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PHARM > Week 6 - Reproductive Drugs > Flashcards

Week 6 - Reproductive Drugs Flashcards

(58 cards)

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1
Q

What are teratogens?

A

Substances that can cause developmental abnormalities

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2
Q

Teratogens can result in characteristic set of ______. Exerts effects at _____________.

A

Teratogens can result in characteristic set of malformations. Exerts effects at a particular stage of fetal development.

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3
Q

Cigarette smoking effect on fetus (2)

A

Intrauterine growth restriction, still birth

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4
Q

Alcohol effect on fetus (2)

A

Neurocognitive delay, miscarriage

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5
Q

Drugs with significant teratogenic or other adverse effects

A

ACE inhibitors, amphetamines, acutane, androgens, busulfan, cocaine, diazepam, ethanol, heroin, metronidazole, phenytoin, smoking, thalidomide, tetracycline, warfarin

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6
Q

Tetracycline effect on fetus

A

Limb reduction

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7
Q

FDA pregnancy categories - A

A

No risk

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8
Q

FDA pregnancy category A example

A

Anti-emetics

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9
Q

FDA pregnancy categories - B

A

No fetal risk in animal studies - no risk assumed in humans

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10
Q

FDA pregnancy categories - C

A

Fetal risk in animal studies - weigh risk vs benefit

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11
Q

FDA pregnancy categories - D

A

Proven fetal risk in human studies - weigh risk vs benefit if life-threatening

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12
Q

FDA pregnancy categories - X

A

Proven fetal risk in humans studies - the risk is greater than benefit, AVOID in pregnancy

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13
Q

Therapeutic Uses of estrogen and progestin (4)

A
  • Menopausal hormone therapy
  • Issues with period irregularity and symptom relief
  • Anti-estrogen works against hormone responsive breast cancer, and can help with infertility
  • Anti-progestin can induce medical abortion (RA46 pill) - only for pregnancies less than 7 weeks
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14
Q

Combined Hormone Contraceptives (CHC) are made up of…

A

Synthetic version of estrogen (Ethinyl estradiol) and progestin (natural or synthetic progesterone)

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15
Q

Progestins ____ out the badass effects of ______

A

Progestins balance out the badass effects of estrogen

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16
Q

How are combined hormone contraceptives differentiated?

A

By the STRENGTH of the estrogen and TYPE of progestin

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17
Q

CHC routes

A

PO, transdermal, transvaginal

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18
Q

CHC mechanism

A

Produce drug-induced anovulatory cycles by suppressing pituitary secretion of FSH and LH through negative feedback system

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19
Q

Progestins change the uterine ____ to make it less favorable for ____ of a fertalized ovum

A

Progestins change the uterine endometrium to make it less favorable for implanatation of a fertalized ovum

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20
Q

Progestins change the _____ and ____ of the cervical mucus, making it thick and hostile to ___ _____

A

Progestins change the quantity and viscosity of the cervical mucus, making it thick and hostile to sperm penetration

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21
Q

Progestins alter the motility of the fallopian muscles and mucus to “plug” the cervix, preventing _______

A

Progestins alter the motility of the fallopian muscles and mucus to “plug” the cervix, preventing movement of the ovum and sperm

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22
Q

Estrogen _____ the uterine ______ to inhibit proliferation and secretory changes – this ______ irregular and or heavy bleeding

A

Estrogen stabilizes the uterine endometrium to inhibit proliferation and secretory changes. This decreases irregular and or heavy bleeding.

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23
Q

What is the most commonly prescribed category of contraceptive? Why? (3)

A

CHC - easy to use, high degree of effectiveness, relatively safe

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24
Q

Higher the dose of estrogen, ____ risk for (3)

