Men's & Women's Health Medications

Estrogen

what does it do: stimulate estrogen receptors

use for: vaginal atrophy, vasomotor symptoms, hypogonadism, contraception (estrogen alone is not used in contraception)

side effects: HTN, n/v/d, breast tenderness, AUB, dementia, cancer, DVT, stroke

dont use w/: HTN, hypercoagulation, estrogen + cancer, pregnancy, unknown AUB, liver disease, st john’s wort, anticoagulants

• vaginal route has different complications: unknown uterine bleeding

education: unopposed estrogen, treat the symptom, gloves for administration

comes in pills, gels, creams, suppositories, and patches

Progestin

what does it do: promotes progestin activity

use for: AUB, cancer, endometriosis, contraception, pregnancy support

side effects: weight changes, acne, AUB, liver disfunction, n/v

dont use w/: unknown AUB, liver disease, breast/GYN cancer, thromboembolic disorders, benzodiazepines, rifampin, st john’s wort

education: administration, bleeding expectations, contraceptive benefit

Medroxyprotesterone

progestin

tablets

Levonorgestrel

Progestin

IUD

Esongestrel

progestin

rod

Norethindrone

Progestin

tablets

Progesterone

progestin

IV or cream

Androgen

what does it do: development of male organs and sex characteristics

use for: hormone replacement (old age not a good enough reason), hypogonadism, oligospermia, breast cancer, endometriosis

side effects: thromboembolism, liver damage (peliosis - cavities filled w/ blood), edema, HA, libido changes, depression, acne, priapism, hirutism

dont use w/: androgen responsive tumors, HTN, cyclosporine, warfarin, corticosteroids

education: wash hands after aplication, cover area, monitor weight, weaning required to stop

comes in sprays, gels, creams, patches, injections, pellets

Methyltestosterone

Androgen

Fluoxymesterone

Androgen

Testosterone

Androgen

Danazol

Androgen

Biophosphonates

what does it do: inhibits osteoclast bone reabsorption (prevent reabsorption)

use for: osteoporosis prevention and treatment (someone w/ osteopenia might use med)

side effects: eophageal burns, osteonecrosis of the jaw

dont use w/: hypocalcemia, esophageal dysfunction (varices), inability to sit upright, just dont take at same time (calcium supplements, antacids, NSAIDS, and asprin)

education: take w/ 8oz water, sit upright for 30 min, 1-2 hr b/w Ca or antacids

Alendronate

biophosphate

Zoledronic Acid

biophosphate

Selective Estrogen Receptor Modulators

what does it do: stimulate estrogen receptor

use for: osteoporosis prevention

side effects: hot flashes, leg cramps, DVT

dont use w/: pregnancy or desiring pregnancy, thromboembolism, warfarin, ampicillin

education: positive effects on cholesterol, coagulation issues, blood pressure monitoring contraception

raloxifene

selective estrogen receptor modulators

Parathyroid hormone analog

what does it do: stimulates bone formation (by affecting parathyroid)

use for: osteoporosis treatment for those w/ highest fracture risks

side effects: orthostatic hypotension, chest and joint pain, hypercalcemia

dont use w/: minimal interactions

education: used for 24 mnths only, need Ca and vit D, change positions slowly (orthostatic hypotension risk)

Teriparatide

Parathyroid hormone analog

Monoclonal antibody

what does it do: inhibits osteoclast activation

use for: osteoporosis treatment

side effects: hypocalcemia, infection

dont use w/: kidney disease, corticosteroids, immunosuppressants

education: monitor calcium levels, do not skip doses as fracture risk increases, subCut q6mnth w/ daily Ca and Vit D

5-Alpha reductase inhibitors

what does it do: inhibits 5 alpha reductase

use for: BPH, male pattern baldness

side effects: reduced libido, hypotension, dizziness, drowsiness

dont use w/: preganncy (teratogentic); NOT for women

education: women wear gloves for handling, monitor PSA, 6 mnths for effects, monitor urinary frequency

Finasteride

5-Alpha reductase Inhibitors

Alpha 1 adrenergic blockers

what does it do: relaxation of smooth muscle

use for: relief of obstruction, less effective for HTN

side effects: tachycardia, hypotension, syncope, impotence, HA

dont use w/: sulfa allergy, BP meds, antifungals, erythromycin

Education: immediate shrinkage, change positions slowly, 30 min after same meal daily

Tamsulosin

Alpha 1 adrenergic blockers

Phosphodiesterase

what does it do: inc guanosine monophosphate

use for: erectile dysfunction, pulmonary hypertension (different trade names)

side effects: HA, flushing, dyspena, priapism, hypo/hypertension, loss of vision

dont use w/: cardiovascular disease, caution w/ renal disease, nitroglycerin, grapefruit

education: onset 1 hr and duration 4-6 hrs, dec renal clearance, high fat meal delays absorption (up to 60 min)

Sildenafil

phosphodiesterase

viagra

Tadalafil

phosphodiesterase inhibitor

cialis

Soy

herbal therapies

chemical similar to estrogen

dietary sources: tofu, soy sauce/bean/milk, chickpeas

Estrasorb - helps with hot flashes, memory changes

adverse effects: n/v/d, abd pain

interacts w/ thyroid hormone

Saw Palmetto

herbal therapy

what does it do: inhibits dihydrotestosterone & 5-alpha reductase

use for: BPH, diuretic, UTI prevention, alopecia

adverse effects: GI, HA, back pain, dysuria

drug interactions: NSAIDS, hormones, immunostimulants, ED meds, women should not take