Flashcards in Week 2: Disorders related to Menstruation Deck (20):
Patients excluded from self treatment are those that have ____.
1. severe dysmenorrhea and or heavy bleeding
2. secondary dysmenorrhea
3. using if IUD
4. bleeding disorders (NSAIDs increase the risk of bleeding)
5. active GI disease (NSAIDs can cause or worsen ulcers)
The pharmacologic therapy _____ is used to DECREASE PROSTAGLANDIN PRODUCTION for treatment of primary dysmenorrhea.
Using ____ for primary dysmenorrhea should begin the DAY BEFORE MENSES or as soon as menses begins. It is NOT PRN and should be taken as regular, scheduled doses for 3-5 days.
What are 3 non-pharmacologic ways to TREAT primary dysmenorrhea?
1. hot baths
2. heating pads
What are 3 non-pharmacologic ways to PREVENT primary dysmenorrhea?
1. smoking cessation
2. fish oil supplement
3. regular exercise
Take calcium in ____.
Non-Rx doses are usually insufficient. What should you recommend?
approach the max non-Rx dose first - then go to Rx dosing if not sufficient.
example: Advil 600 mg (3 tabs) PO TID-QUID
Non-Rx max = 1200 mg
Rx max = 3200 mg
Describe the rational behind using NSAIDs over APAP/ASA for dysmenorrhea.
Acetaminophen is a:
- WEAK inhibitor of prostaglandin synthesis.
- used only for MILD symptoms
- the max dosage of 4 g/day is LESS effective than ibuprofen
Counsel a patient on use of a heat patch.
1. do NOT apply on the skin
2. apply adhesive side on UNDERGARMENT
3. it takes about 30 minutes to reach max temperature
4. each patch lasts for 8 hours
5. do NOT apply the patch for more than 8 hours in the same location in 24 hours
6. do NOT microwave or reheat the patch
7. follow instructions to PREVENT BURN
8. caution in patients with PERIPHERAL NEUROPATHY
Other therapies that might help with PMS is _____ which is also helpful in prevention of osteoporosis.
calcium (1200 mg/day) + vitamin D (600 IU/day)
Dysmenorrhea are menstrual cramps that cause pain DUE TO _____.
increase in PROSTAGLANDINS leading to uterine contraction
____ dysmenorrhea symptoms begin 6-12 months after menarche. They are cyclic in nature and are directly related to the onset of menstruation. You may self treat.
In primary dysmenorrhea, there are cramp-like lower abdominal pains at the time of menstruation in the ____.
absence of pelvic disease
___ dysmenorrhea is associated with pelvic pathology. You do NOT self treat.
What is the rational behind using the pharmacologic therapy of PAMABROM and CAFFEINE for dysmenorrhea?
pamabrom and caffeine are diuretics and reduce bloating
What is the rational behind using the pharmacological therapy of PYRILAMINE for dysmenorrhea?
pyrilamine is an antihistamine and reduces irritability
Pamprin All day is the same as _____.
Naproxen sodium 220 mg
Other therapies that might help with PMS is _____ in which you CANNOT EXCEED 100 mg/day due to risk of peripheral neuropathy (which is the sensation of prickling, tingling, creeping on skin; also muscle weakness, stinging, burning, itching sensation)
Pyridoxine (Vitamin B6)
____ is recommend for patients who are on PPI.