day 1 2 tabs to start then 1 every 6-8 hours. day 2&3 - 1 tab every 6-8 hours. MAX 3 DAYS USE - and 750mg nail. only licensed for dysmenorrhea.

If NSAIDS contra indicated -

(a) paracetamol - 500-1000mg up to QDS
(b) codeine with ibuprofen or para - co-codamol 8/500mg, solpadeine = 200/12.8g

(c) dihydrocodeine - 7.46g with paracetamol 500mg - paramol
(d) hycosine butylbromide - 10mg tabs- buscopan cramps

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2
Q

what is the limit on naproxen for dysmenorrhoea

A

max 3 days use, 750mg daily

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3
Q

brand names for ibuprofen and naproxen for period pain

A

ibuprofen - feminax, neurofen

naproxen - feminax ultra, boots period pain relief

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4
Q

red flags for dysmenorrhoea

A

pain and bleeding between periods, after sex or urination
sudden severe pain
amenorrhoea/menorrhagia
post menopausal women
unpleasant discharge
IUD
painkillers used for 3-4 cycles and not worked

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5
Q

what is menorrhagia?

A

heavy period - excessive menstrual blood loss which interferes with women physical, emotional and social quality of life.

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6
Q

treatment for menorrhagia?

A

tranexamic acid tablets - OTC (switched from POM to P in 2011)
2 x 500mg tablets TDS - for a max 4 days
Up to 4g daily (8 tabs)

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7
Q

Mechanism & indication of tranexamic acid tablets

A

anti-fibrinolytic competitive inhibitor of activation of plasminogen to plasmin
Indication - to reduce menstrual bleeding for ages 18-45 years with regular 21-35 day cycles

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8
Q

red flags for menorrhagia

A 
irregular bleeding
increase blood loss 
pain in sex
discharge
pelvic pain
tranexamic acid tabs oTC not suitable
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9
Q

physical & psychological symptoms of pre menstrual syndrome

A

physical - bloated, pain, headache, sleep issues weight gain (1kg)
Psychological - mood swings, irritable, anxiety, forgetfulness, tired, restless, loss of libido

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10
Q

how is PMS treated?

A

(a) symptom specific - NSAIDS, paracetamol, buscopan
(b) holistic - changes to diet e.g reduction in caffeine, evening primrose oil, calcium ,magnesium,
Herbal - vitex agnus -castus

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11
Q

What is thrush?

A

vulvovaginal candida

common opportunistic infection with yeast like fungus Candida albicans - vaginal area

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12
Q

precipitating factors of thrush

A 
ages 20-30
pregnancy
antibiotics
immunocompromised
diabetes mellitus
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13
Q

symptoms of thrush

A

vaginal - itchy, burn, sore, discharge or creamy and curd like or thin and watery - odourless
Dysuria- pain / sting on urination
dyspareunia - pain in sex

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14
Q

what is treatment for thrush?

Topical imidazole antifungals

A
  1. Clotrimazole:
    canesten pessary 500mg alone or with +2% thrush cream
    canesten 10% vaginal cream, +2% thrush cream
    canesten 200mg pessary x3
    canesten 100mg pessary x6
  2. Miconazole cream 2% for vulval use
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15
Q

Treatment for thrush - oral triazole antifungals

A

fluconazole - capsule 150mg single dose (canesten oral or generic)

  • Also marketed as canesten duo (fluconazole capsule and clotrimazole cream)
  • LOTS of contra indications e.g. preg/BF, under 16, >60

fluconazole 150mg / clotrimazole 2% cream is licensed for balanitis

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16
Q

Can clotromazole be used in pregnancy?

A

Yes under the physician supervision - the pessary must be inserted without an applicator

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17
Q

red flags for thrush

A 
first occurrence
>2 in 6 months
under 16 or over 60 
pregnancy 
discharge is yellow/green
blisters
abnormal bleeding
lower abdominal pain
pain in sex or urination
treatment fail
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18
Q

what is cystitis?

Study These Flashcards
A

inflammation of the bladder - usually caused by bacterial infection - caused by e.g not emptying the bladder properly, bacteria transferred from anus to urethra (common as urethra shorter), soaps, chemicals, medication

19
Q

what bacteria causes cystitis?

Study These Flashcards
A

E.coli

staphylococcus saprophyticus

20
Q

symptoms of cystitis

Study These Flashcards
A

frequency/urgency
pain during urine
pain in blader
strong smelling urine and cloudy

21
Q

red flags of cystitis

Study These Flashcards
A 
first time occurring
very dark or cloudy urine (indicates haematuria)
fever is 38 degrees or above 
vomiting
discharge
3 or more occurrences in a year
lasting longer than2 days
pregnancy 
men and children
22
Q

cystitis treatment

Study These Flashcards
A 
plenty of water
avoid alcohol, caffeine, tea juices 
avoid sex until clear
paracetamol and ibuprofen 
alkalinising agents e.g - sodium citrate/bicarbonate, potassium citrate/bicarbonate
23
Q

what are the medication interactions with the alkalinising agents sodium and potassium citrate/bicarbonate?

