ATI Pharmacology Medication Affecting Reproductive System.
General Keypoints about reproductive drugs - ✔• Testosterone produced by testes,
... [Show More] ovaries, and adrenal cortex. Primary androgen in both genders.
• ♀: Primary estrogen and progestional are estradiol and progesterone. Both made in ovaries --> maturation of ♀ reproductive organs & 2º sex characteristics.
• Menstruation results from increased progesterone toward end of cycle
• Menopausal symptoms result from decreased estrogen levels.
• Clinical uses of hormone preparations: Hormone deficiencies and oppositional treatment of hormone-dependent cancers.
• Postmenopausal HRT: Benefits include vasomotor symptom relief and prevention of osteoporosis. Risks include embolic events and cancers.
• Oral contraceptives suppress ovulation using ethinyl, estradiol, and norethindrone
• OC risks are minimal except in smokers and those with Hx of embolic events.
• Oxytocics are uterine stimulants used to induce or assist labor; Tocolytics are used to delay preterm labor.
Oxytocics - ✔Proto: oxytocin (Pitocin), Others: methylergonovine (Methergine)
Expected Action: • increased strength, frequency, and duration of uterine contractions
Therapeutic Uses: •
• Methergine: Emergency intervention for serious postpartum hemorrhage
• Oxytocin: Labor induction or enhancement // Delivery of afterbirth // Control of postpartum bleeding // Fetal stress testing // Milk letdown (intranasal)
Adverse Effects: •
• Methergine: Hypertensive crisis (IV): Headache, nausea, increased BP
• Oxytocin: Uterine rupture {Relax myometrium ĉ Mg(SO4)}
Contraindications/Precautions: ♀ (?) Methergine: Hypertension
Caution: Methergine: Cardiovascular, renal, or hepatic failure.
Oxytocin: unripened cervix, Hx of multiples, uterine surgery // immature lungs, cephalopelvic disproportion, prolapsed umbilical cord, fetal distress.
Interactions: • Vasopressors --> hypertension
Education: • Use infusion pump and gradually increase rate
• Call physician if contractions longer than 60 sec, freq > q 2-3 min infusion
Tocolytic Medications - ✔Proto: Terbutaline sulfate (Brethine), Others: magnesium sulfate, ritodrine
Expected Action:
• Selectively activates β2-adrenergic receptors uterine smooth muscle relaxation
Therapeutic Uses: • Delay of preterm labor
Adverse Effects: • Tremors, anxiety, headache (β2 skeletal muscle side effects)
• Tachycardia, palpitations, chest pain (β1 side effects)
Contraindications/Precautions: ♀ (?) Pregnancy // lactation [Show Less]