Pharmacology Review: Reproductive and Genitourinary Systems (Lecture Notes)

A set of Q&A flashcards covering key concepts from the notes on contraceptives, menopause/HRT, infertility, labor/delivery drugs, reproductive androgens, and urinary/genitourinary pharmacology. Designed to reinforce mechanism, indications, risks, interactions, and nursing considerations.

What is the primary mechanism by which hormonal contraceptives prevent ovulation?

They suppress the release of FSH and LH from the anterior pituitary, preventing ovulation.

Besides preventing ovulation, what other actions do hormone contraceptives have to prevent pregnancy?

They thicken cervical mucus to block sperm and prevent implantation by inhibiting endometrial thickening.

What is the biggest risk associated with hormone contraceptives?

Thromboembolism (blood clots).

What are common signs and symptoms of thromboembolism you should assess for?

Pain, redness, swelling in an extremity; chest pain; shortness of breath; vision changes; sudden severe headache.

Which populations are at higher risk for thromboembolism when using hormone contraceptives?

Smokers, older adults, people who are obese or have diabetes, and those with cardiovascular or autoimmune conditions.

List some common side effects and risks associated with hormonal contraceptives besides thromboembolism.

Abnormal uterine bleeding, breast tenderness or enlargement, weight gain, headaches, decreased libido, and potential breast cancer risk.

What drug interactions should you consider with oral contraceptives?

Antibiotics (certain ones) and anticonvulsants like rifampin can affect effectiveness; some drugs can either decrease or increase the effectiveness of the contraceptive.

What is the recommended action if a patient misses one, two, or three consecutive birth control pills?

Miss one: take the missed pill with the next pill; miss two consecutive days: take two pills for two days; miss three consecutive days: start over with backup contraception until the new cycle begins.

What is Depo-Provera, and what is a key consideration for its use?

A hormonal contraceptive given as a subcutaneous/intramuscular injection every three months; advantageous for those who have trouble taking a daily pill but requires clinic visits for administration.

How long can an intrauterine device (IUD) provide contraception?

Typically 3 to 8 years, depending on the type.

Describe the hormone contraceptive ring and the patch in terms of their usage schedules.

Ring: worn for 3 weeks, removed for 1 week. Patch: worn for 3 weeks, replaced weekly for 3 weeks, then off for a week.

What should you know about emergency contraception (Plan B) in terms of timing and efficacy?

Take within 72 hours of unprotected intercourse; effectiveness decreases with higher BMI (less effective if BMI > 30) and later timing; available OTC in many places.

What is the effect of BMI on Plan B efficacy?

BMI over 30 reduces effectiveness; speak with a healthcare provider for alternatives.

What is the historical guidance on hormone replacement therapy (HRT) for menopause, and how has it changed?

Historically used broadly to prevent aging effects and cardiovascular issues; studies showed increased cardiovascular disease and breast cancer risk, leading to current guideline of short-term, symptom-focused use in healthy women.

For menopausal hormone therapy, what is the difference in administration for women with uterus versus those who have had a hysterectomy?

Women with a uterus: estrogen plus progesterone to protect the uterus; women without a uterus: estrogen alone.

What is Lupron (leuprolide) used for in endometriosis, and what are key teaching points about calcium and vitamin D?

A GnRH agonist that puts the body in a temporary menopausal state to shrink endometrial tissue; recommend increased calcium and vitamin D and monitor for menopausal symptoms.

How does progesterone help in endometriosis treatment?

Progesterone antagonizes estrogen-stimulated tissue growth to reduce endometrial tissue inflammation.

What fertility drugs are Clomid and HCG, and what are their roles?

Clomid (clomiphene) stimulates follicle maturity; HCG (pregnant) triggers ovulation when follicles are ready.

What medication is used for amenorrhea due to low prolactin and how is it administered?

Cabergoline (Dopamine agonist) to increase prolactin levels; typically taken orally as prescribed.

Name two labor and delivery drugs and their primary uses.

Oxytocin (Pitocin) to induce or augment labor contractions; Methergine (methylergonovine) to promote uterine contraction postpartum and reduce bleeding.

