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Pharmacology Final
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Contraindications for oral contraceptives
thrombophlebitis/thromboembolic disorders
CV or CA disease
breast carcinoma
endometrium carcinoma
undiagnosed abnormal bleeding
jaundice
hepatic adenomas or carcinomas
pregnancy
Increases risk of cardiovascular side effects from oral contraceptives
smoking more than 15 cigarettes/day
more so in women over 35
Levonorgestrel (norplant, plan B)
hormones that prevent ovulation
emergency contraceptive (must take w/in 72 hours)
Drug interactions with levonorgestrel
barbiturates
carbamazepine
ADEs with levonorgestrel
n/d/stomach pain
breast tenderness
dizziness
tired feeling
change in menstrual periods
headache
Medroxyprogesterone Acetate (Provera)
synthetic progestin
more potent than progesterone
Indications for medroxyprogesterone
contraceptive
treatment of amenorrhea
treatment of abnormal bleeding
treatment of endometriosis
Mechanism of action for medroxyprogesterone
slow frequency of release of GnRH from the hypothalamus and blunt pre-ovulatory LH surge
ADEs with medroxyprogesterone
loss of bone mineral density
Norethindrone
synthetic oral progestin
Metabolism of norethindrone
t 1/2 = 7 hrs
metabolized by p450s
Effectiveness of progestin-only pill is reduced by
hepatic enzyme inducing drugs such as anticonvulsants; phenytoin, carbamazepine & barbiturates.
Fluoxymesterone
replacement therapy for symptoms associated with deficiency or absence of endogenous testosterone.
Fluoxymestrone uses
delayed puberty
adrogen-responsive recurrent mammary cancer in post menopausal women
ADEs of fluoxymestrone in women
amenorrhea/menstral irregularities
inhibition of gonadotropin secretion
virilization = deep voice & clitoral enlargement (irreversible)
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
Drug interactions with fluoxymesterone
increase sensitivity to oral anticoagulants
increases levels of oxyphenbutazone
decreased blood glucose and insulin requirments
Warnings with fluoxymestrone
hypercalcemia in immobilized pt with breast cancer
hepatic adenoma
cholestatic hepatitis & jaundice
prostatic hypertrophy and carcinoma
Clomiphene indications
ovulatory dysfunction in women desiring pregnancy
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
Clomiphene ADEs
Acne
migraine
anxiety
transaminases increased
hepatitis
Warnings with clomiphene
blurring/spots in vision that increase with dose
ovarian hyper-stimulation syndrome
Danazol (Danocrine)
synthetic anti-estrogen used for:
Pain/infertility due to endometriosis
Fibrocystic breast disease
Angioedema
Post coital contraception
Drug interactions with Danazol
Carbamazepine
cyclosporin
thrombolytic agents
ADEs with Danazol
Acne
alopecia
increase hepatic enzymes
edema
Mifepristone (Mifeprex)
RU-486
for medical termination of intrauterine pregnancy through 49 days
19-norsteroid
Author
Rx2013
ID
81631
Card Set
Pharmacology Final
Description
Oral Contraceptives
Updated
2011-04-25T13:35:25Z
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