Midterm | Pharma

Hormones

Estrogen, Progesterone, Testosterone.

Hormonal Contraceptives

Combination or progestin-only.

Drugs for BPH

5-alpha reductase inhibitors, Alpha-1 adrenergic blockers.

Drugs for ED

PDE5 inhibitors.

Estrogens

Examples: Conjugated equine estrogens, Estradiol.

Estrogens Routes

Oral, transdermal (less nausea, stable levels), vaginal, IM, IV.

Estrogens Action

Stimulates growth & maturation of female reproductive tract.

Estrogens Uses

Contraception.

Estrogens Complications

Endometrial/ovarian/breast cancer risk.

Estrogens Nursing Considerations

Always combine with progestin if uterus intact (↓ cancer risk).

Estrogens Contraindications

Pregnancy X.

Progesterones

Examples: Medroxyprogesterone, Norethindrone, Megestrol.

Progesterones Routes

Oral, IM, SC, patch, vaginal.

Progesterones Action

Prepares & maintains uterus for pregnancy.

Progesterones Uses

Contraception (alone/with estrogen).

Progesterones Complications

Breast cancer risk (with estrogen).

Progesterones Nursing Considerations

Monitor BP, weight, liver enzymes.

Progesterones Contraindications

Undiagnosed vaginal bleeding.

Hormonal Contraceptives Types

Combination OCs (estrogen + progestin).

Hormonal Contraceptives Action

Prevent ovulation.

Hormonal Contraceptives Uses

Prevent pregnancy.

Hormonal Contraceptives Complications

Clots, HTN, breast cancer growth.

Hormonal Contraceptives Nursing Considerations

Record breakthrough bleeding.

Hormonal Contraceptives Contraindications

Pregnancy X.

Androgens (Testosterone)

Examples: Testosterone, Methyltestosterone.

Androgens Routes

IM, transdermal, buccal, pellets.

Androgens Action

Develops male sex traits.

Androgens Uses

Hypogonadism, delayed puberty.

Androgens Complications

Virilization in women (deep voice, hirsutism, acne).

Androgens Nursing Considerations

Monitor liver enzymes, cholesterol, prostate health.

High abuse potential

Refers to substances that have a significant risk of being misused or abused.

Nursing Considerations

Key actions and assessments that nurses should take when caring for patients.

Monitor liver enzymes

Regularly check liver function indicators in blood tests.

Monitor cholesterol

Keep track of cholesterol levels to assess cardiovascular health.

Monitor prostate health

Regular assessments to evaluate prostate condition.

Watch for weight gain

Observe patients for any significant increase in body weight.

Watch for edema

Monitor for swelling due to fluid retention.

Educate on abuse potential

Inform patients about the risks of substance misuse.

Contraindications

Conditions under which a drug should not be used.

5-Alpha Reductase Inhibitors

Medications that inhibit the enzyme 5-alpha reductase, affecting DHT levels.

Examples of 5-Alpha Reductase Inhibitors

Finasteride, Dutasteride.

Action of 5-Alpha Reductase Inhibitors

Inhibit 5-alpha reductase → ↓ DHT → shrink prostate, ↑ hair growth.

Uses of 5-Alpha Reductase Inhibitors

BPH, male baldness.

Complications of 5-Alpha Reductase Inhibitors

↓ libido, gynecomastia, ↓ ejaculate volume.

Nursing considerations for 5-Alpha Reductase Inhibitors

Effects seen after 6+ months, monitor PSA, Category X (pregnant women must not handle).

Alpha-1 Adrenergic Antagonists

Medications that block alpha-1 adrenergic receptors.

Examples of Alpha-1 Adrenergic Antagonists

Tamsulosin, Silodosin, Terazosin, Doxazosin.

Action of Alpha-1 Adrenergic Antagonists

Relax bladder neck & prostate → ↓ obstruction → ↑ urine flow.

Uses of Alpha-1 Adrenergic Antagonists

BPH, urinary retention.

Complications of Alpha-1 Adrenergic Antagonists

Hypotension, dizziness, nasal congestion, ejaculatory dysfunction.

Nursing considerations for Alpha-1 Adrenergic Antagonists

Monitor BP, advise slow rising, caution with cataract surgery (floppy iris).

Examples of PDE5 Inhibitors

Sildenafil, Tadalafil, Vardenafil.

Action of PDE5 Inhibitors

Enhance Nitric Oxide (NO) → ↑ cGMP → vasodilation → erection.

Uses of PDE5 Inhibitors

Erectile dysfunction.

Complications of PDE5 Inhibitors

MI, sudden death, priapism, hearing loss.