Study These Flashcards
A

sodium - lithium
Potassium - ACE inhibitors (e.g ramipril),
K+ sparing diuretics e.g amiloride,
aldosterone antagonists

24
Q

what are sodium and potassium bicarbonate contra-indicated in in cystitis?

Study These Flashcards
A 
heart disease
renal disease
pregnancy 
men
children 
(sodium in hypertension)
25
Name 2 types of emergency hormonal contraception | Do they interrupt existing pregnancies?
1. levonelle one step (levonorgestrel 1500mcg, 1.5 mg) 2. EllaOne - ulipristal acetate 30mg Neither EHC interrupt existing pregnancies
26
describe levonelle one step EHC?
prevents ovulation & fertilisation if the intercourse is in the preovulatory phase, when the likelihood is the highest - ineffective once implantation has begun License - >16 years
27
Time frame for levonelle one step?
within 72 hours of intercourse - 3 days
28
describe EllaOne EHC?
inhibits/postpones ovulation via binding to the progesterone receptor and suppress LH surge. LICENSE- any woman of child bearing age including adolescents
29
Time frame for EllaOne?
120 hours- 5 days
30
side effects of EHC?
nausea, abdominal pain, headache, dizziness, fatigue, menstrual cycle disruption NOTE: must repeat dose if vomit within 3 hours of taking. - Must wear a barrier method e.g condoms until the next period and continue with oral contraception as usual
31
how is pregnancy detected?
pregnancy tests - used from day 1 of missed period - measures human chorionic gonadotrophin - clearblue
32
Common pregnancy symptoms
morning sickness (goes by week 20) heartburn/indigestion Constipation Haemorrhoids - enlarged veins around anus itching - due to stretching of skin or increased blood perfusion of skin backache
33
how can morning sickness be treated?
``` small frequent meals acupressure bands ginger- capsules, lozenges, biscuits pregnancy vitamins e.g pregnacare folic acid ```
34
treatment of haemorrhoids symptom pregnancy?
diet, moist wipes, sudocrem, germoloids
35
treatment of itching during pregnancy
emollient creams etc, bio oil | if It is severe then it may be possible obstetric cholestasis - so refer then
36
what is menopause?
end of menstruation caused by reduction in oestrogen levels. 45-55 years old it starts Usually gradual i.e perimenopausal stage heavy or lighter periods, and longer intervals between them
37
Symptoms of menopause? last for 2-5 years
``` hot flushes loss of libido vaginal atrophy - dryness, pain headaches moods - depression insomnia UTIs ```
38
what are treatments for vaginal dryness and hot flushes in menopause?
vaginal dryness - replens MD, sylk balance activ moisture plus acidic intravaginal moisturisers flushes: avoid triggers e.g caffeine, exercise, cool room
39
what are alternative treatments for menopause?
yoga, aromatherapy vitamin D evening primrose oil (helps breast pain) BUT contains gamma linolenic acid which is bad for flushes red clover, soya, flaxseed - contains phytoestrogens for flushes - st johns wort, Agnus Casus, valerian root
40
What are the common minor ailments in women health?
- dysmenorrhoea (period pain) - Menorrhagia (heavy period) - pre menstrual syndrome - thrush - bacterial vaginosis - cystitis - suspected pregnancy/pregnancy - menopause
41
what is bacterial vaginosis?
shift in the bacterial flora - anaerobic bacterial growth which increases pH - leads to discharge, fishy odour, white, thin, grey colour. Usually caused by soaps, IUD, sex, douching, antibiotics
42
treatments for BV
POM - metronidazole tablets, gel, clindamycin vaginal cream ``` OTC - balance activ BV gel, pessaries Canesbalance gel (contains lactic acid and glycogen which restores ph to 4-4.5) - use daily 1 week ``` also use of yoghurts, acidifiers (replace lactobacilli bacteria)
43
how can thrush be prevented?
wash vagina with water avoid soaps use emollient e.g E45 as soap substitute and greasy moisturiser to protect vagina toilet hygiene - wipe front and back with different paper avoid tight clothing ALSO pharmaceutically: yoghurt/probiotic supplements, canesflor vaginal capsules - lactobacillus planar - 1 cap each night for 6 days then 1 cap weekly for 4 weeks

Pharmacy Professionalism & practice (25 decks)

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