Protects against bone mineralization & heart problems (lowers cholesterol)
Adverse effects of estrogen?
Breast Cancer
Ovarian Cancer
Promotes DVT
Nausea
Adverse effects in pregnancy
Endometrial hyperplasia
Therapeutic effects of tamoxifen (nolvadex)?
Used prophylactically for cancer
Activates estrogen
Breast cancer treatment
Protects against osteoporosis
Side effects of tamoxifen (nolvadex)?
Hot Flashes ?
Risk for endometrial cancer and hypogonadism
Is it ok to take estrogen if you don't have a uterus?
Yes because estrogen doesn't shed the uterine wall like progestin does, therefore if you have a uterus you need to take something with progesterone in it.
Who are oral contraceptives contraindicated in?
Smokers ?
Hypertension
How does estrogen work?
Builds up uterine wall
How does progestin work?
Sheds uterine wall
If someone is experiencing ammenorhea what drug would you give them?
Progestin
Side effect of progestin?
Irregular Bleeding
Teratogenic effects
Gynecological effects
Breast cancer
Depression
Breast tenderness
Therapeutic uses of progestin?
Post menopausal hormone therapy
Ammenorrhea
Prematurity prevention
Endometrial carcinoma/hyperplasia
Benefits of Menopausal Hormone Therapy? (progestin)
Prevents osteoporosis/fractures
Prevents colorectal cancer
Helps wounds heal
Glycemic control
Mngmt of urogenital atrophy
What did the landmark studies (WHI & HERS) show about HRT?
Increased Cancer Risk
Therapy Risk of Menopausal Hormone Therapy? (progestin)
Cardiovascular events
(MI, pulmonary embolism, STROKE, DVT)
Endometrial cancer
Ovarian cancer
Breast cancer
Gallbladder disease
Dementia
Urinary incontinence
When is the best time to give a vaginal suppository?
At night (due to discharge & itching)
What type of vulvovaginitis is common in sexually active women?
Bacterial
What type of vulvovaginitis is a candida?
Yeast infection (cheese curd like discharge)
Common with what drugs would you give to a girl who has a candida infection?
Fluconazole (diflucan) Oral
Clotrimazole (Monistat) vaginal
Patient teaching for someone with candidas taking diflucan?
Wear cotton underwear
Wash after sex
Fluconazole (diflucan) patient teaching?
Contraindicated in LIVER pts!
T/F: once you get a UTI you are at more risk for getting a second one.
True
Patient has painful lesions, lymphadenopathy (groin), and systemic illness with the first outbreak being the most severe is what type of infection? Tx?
Genital Herpes
Treated with Acyclovir (suppresses it)
Which sex presents symptoms of STDs more often?
Females ?
A patient that has painful urinating, mucopurlent discharge, large WBC on smear might have what infection (strep throat like symptoms)? Tx?
Chlamydia
1 dose of Azithromycin
Gonorrhea symptoms and treatment?
Irritative voiding & purulent discharge
1 time treatment of Rocephin
A patient presents with dysuria, itching, vag irritation, dysparenia, frothy discharge, and a motile organism on smear, what would you expect? Tx?
Trichomoniasis
Oral Metronidazole (flagyl)
What shot would you get to prevent HPV?
Guardisil
What is the leading cause of infertility?
PID (gonorrhoeae & chylamdia)
Adverse effects of combination oral contraceptives?
DVTs
Hypertension
Cancer
Teratogenic effects
Abnormal uterine bleeding
Preg/lactation (progestin only pill - dipo shot)
Glucose intolerance
Hepatic adenoma
What type of effect do antibiotics have on birth control?
Decreases in effectiveness
(as well as st. Johns wort)
Benefits of noncontraceptive OCs?
Lower risk of:
ovarian and endometrial cancer
Ovarian cysts
PID
Breast disease
Iron deficiency (anemia)
Acne
Favorable effects of noncontraceptive OCs on menstrual cycles?
Reduced cramps, lighter, shorter and more predictable
What should be avoided in patients that take Yasmin (yaz)?
Drugs that elevate Potassium (aldosterone in it which retains K)
What are some drugs that are reduced by combination oral contraceptives?
Warfarin
Insulin
Oral Hypoglycemics
What is Mifepristone RU 486?
Abortion Pill
Patient teaching with plan B?
Take 1 tablet within 72 hours and another 12 hours later
Pill contains 2 high doses of progestin
What should u do if u miss 1 dose of BC?
Take 2 doses the next day the same time as you usually do
Best prevention for osteoporosis?
Proper amount of calcium and weight bearing exercise (calcium stops building at age 30)
What drug would you take to prevent osteoporosis?
Fosamax
Patient teaching for someone taking Fosamax?
Take in AM
Sit up 30 min afterwards
Full glass of water
Empty stomach
(all to prevent esophageal erosion)
What would alarm you to call your doctor after taking Fosamax?
Substernal Burning (heart burn)
Adverse effects of Viagra, Levitra, & Cialis?
Hypotension
Priapism
Rare: vision changes and hearing loss
When should you call your doctor after taking Viagra, Levitra, & Cialis?
If you have an erection lasting longer than 4 hours