What is Dinoprostone (Dinopristone) used for in obstetrics?

A prostaglandin inserted vaginally to soften the cervix and help initiate or progress labor.

Which drug is used to stop premature labor, and what is a key safety concern?

Terbutaline (beta-adrenergic agonist); monitor for pulmonary edema and cardiovascular status; hospitalize if used for stopping contractions.

Why is Betamethasone given during preterm labor, and what should you monitor?

Corticosteroid to accelerate fetal lung maturity; monitor maternal glucose and fetal status, watch for hyperglycemia and respiratory effects.

What is magnesium sulfate used for in preeclampsia, and what is the major safety concern and antidote?

Used to prevent seizures in preeclampsia; adverse effects include hypotension, bradycardia, decreased reflexes; antidote is calcium gluconate.

How should you think about IV drip calculations in nursing exams, and what are some key rounding rules?

Use the drop factor to convert mL to drops per minute; round to the nearest whole drop; use a leading zero if applicable and avoid trailing zeros.

What is Finasteride (Propecia) used for, and what is a major consideration about onset and side effects?

5-alpha reductase inhibitor for BPH and male pattern hair loss; therapeutic effects can take up to 12 months; potential side effects include decreased libido, erectile/ejaculatory changes, gynecomastia, and PSA changes.

What is Flomax (tamsulosin) used for and what is a common adverse effect that affects safety?

Alpha-adrenergic blocker for BPH; relaxes urinary tract to improve flow; can cause orthostatic hypotension and dizziness.

What should patients know about sildenafil (Viagra) use, timing, and important interactions?

Used for erectile dysfunction; take about 1 hour before activity; do not use with nitrates; can cause priapism; high-fat meals can delay peak effect.

What are the common anticholinergic side effects of Ditropan (oxybutynin) and a key contraindication?

Dry mouth, blurred vision, constipation, urinary retention; contraindicated in narrow-angle glaucoma.

What is Uracoline used for, and how does it differ mechanistically from anticholinergics like Ditropan?

Uracoline is a cholinergic agent used for neurogenic bladder (to promote bladder contraction); opposite effect to anticholinergics like Ditropan which relax the bladder.

What practical tip should you remember when applying testosterone gels for gender transition care?

Wear gloves during application to avoid transdermal transfer to others.

A nurse is explaining the mechanism of action of combination oral contraceptives to a client. Which statement accurately describes how these medications primarily prevent pregnancy?

Oral contraceptives primarily prevent ovulation by suppressing the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland.

In addition to preventing ovulation, a nurse should inform a client that hormonal contraceptives also contribute to pregnancy prevention through which other mechanisms?

Hormonal contraceptives also thicken cervical mucus, making it difficult for sperm to reach the ovum, and they inhibit endometrial thickening, preventing implantation of a fertilized egg.

A nurse is educating a client about the most serious potential adverse effect of hormonal contraceptives. Which risk should the nurse prioritize in the discussion?

The biggest risk associated with hormonal contraceptives is thromboembolism (blood clots).

A client on hormonal contraceptives calls the clinic reporting sudden, severe calf pain and shortness of breath. Which of these findings indicates a potential life-threatening complication requiring immediate medical attention?

Signs and symptoms of thromboembolism include pain, redness, swelling in an extremity, chest pain, shortness of breath, vision changes, and sudden severe headache.

The nurse is reviewing the health history of a client considering hormonal contraceptives. Which finding would place the client at a significantly higher risk for thromboembolism?

Populations at higher risk for thromboembolism when using hormone contraceptives include smokers, older adults, individuals who are obese or have diabetes, and those with cardiovascular or autoimmune conditions.

A client starting hormonal contraceptives asks about common side effects. Which of the following should the nurse include in the teaching, besides the risk of blood clots?

Common side effects and risks associated with hormonal contraceptives include abnormal uterine bleeding, breast tenderness or enlargement, weight gain, headaches, decreased libido, and a potential, though small, breast cancer risk.

A nurse is providing education to a client starting oral contraceptive pills regarding drug interactions. Which statement by the client indicates a need for further teaching?

