GU drugs

Question 1

FSH

Answer 1

stimulates the release of the follicule and increases estrogen

Question 2

LH

Answer 2

causes the follicle to swell and open midcycle, releasing ovum. The empty follicle becomes a corpus luteum and secretes estrogen and progesterone. estrogen stimulates the endometrium to thicken. if pregnancy does not occur the corpus luteum stops secreting its hormones and the endometerium falls away (this is menses)

Question 3

PMS symptoms

Answer 3

begin during the luteal phase and end when menses begins.

1. water retention
2. headache
3. diarrhea
4. mood swings

Question 4

oral contraceptive uses

Answer 4

1. prevent pregnancy
2. reduces fluid retention associated with PMS
3. can be used for migraine headaches

Question 5

oral contraceptive prototypes

Answer 5

1.Ethinyl estradiol and drospirenone (Yasmin)

Question 6

oral contraceptive action

Answer 6

1. suppresses secretion of FSH and LH.
2. thicken cervical mucus to prevent adequate sperm movement
3. acts like spironolactone

Question 7

oral contraceptive SEs

Answer 7

1. thromboembolism
2. uterine bleeding
3. increase risk of breast cancer (BRC1 women only) but decrease risk for
4. HTN and hyperkalemia (spironolactone like action)

Question 8

oral contraceptive interventions

Answer 8

1. monitor for thrombi (smoking increases risk)

2. monitor ECG periodically (can cause dysrhythmias)

Question 9

oral contraceptive admin

Answer 9

if 1 pill is missed take an extra pill with the next pill. If two missed pills take an extra pill for two consecutive days. If 3 pills are missed you need to start a new 7 day cycle.

Question 10

oral contraceptive teaching

Answer 10

1. do not smoke
2. regular BP checks
3. watch out for heart problems
   - edema, sudden vision changes, severe headache, SOB

Question 11

oral contraceptives contraindications

Answer 11

1. history of embolic events
2. breast cancer
3. altered liver, renal, or adrenal function
4. smokers above age 35

Question 12

oral contraceptive interactions

Answer 12

1. ace inhibitors can cause hyperkalemia
2. can reduce effects of warfarin and hypoglycemic drugs
3. can increase levels of theophylline, diazepam, chlordiazepoxide and antidepressants

Question 13

the 3 Uterine stimulants

Answer 13

1.oxytocin
2.dinoprostone
3.methylergonovine
in order for these drugs to work there must be effacement (soft and thin cervix) and cervix must be dilated

Question 14

Oxytocin uses

Answer 14

1. uterine stimulant
2. induce or enhance labor
3. treats postpartum hemorrhage

Question 15

oxytocin action

Answer 15

1. stimulates smooth muscle to contract (as pregnancy progresses there are more receptors)
2. responsible for milk ejection
3. causes water retention

Question 16

oxytocin SEs

Answer 16

1. uterine hyperstimulation
   - leading to major bleed
2. HTN crisis and water intoxication due to water retention

Question 17

oxytocin interventions

Answer 17

1. monitor for risk factors such as multiple deliveries
2. monitor for headache, n/v and BP
3. monitor I and O and LOC
4. for hyperstimulation turn patient to side, stop infusion, and give o2 and give a uterine relaxant

Question 18

what is considered uterine hyperstimulation

Answer 18

contractions that last longer then 60 seconds and occur more frequently then every 2-3 mins. Or a resting uterine pressure greater then 20 mmhg.

Question 19

oxytocin admin

Answer 19

monitor fetal HR (110-160)

Question 20

oxytocin teaching

Answer 20

report drowsiness, headache, palpitations, nausea, or chest pain

Question 21

oxytocin contraindications

Answer 21

1. unripe cervix
2. active genital herpes
3. prolapse or breech

Question 22

oxytocin interactions

Answer 22

1. vasopressors, can cause HTN

2. cyclopropane anesthesia can cause hypotension, bradycardia and dysrhytmias

Question 23

Ergot alkaloids uses

Answer 23

prevent and treat postpartum and post abortion hemorrhage

Question 24

ergot alkaloids prototypes

Answer 24

1. Methylergonovine (Methergine)

2. Ergonovine (Ergotrate)

Question 25

Ergot alkaloids action

Answer 25

substances that come from ergot, a dry substance that grows on rye plants. they cause 1.strong uterine contractions by stimulating the smooth muscle in the uterus

Question 26

Ergot alkaloids SEs

Answer 26

Ses are rare for oral admin 1. HTN 2. N/V and headache 3. bradycardia 4. seizures

Question 27

Ergot alkaloids interventions

Answer 27

1. monitor BP and heart rate 2. monitor for n/v and headaches and note worsening headaches 3. watch for seizures

Question 28

Ergot alkaloids admin

Answer 28

1. check BP and hold if BP is greater then 140 | 2. dont give until both fetus and placenta have been delivered

Question 29

ergot alkaloids teaching

Answer 29

report headache nausea and weakness/palpitations

Question 30

ergot alkaloids contraindications

Answer 30

1. induction of labor 2. HTN 3. Cardiac disease

Question 31

Ergot alkaloids interactions

Answer 31

1. parenteral sympathomimetics and triptans can cause HTN | 2. Protease inhibitors and itraconazole increase risk of toxicity

Question 32

Synthetic prostaglandins uses

Answer 32

promote effacement (softening, shortening, dilating of the cervix)

Question 33

synthetic prostaglandin prototype

Answer 33

1. Dinoprostone (Cervidil) | 2. Misoprostol (cytotec)

Question 34

synthetic prostaglandin action

Answer 34

1. activates collagenase which breaks down the rigid collagen complex that keeps the cervix closed and inflexible. Then it softens the cervix and stimulates labor by starting uterine contractions.

Question 35

synthetic prostaglandins SEs

Answer 35

1. uterine hyperstimulation 2. N/V/D 3. Fever

Question 36

synthetic prostaglandin interventions

Answer 36

1. monitor contractions 2. maintain hydration 3. monitor temperature - fever is expected within 15-45 mins after instillation and resolves within 2-4 hours

Question 37

prostaglandin admin

Answer 37

1. when giving the gel from have patients void prior to insertion 2. have patients lie supine after insertion and remain supine for 30 mins

Question 38

prostaglandins teaching

Answer 38

1. report n/v/d and fever | 2. increase clear fluids

Question 39

prostaglandin contraindications

Answer 39

1. acute PID 2. active cardiac/lung disease 3. liver or kidney impairment

Question 40

prostaglandins interactions

Answer 40

oxytocic agents increase risk for hyperstimulation