Nursing considerations for PDE5 Inhibitors

Contra with nitrates (fatal hypotension), avoid grapefruit juice, monitor CV status, instruct ER if elevated.

Estrogen risks mnemonic (ABCDE)

A: Amenorrhea/abnormal bleeding, B: Breast/Endometrial cancer, C: Clotting (DVT, PE, Stroke), D: Dyslipidemia, E: Embolic events.

Hormone therapies for Females

Balance estrogen/progesterone, monitor cancer/clot risk.

Hormone therapies for Males

Testosterone replacement, watch for liver/prostate risks.

Baseline labs to assess

LFTs, cholesterol, PSA, INR/PT, Pap smear, mammogram.

Patient education priorities

Smoking cessation, adherence, missed pill rules, self-exams.

Purpose of the Respiratory System

Deliver oxygen to the body and remove carbon dioxide.

Upper respiratory tract

Nose, pharynx, larynx; filters, warms, and humidifies air.

Lower respiratory tract

Trachea, bronchi, lungs; responsible for gas exchange.

Pulmonary ventilation

Inhalation and exhalation (mechanical breathing).

External respiration

O₂ and CO₂ exchange between lungs and blood.

Internal respiration

O₂ and CO₂ exchange between blood and tissues.

Bronchodilators

Drugs that relax airway smooth muscle to improve airflow.

Xanthines

A class of bronchodilators including Aminophylline and Theophylline.

Sympathomimetics

Drugs that stimulate adrenergic receptors, including Epinephrine and Albuterol.

Anticholinergics

Drugs that block acetylcholine to prevent bronchoconstriction.

Hydration

Encourage hydration, sugarless lozenges for dry mouth.

Urination before dose

Instruct patient to urinate before dose to prevent retention.

Driving caution

Caution with driving due to dizziness.

Anti-Inflammatory Drugs

These do not cause bronchodilation, but they reduce inflammation → prevent airway hyperreactivity.

Inhaled Corticosteroids

Examples include Budesonide and Fluticasone.

Use of Inhaled Corticosteroids

Long-term prevention in asthma, adjunct in uncontrolled asthma.

Action of Inhaled Corticosteroids

↓ airway inflammation, prevent mucosal edema and mucus production.

Adverse effects of Inhaled Corticosteroids

Oral thrush, hoarseness, cough, nosebleeds.

Nursing considerations for Inhaled Corticosteroids

Rinse mouth after inhalation → prevent fungal infection.

Leukotriene Receptor Antagonists

Examples include Montelukast and Zafirlukast.

Use of Leukotriene Receptor Antagonists

Long-term asthma management, especially in children.

Action of Leukotriene Receptor Antagonists

Blocks leukotrienes (inflammatory mediators) → prevents bronchospasm and airway edema.

Adverse effects of Leukotriene Receptor Antagonists

Headache, dizziness, nausea, fatigue, infections.

Nursing considerations for Leukotriene Receptor Antagonists

Take on empty stomach (1 hr before or 2 hrs after meals).

Lung Surfactants

Example: Beractant (Survanta).

Use of Lung Surfactants

Prophylaxis & rescue in premature infants at risk of Respiratory Distress Syndrome (RDS).

Action of Lung Surfactants

Replaces deficient surfactant → lowers alveolar surface tension → keeps alveoli open for gas exchange.

Adverse effects of Lung Surfactants

Bradycardia, hypotension, pneumothorax, pulmonary hemorrhage, infection.

Nursing considerations for Lung Surfactants

Administer intratracheally, in NICU setting.

Anti-Fibrotic Agents

Examples include Nintedanib and Pirfenidone.

Use of Anti-Fibrotic Agents

Slow progression of lung scarring in Idiopathic Pulmonary Fibrosis (IPF).

Action of Anti-Fibrotic Agents

Antifibrotic activity reduces fibroblast proliferation and collagen formation.

Adverse effects of Anti-Fibrotic Agents

GI upset, liver toxicity, photosensitivity, fatigue.

Nursing considerations for Anti-Fibrotic Agents

Frequent liver function monitoring.

Diuretics

Promote diuresis → excretion of sodium and water.

Thiazide Diuretics

Examples include Hydrochlorothiazide and Chlorothiazide.

Action of Thiazide Diuretics

Act on distal tubule, block reabsorption of Na⁺, Cl⁻, and water.

Uses of Thiazide Diuretics

Hypertension, mild heart failure edema.

Adverse effects of Thiazide Diuretics

Hypokalemia, hyponatremia, hyperglycemia, hyperuricemia (caution in gout).