Study These Flashcards
A

Higher the dose of estrogen, increased risk for VTE, MI, and stroke

25
Side effects of oral contraceptives (2)
Breakthrough bleeding - occurs during the active pill cycle | Withdrawal bleed - between cycles, not a real menstruation
26
Dangerous side effects of oral contraceptives - ACHES
``` A - abdominal pain C - chest pain/SOB H - headache, dizziness, weakness, numbness, speech difficulty E - eye disorder S - severe leg pain/swelling ```
27
Oral contraceptives assessment (4)
- Drug and herb use - Baseline BP and weight - Pregnancy status - History of contraindications especially smoking and HTN
28
Monophasic
Fixed ratio every day
29
Most common type of oral contraceptive
monophasic
30
Biphasic
Fixed estrogen, progesterone amount varies
31
Triphasic
Newest, low doses, few side effects - either the estrogen or progesterone varies throughout the cycle in different ratios during 3 phases
32
Extended cycle
24 days of active therapy, 4 days of hormone free pills
33
Continuous
Continuous active therapy
34
What is drospirenone?
Progestin derived from spironolactone (instead of testosterone)
35
Drospirenone is used in combination with
Ethinyl Estradiol
36
Drospirenone can increase ____
Potassium
37
Drospirenone contraindications (9)
Kidney/liver/adrenal disease, NSAIDs, potassium-sparing diuretics, ACE inhibitors, potassium supplementation, Angiotensin II Receptor Antagonists (ARBs), heparin
38
What should you always check when giving Drospirenone
Serum potassium levels
39
Yasmin - classification, type, route
Estrogen Combined with DRSP, monophasic, oral BCP
40
Yaz - classification, type, route
Estrogen Combined with DRSP, extended cycle (24 days of active hormonal therapy)
41
Beyaz - classification, type route
Estrogen Combined with DRSP, extended cycle (24 days of active hormonal therapy + 4 days of hormone free pills); during the active pill cycle, contains folic acid to promote healthy folic acid levels
42
Hormone Therapy improves ____ symptoms and vaginal ___, _____ risk of _____ and ____ ______
Hormone therapy improves vasomotor symptoms and vaginal dryness, decreases risk of osteoporosis and osteoporotic fractures
43
HT boxed warning: HT should only be used only for the ____ of menopausal symptoms at the ____ dose possible for the ____ duration possible (usually less than ____ years)
HT should only be used for the treatment of menopausal symptoms at the lowest dose possible for the shortest duration possible (usually less than 5 years)
44
Estrogen-Progestin Therapy (EPT) should be used in women with...
An intact uterus
45
Estrogen Therapy (ET) should be used in women...
Who have had a hysterectomy (surgical removal of uterus) because estrogen thickens the uterine lining
46
Contraindications to HT (9)
Pregnancy, history of endometrial or breast cancer, history of thromboembolic disorders, active liver disease/chronic impaired liver function, active gallbladder or pancreatic disease, CAD, undiagnosed vaginal bleeding, endometriosis
47
Osteoporosis
Progressive, debilitating skeletal disease that affects the elderly
48
Is HT recommended for treatment of Osteoporosis?
NO
49
HT can be used as a preventative measure of osteoporosis in who?
Postmenopausal women who are at risk
50
What kind of medications can be used osteoporosis (2)? Mechanism?
- Biphosphates slow bone resorption | - Selective estrogen receptor modulators (SERMs)
51
Other methods of preventing osteoporosis
Vitamin D, calcium, weight baring exercise, fall prevention
52
What category of drugs is used for sexual dysfunction?
Phosphodiesterase
53
Phosphodiesterase mechanism
cGMP increases vasodilation and relaxation of smooth muscle to increase blood flow and strengthen erection (works mainly on corpus cavernosa)
54
Sildenafil (Viagra) - classification, onset, contraindications (6)
Phosphodiesterase - 60 - 120 minutes onset of action - Contraindicated if on nitrates (potentiates hypotensive effect), CHF, cardiomyopathy, CAD, anatomic deformities, conditions predisposing to priapism
55
Sildenafil side effects (5)
*H/A, flushing, dyspepsia (GI distress), nasal congestion, diarrhea
56
Sildenafil rare side effects (4)
Blurred vision, photosensitivity, changes in color perception (blue and green), urinary tract symptoms (frequency, painful urination, cloudy/bloody urine)
57
What is unique about Cialis?
It is longer acting
58
What are essentially important to monitor in transgender on HT (3)?
BP, vascular status, lipids

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