HRT- ESTROGEN
What is it used for?
menopause
- may decrease the risk for hip fractures and colorectal cancer
Administration
shot- works for 3 months
Can cause an abscess- rotate sites
can give PO- use din pellet therapy
Why is this drugs primary use?
Stimulates uterine contraction- used in L&D (uterine stimulant)
Helps induce labor- have to have the right conditions
Causes contractions to get closer together- you have to be dilated and uterus is ripe- can cause uterine rupture if not
Assess for...
hypertensive crisis- this drug increases BP
symptoms of water intoxication
Frequently assess patient in labor & discontinue if fetal distress or hypertensive crisis
Drug of choice for infertility due to lack of ovulation
CLOMEIPHENE
Stimulates the release of LH
Helps increase the number of follicles
Works very well- most widely used
Adverse effects
nausea, fluid retention, acne, depression, fatigue
Monitor side effects, report signs of depression,
Will not have...
menstrual cycle
Why would this drug be used postpartum?
Postpartum - suckling helps release oxytocin that helps the milk be released
Cytotec for cervical ripening
Can be used for postpartum hemorrhage- contracts the uterus down squeezing and applying pressure and stopping the bleed
Side effects
Anxiety, maternal dyspnea,hypotension or hypertension
Nausea, vomiting, neonatal jaundice, maternal or fetal dysrhythmias
MALE INFERTILITY: Statistics
30-40% of infertility is caused by male reproductive system
5% causes by endocrine problems
HRT- CONJUGATED ESTROGEN (cenestin)
What is it used for? How is it given?
Palliative tx of prostatic cancer
Given as vaginal cream- use applicator
Adverse effects
Adverse effects: breakthrough bleeding, vaginal candidiasis, fatigue, etc
Monitor for sudden severe headaches- sign of a stroke, dyspepsia,
Can cause photosensitivity
Adverse reactions
Fetal- dysrhythmias, ICP, brain hemorrhage
Uterine rupture, seizures, and coma
Is this med for labor induction?
NOT GIVEN FOR THE ELECTIVE INDUCTION OF LABOR UNLESS OVER 40 WEEKS
Where does this occur?
Can occur at level of hypothalamus, pituitary, pr ovary
Need to know where the dysfunction is coming from to help the infertility
HRT- COJUGATED ESTROGEN(cenestin)
Contraindications & interactions
AVOID IN BREAST CANCER
Risk for blood clots (decreases effects of warafin)
Herbal foods: interacts with red clover and black cohosh (taken for hot flashes)
Labs
May increase values for alkaline phosphatase( ASt/ALT)
Increases HDL
Administration
Typically given IV - must have right conditions unless its a black box warning
Dilated, baby is seen
Give low and slow (drug is increased in low increments)
Want to keep the normal labor pattern
Stay once you reach the normal labor pattern ro reduce risk of uterine rupture
What are tocolytics given for? Adverse effects?
Inhibit uterine contractions- used in premature labour AKA delays labor
Adverse effects : tachycardia in mother and baby
MALE INFERTILITY: for hypogonadism
testosterone therapy
Human chorionic gonadotropin (HCG) increases testosterone & sperm production
Menotropin mixture of FSH and LH
HRT- COJUGATED ESTROGEN (cenestin)
Increases risk for...
Affects bone density and cholesterol
Increases bone density and decreases LDL and decreases risk for colon cancer
Increases risk for blood clots
fetus
deletus
Contraindications
Cephalopelvic disportions (fetus head is too big to come out), vasoconstrictors (may cause severe hypertension)
Why would magnesium sulfate be given?
Given for premature labor- a drip of MgSulfate
(tocolytic)
MALE INFERTILITY: antiestrogens- tamoxifen
to block negative feedback