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hormones and reproduction drugs (androgens:(Danazol ....fluoxymesterone)…
hormones and reproduction drugs
androgens:(Danazol ....fluoxymesterone)
side effects
Common effects: headache (possibly related to fluid and electrolyte changes), dizziness, sleep disorders and fatigue, rash, and altered serum electrolytes.
A potentially life-threatening effect that has been documented is hepatocellular cancer.
Antiestrogen effects: flushing, sweating, vaginitis, nervousness, and emotional lability.
Androgenic effects: acne, edema, hirsutism (increased hair distribution), deepening of the voice, oily skin and hair, weight gain, decrease in breast size, and testicular atrophy.
indications
is used for treatment of endometriosis, fibrocystic breast disease, and hereditary angioedema. It does this by inhibiting the hypothalamic-pituitary-adrenal (HPA) and gonadotropin-releasing hormones (GnRH), leading to a drop in follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
route of administration
administered orally
mechanism of action
Increase the retention of nitrogen, sodium, potassium, and phosphorus and decrease the urinary excretion of calcium.
Increase protein anabolism and decrease protein catabolism.
Growth and development of male sex organs and the maintenance of secondary male sex characteristics.
Increase the production of red blood cells.
storage conditions
keep out of reach
keep in a cool dry place
keep in a tight container
away from sun light
contraindications
Presence of prostate or breast cancer in men.
Liver dysfunction, CV disease
lactation. Potential adverse effects on the neonate
risk of thromboembolic events, fetal abnormalities, hepatitis, and intracranial hypertension.
allergy to androgens or other ingredients in the drug
nursing consideration
Perform a thorough physical assessment
Arrange for radiographs of the long bones in children to assess for testosterone effects on growth.
Assess for the mentioned cautions and contraindications (e.g. drug allergy, hepatic dysfunction, CV diseases, breast/prostate cancer in men, etc.)
anabolic steroids:(alprostadil.....oxymetholone)
storage conditions
keep out of reach of children
keep away from light
store the pills in a cool dry place
indication
Promote weight gain and tissue repair in debilitated patients and protein anabolism in patients who are receiving long-term corticosteroid therapy.
Anemias, certain cancers, and angioedema
use illegally for the enhancement of athletic performance by promoting increased muscle mass, hematocrit, strength, and endurance.
route of administration
subcutaneous injection
intramuscular injection
orally
topically
mechanism of action
Reverse catabolic or tissue-destroying processes
Increase hemoglobin and red blood cell mass.
Promote body tissue-building processes.
contraindication
Allergy to androgens or other ingredients in the drug
Pregnancy, lactation.
Liver dysfunction.
Coronary disease.
Prostate/breast cancer in males
side effects
In prepubertal males: virilization (e.g. phallic enlargement, hirsutism, increased skin pigmentation).
In postpubertal males: inhibition of testicular function, gynecomastia, testicular atrophy, priapism (painful and continual erection of the penis), baldness, and change in libido.
In women: hirsutism, hoarseness, deepening of the voice, clitoral enlargement, baldness, menstrual irregularitie.
nursing cosideration
Perform a thorough physical assessment
Arrange for radiographs of the long bones in children to assess for testosterone effects on growth.
Assess for the mentioned cautions and contraindications
estrogens:(estropipate ...desogestrel)
mechanism of action
Affect the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
Responsible for the proliferation of the endometrial lining and are known to compete with androgens for receptor sites.
The most potent endogenous female sex hormone responsible for estrogen effects on the body.
The loss of estrogen is responsible for the signs and symptoms of menopause in the uterus, vagina, breasts, and cervix.
indications
Used as palliation for the discomforts of menopause in the first few years of menopause, when many of the beneficial effects of estrogen are lost.
Treat female hypogonadism and ovarian failure; to prevent postpartum breast engorgement.
Used for hormone replacement therapy (HRT) in small doses when ovarian activity is blocked or absent.
To slow bone loss in osteoporosis.
Palliation of cancers that have known receptor sensitivity.
side effects
Systemic effects: fluid retention, electrolyte disturbances, headache, dizziness, mental changes, weight changes, edema
GU: breakthrough bleeding, menstrual irregularities, dysmenorrhea, amenorrhea, changes in libido
GI: nausea, vomiting, abdominal cramp, bloating, colitis, acute pancreatitis, cholestatic jaundice, hepatic adenoma
contraindication
allergy to estrogen
History of thromboembolic disorders
Idiopathic vaginal bleeding, breast cancer, estrogen-dependent cancer.
Hepatic dysfunction
Pregnancy
Metabolic bone disease
Renal insufficiency.
Metabolic bone disease
nursing consideration
Perform a thorough physical assessment
Assess for the mentioned cautions and contraindications
Assist with pelvic and breast examinations
Arrange for ophthalmic examination especially for patients who are wearing contact lenses because hormonal changes can alter the fluid in the eye and curvature of the cornea, which can change the fit of contact lenses and alter visual acuity.
Monitor laboratory test results
storage conditions
keep out of reach of childern
keep out of light
keep in a tight container
route of administration
orally
subcutaneous implant
topically-transdermal
progestins:(medroxyprogesterone.. norgestrel)
mechanism of action
Prevent follicle maturation and ovulation as well as uterine contraction.
Exact mechanism of action in its function as a contraceptive is not known but it it thought that circulating progestins and estrogens “trick” the hypothalamus and pituitary and prevent the release of gonadotropin-releasing hormone (GnRH), FSH, and LH. Therefore, follicle development and ovulation are prevented.
Transform the proliferative endometrium into a secretory endometrium. They also inhibit the secretion of FSH and LH.
indications
Prevent follicle maturation and ovulation as well as uterine contraction.
Exact mechanism of action in its function as a contraceptive is not known but it it thought that circulating progestins and estrogens “trick” the hypothalamus and pituitary and prevent the release of gonadotropin-releasing hormone (GnRH), FSH, and LH. Therefore, follicle development and ovulation are prevented.
Transform the proliferative endometrium into a secretory endometrium. They also inhibit the secretion of FSH and LH.
contraindications
Drosperinone is contraindicated in patients who are at risk for hyperkalemia due to its antimineralocorticoid effects and the risk of hyperkalemia.
Pelvic inflammatory disease (PID), sexually transmitted diseases,
epilepsy migraine headaches, asthma, cardiac or renal dysfunction. Potential exacerbation of these conditions.
side effects
Dermal patch contraceptives are associated with same systemic effects, as well as local skin irritation.
Vaginal gel use is associated with headache, nervousness, constipation, breast enlargement, and perineal pain.
Systemic effects are similar to estrogen.
Vaginal use is associated with local irritation and swelling.
Intrauterine systems are associated with abdominal pain, endometriosis, abortion PID, and expulsion of the intrauterine device.
nursing considerations
Assist with pelvic and breast examinations
Arrange for ophthalmic examination especially for patients who are wearing contact lenses because hormonal changes can alter the fluid in the eye and curvature of the cornea, which can change the fit of contact lenses and alter visual acuity.
Perform a thorough physical assessment
Monitor laboratory test results (e.g. urinalysis, renal and hepatic function tests, etc.) to determine possible need for a reduction in dose and evaluate for toxicity.
Assess for the mentioned cautions and contraindications (e.g. drug allergies, cardiovascular diseases, metabolic bone disease, history of thromboembolism, etc.) to prevent any untoward complications.
route of administration
topical-transdermal
subcutaneous implant
orally
storage conditions
keep in a tight and well sealed container
keep away from children
store in a cool dry place , away from light