"I can take my antibiotics as prescribed, and my birth control will still be fully effective." (Certain broad-spectrum antibiotics and anticonvulsants like rifampin can decrease oral contraceptive effectiveness, requiring backup contraception). Other drugs can also either decrease or increase the effectiveness of the contraceptive.

A client calls the clinic stating she missed her oral contraceptive pill yesterday. What is the nurse's most appropriate recommendation regarding a single missed dose?

If one pill is missed, take the missed pill with the next pill. If two consecutive days are missed, take two pills for two days. If three consecutive days are missed, the client should start over with backup contraception until the new cycle begins.

A client is considering Depo-Provera as a contraceptive option. Which statement best describes this method and a key consideration for its use?

Depo-Provera is a hormonal contraceptive given as a subcutaneous/intramuscular injection every three months. It is advantageous for those who have trouble taking a daily pill but requires regular clinic visits for administration.

A nurse is counseling a client about long-acting reversible contraceptives (LARCs). The client asks about the duration of effectiveness for an intrauterine device (IUD). What is the nurse's best response?

An IUD can typically provide contraception for 3 to 8 years, depending on the specific type of device.

A client asks about the proper usage schedule for the hormonal contraceptive ring and transdermal patch. Which information should the nurse provide?

The contraceptive ring is worn for 3 weeks and then removed for 1 week. The contraceptive patch is worn for 3 weeks, replaced weekly for 3 consecutive weeks, followed by a week off.

A client seeks emergency contraception after unprotected intercourse. What crucial information should the nurse provide regarding the timing and efficacy of Plan B?

Plan B should be taken within 72 hours of unprotected intercourse. Its effectiveness decreases with higher BMI (less effective if BMI > 30) and the later it is taken. It is available over-the-counter in many places.

A nurse is counseling a client seeking emergency contraception (Plan B) who has a Body Mass Index (BMI) of 32. What information about Plan B efficacy should the nurse provide?

A BMI over 30 can reduce the effectiveness of Plan B, and the client should speak with a healthcare provider for alternative emergency contraception options.

A postmenopausal client asks about starting hormone replacement therapy (HRT). Which information should the nurse emphasize regarding current HRT recommendations and the shift from historical guidance?

Historically used broadly to prevent aging effects and cardiovascular issues; recent studies showed increased cardiovascular disease and breast cancer risk, leading to current guidelines for short-term, symptom-focused use in healthy women at the lowest effective dose.

A nurse is reviewing prescriptions for menopausal hormone therapy. Which combination is appropriate for a client with an intact uterus, compared to a client who has had a hysterectomy?

For women with an intact uterus, estrogen plus progesterone is administered to protect the uterus from endometrial hyperplasia. Women without a uterus typically receive estrogen alone.

A client with endometriosis is prescribed leuprolide (Lupron). What is a vital aspect of patient education related to potential long-term effects of this medication and necessary dietary adjustments?

Leuprolide is a GnRH agonist that induces a temporary menopausal state to shrink endometrial tissue. Key teaching points include recommending increased calcium and vitamin D intake to mitigate bone density loss, and monitoring for typical menopausal symptoms.

A client with endometriosis asks how progesterone therapy helps manage her condition. Which explanation by the nurse is most accurate?

Progesterone helps in endometriosis treatment by antagonizing estrogen-stimulated tissue growth, thereby reducing endometrial tissue inflammation and proliferation.

A couple undergoing fertility treatment asks the nurse about the roles of Clomid and HCG. Which explanation correctly describes their functions?

Clomid (clomiphene) stimulates follicle maturity in the ovaries, while HCG (human chorionic gonadotropin) triggers ovulation once the follicles are mature.

A client is diagnosed with amenorrhea caused by low prolactin levels. Which medication is most likely to be prescribed, and what is its typical administration route?

Cabergoline, a dopamine agonist, is used to increase prolactin levels for amenorrhea and is typically taken orally as prescribed.

The nurse is preparing to administer medications to a client in labor and a postpartum client. Which pair of medications and their uses are correctly matched?

