SEXXX Flashcards
(30 cards)
Estrogens and Progestins Functions
- promote and regulate female maturation
- pigmentation of nipples and genitals
- help regulate ongoing activity of female reproductive organs
- affect bone mineralization and lipid metabolism*
- positive effect on bone mass and lipid metabolism (raise HDL, lower LDL)
Estrogens : Biosynthesis and elimination
ovary
Estrogens: Effects on sex characteristics
- ductal growth in the breast
- thickening and cornification of the vaginal epithelium
- proliferation of uterine epithelium
- secretion of thickened mucus in endocervical glands
Estrogens: Metabolic Actions
- provide effect on bone mass
- favorable effect on cholesterol levels
Estrogens: Adverse Effects
- endometrial hyperplasia and carcinoma - risk of cancer decreases when used with progestin
- promotes growth of existing breast cancer
- ovarian cancer
- cardiovascular effects
- nausea - most common
- gallbladder disease
- jaundice
- headache
- cholasma
- increases body fat
- depression, headache/migraine
- interferes with thyroid hormone
- increases blood clotting
- decreases libido
- impairs blood sugar control
Estrogens are classified as US FDA Pregancy Category ___ becuase _____
- X
- they have no legitimate use in pregnancy
Estrogen: Therapeutic Effects
- menopausal hormone
- female hypogonadism
- acne
Selective Estrogen Receptor Modulators (SERMs): Overview
- active in some tissues and block estrogen receptors selectively in others
- provide benefits of estrogen while avoiding its drawbacks
three available: Tamoxifen, Toremifene, raloxifene
Progestins: Overview
- compounds that act like progesterone
- produced by ovaries and placenta
Progestins: Adverse Effects
- teratogenic effects
- gynecologic effects
- breast cancer
- depression
- breast tenderness
- bloating
Progestins: Therapeutic Uses
- postmenstrual hormone therapy
- dysfunctional uterine bleeding
- amennorrhea
- infertility
- prematurity prevention
- endometrial carcinoma and hyperplasia
Progestins: Menopausal Hormone Therapy Benefits
- relief of vasomotor symptoms
- management of urogenital atrophy
- prevention of osteoporosis-related fractures
- cardioprotection
- prevention of colorectal cancer
- positive effect on wound healing
- tooth retention
- glycemic control
Physiologic Dose of Estrogen (w/ or w/o progestin) during menopausal hormone therapy
taken to manage symptoms caused by loss of estrogen in menopause
* hot flashes
* sleep disturbances
* urogenital atrophy
* bone loss
* altered lipid metabolism
Major Risks of Hormone Therapy
- congestive heart disease
- myocardial infarction
- deep vein thrombosis
- pulmonary embolism
- stroke
- breast cancer
- gallbladder disease
- dementia
ovarian cancer and lung cancer also a concern
Drugs that affect uterine function
three main categories
- uterine relaxants - toxolytics
- uterine stimulants - oxytocics
- drugs used to decrease menorrhagia (heavy menstrual bleeding)
Tocolytics: Therapeutic Uses
- used to delay delivery in preterm labor
- can accelerate lung development when used with glucocorticoids
- used to buy time to treat infection
Control of Myometrial Contraction
Overview and drug classes (4)
- regulated by multiple mediators inc. beta-adrenergic agonists, oxytocin, prostaglandins
- 4 classes of drugs: decrease availability of phosphorylated light chain
1. b-adrenergic agonists
2. calcium channel blockers
3. COX inhibitors
4. oxytocin-receptor agonists
Tocolytics: Overview
- drugs that promote uterine relaxation and delay delivery when used with glucocorticoids
- indicated for births that occur before 37 weeks gestation
Drugs for Cervical Ripening and Induction of Labor (overview)
stimulate uterine contractions before the onset of labor in a pregnancy that is beyond term which poses risk to mom or baby
Indications for early induction
- placental abruption
- premature rupture of membranes
- gestational hypertension
- pre-eclampsia or eclampsia
- maternal medical conditions - diabetes, renal disease, chronic pumonary disease, chronic htn)
- fetal death
- fetal compromise
Contraindications to Induction
- umbilical cord relapse
- transverse fetal position
- active genital herpes infection
- previous C-section
- hystory of myomectomy (fibroid removal)
- placental previa
cervical ripening MUST occur before induction of labor - maternal and fetal injury can occur
Post-partum hemorrhage causes
may occur post delivery if the fetus fails to contract enough to squeeze blood vessels that supplied the placenta shut.
commonly caused by:
* uterine atony
* lacerations
* maternal coagulopathies
* retention of placental tissue
Drug class for PPH
uterotonic drugs
Menorrhagia Overview
excessive or prolonged menstrual bleeding associated with an otherwise normal cycle
- characterizzed by bleeding that lasts more than 7 days or blood loss that exceeds 80mL
- can cause iron-deficiency anemia if left untreated
- excessive bleeding reduced by drugs or endometrial ablation
