Pharmacology Final

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Author:
Rx2013
ID:
81631
Filename:
Pharmacology Final
Updated:
2011-04-25 09:35:25
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Oral Contraceptives
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Oral Contraceptives
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  1. Contraindications for oral contraceptives
    • thrombophlebitis/thromboembolic disorders
    • CV or CA disease
    • breast carcinoma
    • endometrium carcinoma
    • undiagnosed abnormal bleeding
    • jaundice
    • hepatic adenomas or carcinomas
    • pregnancy
  2. Increases risk of cardiovascular side effects from oral contraceptives
    • smoking more than 15 cigarettes/day
    • more so in women over 35
  3. Levonorgestrel (norplant, plan B)
    • hormones that prevent ovulation
    • emergency contraceptive (must take w/in 72 hours)
  4. Drug interactions with levonorgestrel
    • barbiturates
    • carbamazepine
  5. ADEs with levonorgestrel
    • n/d/stomach pain
    • breast tenderness
    • dizziness
    • tired feeling
    • change in menstrual periods
    • headache
  6. Medroxyprogesterone Acetate (Provera)
    • synthetic progestin
    • more potent than progesterone
  7. Indications for medroxyprogesterone
    • contraceptive
    • treatment of amenorrhea
    • treatment of abnormal bleeding
    • treatment of endometriosis
  8. Mechanism of action for medroxyprogesterone
    slow frequency of release of GnRH from the hypothalamus and blunt pre-ovulatory LH surge
  9. ADEs with medroxyprogesterone
    loss of bone mineral density
  10. Norethindrone
    synthetic oral progestin
  11. Metabolism of norethindrone
    • t 1/2 = 7 hrs
    • metabolized by p450s
  12. Effectiveness of progestin-only pill is reduced by
    hepatic enzyme inducing drugs such as anticonvulsants; phenytoin, carbamazepine & barbiturates.
  13. Fluoxymesterone
    replacement therapy for symptoms associated with deficiency or absence of endogenous testosterone.
  14. Fluoxymestrone uses
    • delayed puberty
    • adrogen-responsive recurrent mammary cancer in post menopausal women
  15. ADEs of fluoxymestrone in women
    • amenorrhea/menstral irregularities
    • inhibition of gonadotropin secretion
    • virilization = deep voice & clitoral enlargement (irreversible)
  16. ADEs of fluoxymestrone in men
    • gynecomastia
    • excessive frequency & duration of erections
    • oligospermia at high doses
    • hirsutism
    • fluid and electrolyte disturbance
    • retention of salts and water
  17. Drug interactions with fluoxymesterone
    • increase sensitivity to oral anticoagulants
    • increases levels of oxyphenbutazone
    • decreased blood glucose and insulin requirments
  18. Warnings with fluoxymestrone
    • hypercalcemia in immobilized pt with breast cancer
    • hepatic adenoma
    • cholestatic hepatitis & jaundice
    • prostatic hypertrophy and carcinoma
  19. Clomiphene indications
    ovulatory dysfunction in women desiring pregnancy
  20. Clomiphene indicated only in pt that meet these criteria
    • pt is not pregnant
    • pt w/o ovarian cysts
    • pt w/o abnormal bleeding
    • pt w/ normal liver function
  21. Clomiphene ADEs
    • Acne
    • migraine
    • anxiety
    • transaminases increased
    • hepatitis
  22. Warnings with clomiphene
    • blurring/spots in vision that increase with dose
    • ovarian hyper-stimulation syndrome
  23. Danazol (Danocrine)
    • synthetic anti-estrogen used for:
    • Pain/infertility due to endometriosis
    • Fibrocystic breast disease
    • Angioedema
    • Post coital contraception
  24. Drug interactions with Danazol
    • Carbamazepine
    • cyclosporin
    • thrombolytic agents
  25. ADEs with Danazol
    • Acne
    • alopecia
    • increase hepatic enzymes
    • edema
  26. Mifepristone (Mifeprex)
    • RU-486
    • for medical termination of intrauterine pregnancy through 49 days
    • 19-norsteroid

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