Pharm Labor & Delivery and Reproductive

What medication prevents preeclampsia related seizures?

magnesium sulfate

Complications of magnesium sulfate

excessive thirst, confusion, loss deep tendon reflex, output less than 25mL/hr, PE, severe hypotension, chest pain, respirations less than 12

Antidote for magnesium sulfate

calcium gluconate

Nursing action for magnesium sulfate

- monitor deep tendon reflexes
- monitor magnesium levels
- limit IV fluid to 125 mL/hr
- DISCONTINUE INFUSION W/ any intolerable adverse effects

What drug treats bengin prostatic hyperplasia/issues urinating?

Finasteride
- also treat bph, male baldness (alopecia)

MOA of finasteride

decreases usable testosterone by inhibiting the converting enzyme causing a reduction of the prostate and INCREASED HAIR GROWTH

contraindication of finasteride

pregnancy, caution w/liver disease

what should be assessed before taking finasteride?

s/sx of hepatotoxicity, ast, alt

complications of finasteride

decreased libido, ejaculate volume(sperm), gynecomastia (breast in man)

Pt education for finasteride

- therapeutic effect can take 6 months
- do not donate blood for a month
- increased hair growth

What drug prevents ovulation?

estrogen-progestin: ethinyl estradiol & drospirenone

Other therapeutic uses of ethinyl estradiol & drospirenone

premenstrual dysphoric disorder
acne
reducing menstrual blood loss (iron deficiency anemia)
reducing menstrual cramping (dysmenorrhea)
ovarian cancer and endometrial cancer

Important information about social history before taking ethinyl estradiol & drospirenone

pregnancy, smoking, breastfeeding

complications of estradiol & drospirenone

thromboembolic events
hypertension
breakthrough or irregular uterine bleeding
breast cancer
hyperglycemia
hyperkalemia

labs for estradiol & drospirenone

HCG, bun, creatinine

patient history to assess before taking estradiol & drospirenone

age: 35+
smoker
risk factors for breast cancer
vaginal bleeding
HTN
DB
uterine thyroid
seizure
migraine bladder
hyperkalemia

pt education for estradiol & drospirenone

same time every day
no tobacco
report s/sx of thromboembolic events
report abdominal pain, chest pain, headache, eye problems, leg pain, swelling and redness in legs

What does conjugated equine estrogen (estradiol) treat?

relieve moderate to severe post-menopausal symptoms
prevent post-menopausal osteoporosis
contraceptive

complications of equine estrogen (estradiol)

endometrial or ovarian cancer > vaginal bleeding
potential risk for estrogen-dependent breast cancer
altered coagulation (suppresses it or promotes it) > monitor embolic events

contraindication for conjugate equine estrogen (estradiol)

thromboembolic events
vaginal bleeding
breast or estrogen dependent cancer
smoking or tobacco
pregnancy

Nurisng action for equine estrogen (estradiol)

- apply to skin or trunk
- discontinue prior to knee or hip surgery

Pt education for equine estrogen (estradiol)

- avoid smoking
- same time, everyday
- report menstrual changes or breast changes
- notify provider of swelling or redness in legs, sob, chest pain

What does sildenafil treat?

erectile dysfunction

Complications of sildenafil

MI, sudden death, priapism(4 hr erection), sudden hearing loss

What should pt. do if erection lasts longer than 4 hrs?

seek immediate medical treatment because may lead to irreversible damage

When should sildenafil be discontinued?

sudden hearing loss

What medication should not be taken with sildenafil?

nitroglycerin

Contraindication for sildenafil

pregnancy

Pt. education for sildenfil

- take 1 hr before sexual activity (30 min - 4 hrs)
- only one dose a day
- if taking for pulmonary artery htn, take 3/day, 4 hrs apart

what is the therapeutic use of progestin?

contraception (SYNTHETIC HORMONE MEANT TO MIMIC PROGESTERONE)
counter adverse effect of estrogen
cancer (vaginal related)
support early pregnancy
prevention of preterm death
amennorrhea
dysfunctional uterine bleeding

complications of progestin

breast cancer (if using w/estrogen)
thromboembolic events
breakthrough bleeding, amenorrhea, breast tenderness
edema
migraine headaches

progestin contraindications

pregnancy
vaginal bleeding
breast cancer
thromboembolic events
cardiovascular or cerebrovascular disease

pt education for progestin

withdrawal bleeding 3 to 7 days after stopping medication
avoid smoking

What decreases effectiveness of oral contraceptives?

antibiotics

Who can safely taken estrogen?

women w/out an uterus