Last Pharm session!!!
- increase synthesis of DNA, and proteins.
- can cause Na retention and lower cholesterol
- For estrogen deficiency, osteoporosis prevention and health
- SE: WEIGHT GAIN, changes in menses pattern
- gain about 5lbs of weight from the medication.
- cautions: endometrial cancer with use over 2 years, do not give to breast feeding women, effects liver, clotting(MI, Stroke), bladder stones,
- contraindications: breast cancer, abnormal vaginal bleeding, Thrombophlebitis, PE, hyperCa, endometriosis
- smoking can increase cardiac issues and chance of stroke.
- Progestin (megace)
- changes the thickness of the endometrial lining for the embryo to attach to
- suppression of ovulation during pregnancy
- increase appetite which is helpful in anorexia and HIV
- For hormone imbalance, to start bleeding or stop vaginal bleeding
- about the same dose for starting and stopping bleeding
- older meds had higher amounts of the hormones, which caused higher levels of side effects
- lower dose now and based on a thin teenager, so less effective in a heavier people
- tested originally in male beagle dogs
- Action: inhibit FSH and LH secretion, impairs implantation, increases cervical mucus to hinder sperm.
- SE: gallstones, acne, increased clotting, changes in menses, weight gain
- can help with anemia but lessening vaginal bleeding.
- protection against pregnancy if the person remembers to take it
- Phasic – the number of times that the progestin increases from one to three (mono, bi, tri)
- Seasonale meds are 3 months on then three months off developed for Sally Wright so that she could go to space.
- YAZ is similar to aldosterone(diuretic) , higher risks of clotting, there is a link to glaucoma after taking for two years. Get your ocular changes checked.
non pill contraceptives
- insert for 3 wk
- take out after menses
- higher risk of clot than PO
- change wkly, three in a box
- do not put on the breast
- Higher risk of clot than PO
- long acting progestin only
- Implanon – inserted in the arm (3-5 years)
- Depo – Provera (IM injection every 3 months) can cause BONE LOSS
- IUD (5 years)
- side effects: vaginal bleeding MM pain, wt gain
- Low-dose progestogens
- no estrogen and less effective,
- for during breast feeding
- miss one tab – take one now
- miss two – take two each of the next two days
- miss three – stop and use a different contraceptive until period.
- Indomethacin will close the ductus arteriosus so do not take it during pregnancy
- Herbals do not have evidence
- SERMs help bones but increases hot flashes.
- Ospemifene (osphena)
- not an immediate impact take for 3 months
- viagra for women
- low % of benefit
- can take hormone replacement for 5 years if the woman starts during menopause.
- schedule II drug
- useful for osteoporosis to increases the building blocks for bone growth
- indicated for hypogonadism, androgen deficiency, may reverse ED, delayed male puberty.
- PO, IM, patches, skin gel
- SE: ab pain, insomnia, gynecomastia, frequent erections, prostate growth, frequent urination
- what group of HTN meds can reduce BPH
- alpha blockers
many drugs lower the labido of a man
many herbals for this but none are proven.
- Alprostadil (prostaglandin)
- injection into the corpus cavernosus
- sildenafil (Viagra)
- action: increase cGMP levels, relaxes smooth muscle, increases blood flow to the erection
- PO one hour before activity
- a pilot cannot take this 6-8 hr before a flight because there are changes in color vision. cannot see runway lights correctly.
- report blue color changes!
- drink 2L of water a day
- can develop dependence if taken when they do not need to.
- does not need alpha blocker meds
- works for 36 hours
- 5mg daily, or 20mg prn
- NOT interchangeable!!
- can cause a heart attack if taking the 20mg daily.
epogen – for anemia reversal
Alu hydroxide(antacid), Ca acetate – to bind extra phosphate
calcitriol (rocaltrol) – vitamin D supplement, activated vit D
HyperK – arrhythmia issues, causes spiked T wave,
- Kayexalate – cation exchange resin, binds K and takes it out of the system.
- Given in enama form and can cause a vagal response slowing down the heart.
- Insulin can decrease K levels
Diuretics – loop and osmotic to deal with fluid balance
Na Bicarbonate – to make the pH more basic
- watch out for the interactions with other meds in the IV line causing the line to clot up and not be patent.
- can hold on to water, so cardiac, pulmonary, and