Oxytocin (Pitocin) is used to induce or augment labor contractions. Methergine (methylergonovine) is used postpartum to promote uterine contraction and reduce bleeding.

A client at term is admitted for labor induction, and Dinoprostone is prescribed. The nurse understands that this medication is used for which obstetric purpose?

Dinoprostone (Dinopristone), a prostaglandin, is inserted vaginally to soften (ripen) the cervix, helping to initiate or progress labor.

A client experiencing preterm labor is prescribed terbutaline. What is a key safety concern the nurse must monitor for during administration of this medication?

Terbutaline, a beta-adrenergic agonist, is used to stop premature labor. A key safety concern is monitoring for pulmonary edema and adverse cardiovascular effects (e.g., tachycardia, palpitations). Hospitalization is typically required if used for stopping contractions.

Betamethasone is prescribed for a client in preterm labor. The nurse explains that this medication serves what primary purpose, and what is an important monitoring parameter?

Betamethasone is a corticosteroid given during preterm labor to accelerate fetal lung maturity. The nurse should primarily monitor maternal glucose levels for hyperglycemia and assess fetal status.

A client receiving intravenous magnesium sulfate for preeclampsia exhibits a respiratory rate of 9 breaths/minute and absent patellar reflexes. What should be the nurse's immediate action, recognizing the major safety concern and antidote?

Magnesium sulfate is used to prevent seizures in preeclampsia. The signs indicate magnesium toxicity, a major safety concern. The immediate action is to discontinue the magnesium sulfate infusion and administer calcium gluconate, which is the antidote.

A nursing student is practicing IV drip rate calculations for an exam. Which principles should the student apply regarding calculations and rounding rules?

For IV drip calculations, use the drop factor to convert milliliters per hour to drops per minute. Key rounding rules include rounding to the nearest whole drop, using a leading zero for decimal numbers less than 1, and avoiding trailing zeros.

A male client is prescribed finasteride for benign prostatic hyperplasia (BPH). Which important information should the nurse include in the client education regarding this medication?

Finasteride is a 5-alpha reductase inhibitor used for BPH and male pattern hair loss. Therapeutic effects can take up to 12 months to be observed, and potential side effects include decreased libido, erectile/ejaculatory changes, gynecomastia, and changes in PSA levels.

A client with benign prostatic hyperplasia (BPH) is prescribed tamsulosin (Flomax). What is a priority safety teaching point for the nurse to emphasize regarding this medication?

Tamsulosin, an alpha-adrenergic blocker, relaxes the urinary tract to improve flow in BPH. A common and critical adverse effect affecting safety is orthostatic hypotension and dizziness, especially when changing positions.

A male client with erectile dysfunction asks about taking sildenafil (Viagra). The nurse identifies which concomitant medication as an absolute contraindication due to the risk of life-threatening hypotension?

Sildenafil, used for erectile dysfunction, should be taken about 1 hour before sexual activity. It is absolutely contraindicated with nitrates (e.g., nitroglycerin), as this combination can cause severe, life-threatening hypotension. Other considerations include the risk of priapism and that high-fat meals can delay its peak effect.

A client prescribed oxybutynin (Ditropan) for overactive bladder reports new-onset blurred vision and severe dry mouth. The nurse recognizes these are common side effects and also recalls what significant contraindication for this medication?

Common anticholinergic side effects of oxybutynin include dry mouth, blurred vision, constipation, and urinary retention. A key contraindication for its use is narrow-angle glaucoma.

A nurse is explaining the difference between Uracoline and Ditropan to a student. Which statement accurately describes Uracoline's use and its mechanistic difference from anticholinergics like Ditropan?

Uracoline is a cholinergic agent primarily used for neurogenic bladder to promote bladder contraction. This mechanism is opposite to anticholinergics like Ditropan, which relax the bladder.

A nurse is instructing a transgender client on applying testosterone gel at home. What is the most crucial practical teaching point to prevent accidental transfer of the medication to others?

When applying testosterone gels, it is crucial to wear gloves during application to prevent accidental transdermal