Reproductive health drugs

Conjugated estrogens MOA

reduces estrogens in postmenopausal women.

Conjugated estrogens AE

headache, breast tenderness, bloating, stroke, endometrial/breast cancer

conjugated estrogens TR

menopause symptoms, osteoporosis prevention

Nursing implications for conjugated estrogen

combine with progestin in women with a uterus (lower risk for cancer), educate on breast self exams and regular screenings, monitor for blood glucose and thyroid levels, combine with progestin in women if uterus is present (lower risk for cancer),

contraindications for conjugated estrogens 

thrombophlebitis, clients/ family history of heart disease, breast cancer

levonorgestrel MOA

inhibits/ delays ovulation

levonorgestrel TR

emergency contraceptive within 72 hrs of unprotected sex

levenorgestrel AE

abdominal pain, menstrual changes, nausea, menorrhagia, fatigue

contraindications for testosterone

older adults and males who have prostate or breast cancer, severe cardiac, renal or liver disease. 

testosterone MOA

promotes the development of male sex characteristics

testosterone TR

delayed puberty, hypogonadism, muscle wasting

testosterone AE

acne, oily skin, polycythemia, liver toxicity, worsening of prostate cancer, facial heair, weight gain, deeper voice

nursing implications for testosterone

monitor liver enzymes, monitor hemoglobin, cardiovascular risk, behavior changes, evaluate psa/prostate levels in men

finasteride MOA

blocks that enzyme that converts testosterone to dihydrotestosterone reducing prostate size

nursing implications for finasteride

pregnant women should not handle crushed tablets, could take months for full effects, monitor urinary output and PSA levels.

finasteride TR

BPH (benign prostatic hyperplasia)

finasteride AE

decreased libido, erectile dysfunction, gynecomastia (breast enlargment) prostate cancer risk, orthostatic hypertension

sildenafil contraindications

pregnancy, medications in the nitrate family (severe risk of hypotension) isosorbide

nursing implications for sildenafil

 take 30min-1 hr before sexual activity

which of the following actions occur with the use of combination oral contraceptives

all of them. 

contraindications of oxytocin

fetal distress, herpes, history of multiple births, vasopressers

interactions for magnesium sulfate

calcium channel blockers, digoxin

oxytocin AE

water intoxication, hyponatremia, uterine rupture, fetal distress

Oxytocin MOA

stimulates uterine smooth contractions, increases the frequency, strength, and duration

Oxytocin TR

induces labor, controls postpartum hemorrhage

Nursing implications for oxytocin

monitor fetal status, monitor for fluid overload/water intoxication, uterine hyperstimulation

Magnesium sulfate MOA

relaxes smooth muscles, decreases acetylcholine at neuromuscular junctions 

magnesium sulfate TR

prevents seizures in preeclampsia, stops preterm labor

magnesium sulfate AE

flushing, sweating, respiratory depression, cardiac arrest, hypotension.

nursing implications for magnesium sulfate

monitor RR, monitor deep tendon reflexes, monitor urine output less than 25ml/hr is not good

antidote for magnesium sulfate

calcium gluconate

estradiol and norethindrone MOA

suppress ovulation via negative feedback on FSH and LH, thickens cervical mucus.

estradiol and norethindrone TR

prevents pregnancy, regulates menstrual cycles treats endometriosis

estradiol and norethindrone AE

headache, nausea, breast tenderness, mood changes

serious risks of estradiol and norethindrone

hypertension, stroke, thromboembolic events

nursing implications of estradiol and norethindrone

assess for contraindications (history of clotting disorders, smoking), educate about missed doses, teach signs of thromboembolism. 

black box warning for estradiol and norethindrone

increased risk of CV events in smokers  > 35 years.

black box warning for conjugated estrogens

risk of stroke, DVT, endometrial cancer

folic acid MOA

stimulates production of WBC and RBC for DNA synthesis

folic acid TR

treats folate deficiency anemia, prevents neural tube defects in pregnancy

folic acid AE

nausea, anorexia, can mask b12 deficiency

black box warnings for testosterone

secondary exposure can cause virilization in children