Female Reproductive System
Conjugated Equine Estrogens 5 box warnings
1. Increased risk for endometrial cancer
2. Cardiovascular disease – increased risk of stroke, DVT, PE, and MI
3. Increased risk for invasive breast cancer
4. Increased risk of dementia in postmenopausal women
5. “Risk versus benefit” - Estrogens with or without progestins should be
prescribed at the lowest effective doses and for the shortest duration
consistent with treatment goals and risks for the individual woman.
Indications of Conjugated Equine Estrogens
Prevent postpartum breast engorgement, acne, slowing bone loss in osteoporosis, treat some cancers, hypogonadism, ovarian failure
Testosterone 3 Box Warnings
Blood pressure increases, Seconday exposure, Pulmanory oil micro-embolism
Nitrofurantoin dangers
c.diff, drug induced liver injury, peripheral neuropathy, pulmaonory toxicity
B2 Agnonists act on what? Which drug is a B2 Agonist
Terbutaline, lungs and uterine contractions
Progesterone - Medroxyprogesterone's indications
Contraceptive, amenorrhea/dysmenorrhea, cancer treatments, endometriosis
Estrogen-Progesterone Indication
Used for contraception, reducing menstrual blood loss and cramping. Protection against endometrial and ovarian cancer. Reduces menstural blood loss for anemia.
Which of the following is true about finasteride (Select all)
- Indicated for BPH
- Safe for female patients
- causes increase libidio
- Risk for skin absorption
- Excess use leads to hypertension
- Indicated for BPH
- Risk for skin absorption
On the first dose of tamsulosin, what should you look out for?
First-dose orthostatic hypotension
What class of drug is Tamsulosin
Alpha-1 Adrenergic Antagonist
Adverse effects of conjugated equine estrogens
Breakthrough bleeding, menstrual irregularities, amenorrhea, libido changes, fluid retention, electroylte distubrances, headache, dizziness, weight gain, edema
Progestin with Levonorgestrel indication and adverse effects
Indication: Emergency oral contraceptive
Adverse effects: Menstrual irrelgularities, abdominal pain, nausea
What drugs can you not take in combination with sildenafil. and what can they cause if you do
nitrates (Nitroglycerin, isosorbide) and Alpha-andrenergic blockers (Doxasin, tamulosin)
Potentially fatal hypotension
Nitrofurantoin, Tamsulosin, Phenazopyridine indications
Nitrofurantoin - Misc. antibiotic
Tamsulosin - BPH (Urinary retention, lower urinary tract symptoms, kidney stone expulsion)
Phenazopyridine - Alleviates symptoms of dysuria, burning sensations, urgency frequency, pain related to UTI
Free points
Free points
When progesterone is used as a contraceptive, when do you take it each day?
At the same time every day without fail
Oxytocin Adverse effects
Cardiac arrhytmias, hypertension N&V, water intoxication, Uterine hypertonicity, spasm rupture, postpartum hemorrhage, decreased fetal HR
Adverse effects of Sildenafil
Hearing loss, headache, abnormal vision, flushing, UTI, rash, hypotension, priapism, MI, hearing loss
Your patient is getting a urinalysis, which drug would interfere with the results?
Phenazopyridine
Postpubecent males taking testosterone may get the following inhibited
Testicular function, gynecomastia, priapism, baldness, reduced libido
Differences between progesterone "mini pill", "Depo-provera", and "Provera"
Mini pill safer for women over 35, smokers, and HTN. only for those with side effects from other BCP's
Depo-provera is long term, injectable birth control, given evert 3 months
Provera, given 5-10 days then stopped; should bleed in 3-7 days
Terbutaline's life threatening impacts
Serious heart arrhytmias, maternal death, pulmonary edema
When should a patient take Sildenafil
one hour before anticipated sexual stimulation
Oxybutynin Indication
Urinary tract antispasmodic
Levonorgestrel becomes less effective when the patient is above what BMI
30