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REPRODUCTIVE SYSTEM DRUGS (Abortifacients (CONTRAINDICATION (Allergy to…
REPRODUCTIVE SYSTEM DRUGS
MALE REPRODUCTIVE DRUGS
Androgens
TYPES OF DRUGS
danazol
fluoxymesterone
testosterone
methyltestosterone
SIDE EFFECT
Androgenic effects, acne, edema, hirsutism, deepening of the voice, oily skin and hair, weight gain and testicular atrophy
Antiestrogen effects, flushing, sweating, nervousness, and emotional lability.
Common effects: headache, dizziness, sleep disorders and fatigue, rash, and altered serum electrolytes
CONTRAINDICATIONS
Danazol has Black Box warning regarding the risk of thromboembolic events, fetal abnormalities, hepatitis, and intracranial hypertension
Liver dysfunction, CV disease. Can be exacerbated by the effects of the hormones.
Potential adverse effects on the neonate. It is not clear whether androgens enter breast milk.
Topical forms of testosterone have a Black Box Warning alerting user to the risk of virilization in children who come in contact with the drug from touching the clothes and skin of the man using the drug.
ROUTE OF ADMINISTRATION
IM
IM cypionate
IM enanthate
Dermal
INDICATIONS
used for treatment of endometriosis, fibrocystic breast disease, and hereditary angioedema.
MECHANISM OF ACTION
nhibiting the hypothalamic-pituitary-adrenal (HPA) and gonadotropin-releasing hormones (GnRH), leading to a drop in follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Anabolic Steroids
INDICATIONS
Anemias, and angioedema
certain cancers
Promote weight gain and tissue repair in debilitated patients
SIDE EFFECT
In prepubertal males: virilization, e.g. phallic enlargement,
In postpubertal males: inhibition of testicular function, gynecomastia, testicular atrophy, priapism and change in libido.
In women: hirsutism, hoarseness, deepening of the voice, clitoral enlargement, baldness, menstrual irregularitie.
CONTRAINDICATIONS
carcinoma of the prostate and mammary carcinoma in the male.
Coronary disease, Potentional increase in cholesterol level through the effect of the drug on the liver.
MECHANISM OF ACTION
They increase the production of proteins
They reduce recovery time by blocking the effects of stress hormone cortisol on muscle tissue, so that catabolism of muscle is greatly reduced.
Inhibiting the action of other steroid hormones called glucocorticoids that promote the breakdown of muscles
also affect the number of cells that develop into fat-storage cells, by favouring cellular differentiation into muscle cells.
TYPES OF ANABOLIC STEROIDS
oxandrolone
oxymetholone
ROUTE OF ADMINISTRATION
Per Oral
Penile Erectile Dysfunction Drugs
CONTRAINDICATIONS
anatomical obstruction or condition that might predispose to priapism.
Penile implants.
Bleeding disorders, CV diseases, optic neuropathy, severe hepatic and renal disorders.
SIDE EFFECT
pain at injection site, infection, priapism, fibrosis, rash.
Effects associated with PDE5 inhibitors: headache, flushing, dyspepsia, urinary tract infection, diarrhea, dizziness,.
INDICATIONS
Treatment of penile erectile dysfunction.
ROUTE OF ADMINISTRATION
Buccal
MECHANISM OF ACTION
prostaglandin alprostadil and phosphodiesterase type 5 (PDE5) receptor inhibitor sildenafil.
Alprostadil acts locally to relax the vascular smooth muscle and allow filling of the corpus cavernosum, causing penile erection
PDE5 receptor inhibitors act to increase nitrous oxide levels in the corpus cavernosum. Nitrous oxide activates the enzyme (cGMP) to cause smooth muscle relaxation and increased flow of blood.
Ind
TYPES OF PED Drugs
alprostadil
sildenafil
tadalafil
vardenafil
FEMALE REPRODUCTIVE DRUGS
Estrogens
TYPES OF DRUGS
estradiol
estrogens, conjugated
estrogens, esterified
estropipate
desogestrel
INDICATIONS
Used for hormone replacement therapy in small doses when ovarian activity is blocked
Used as palliation for the discomforts of menopause in the first few years of menopause
Treat female hypogonadism and ovarian failure, to prevent postpartum breast engorgement.
To slow bone loss in osteoporosis.
Palliation of cancers that have known receptor sensitivity.
CONTRAINDICATIONS
Allergy to estrogens. Prevent hypersensitivity reactions.
Idiopathic vaginal bleeding, breast cancer
cerebrovascular accident, heavy smokers.
Hepatic dysfunction. Estrogen have effects on liver function.
Pregnancy. Estrogen are linked to serious fetal defects
Lactating women. Possible effects to the neonate
Estrogen has bone-conserving effect and could exacerbate the diseases
Renal insufficiency. Can interfere with the renal excretion of the drug
Hepatic impairment. Can alter the metabolism of the drug and increase the risk for the adverse effects, including those on the liver
SIDE EFFECTS
GI: nausea, vomiting, abdominal cramp, colitis, acute pancreatitis, cholestatic jaundice,
GU: breakthrough bleeding, menstrual irregularities, dysmenorrhea, amenorrhea, changes in libido
Systemic effects: fluid retention, electrolyte disturbances, headache, dizziness, mental changes, weight changes, edema
ROUTE OF ADMINISTRATION
Per Oral
Progestins
MECHANISM OF ACTION
Transform the proliferative endometrium into a secretory endometrium.
Prevent follicle maturation and ovulation as well as uterine contraction.
Progestins and estrogens “trick” the hypothalamus and pituitary and prevent the release of (GnRH), FSH, and LH. Therefore, follicle development and ovulation are prevented
TYPES OF PROGESTINS
medroxyprogesterone
norethindrone acetate
norgestrel
progesterone (generic)
ulipristal
CONTRAINDICATIONS
Progestins have effects on the vasculature of the uterus
Drosperinone is contraindicated in patients who are at risk for hyperkalemia due to its antimineralocorticoid effects and the risk of hyperkalemia.
Epilepsy, migraine headaches, asthma, cardiac or renal dysfunction.
SIDE EFFECT
Systemic effects are similar to estrogen.
Vaginal gel use is associated with headache, nervousness, constipation, breast enlargement
Intrauterine systems are associated with abdominal pain, endometriosis, abortion PID
Vaginal use is associated with local irritation and swelling
ROUTE OF ADMINISTRATION
Per Oral
INDICATION
Transform the proliferative endometrium into a secretory endometrium.
Prevent follicle maturation and ovulation as well as uterine contraction
Fertility drugs
INDICATIONS
Treatment of infertility in women with functioning ovaries whose partners are fertile.
Used to stimulate multiple follicle development for harvesting of ova for in vitro fertilization.
Cetrorelix inhibits premature LH surges in women undergoing controlled overain stimulation by acting as a GnRH antagonist.
stimulate follicular development in the treatment of infertility
CONTRAINDICATIONS
Allery to fertility drug. Prevent hypersensitivity reactions
Primary ovarian failure. These drugs only work to stimulate functioning ovaries
Thyroid or adrenal dysfunction. Drugs have effects on the hypothalamic-pituitary acxis
Ovarian cysts. Can be stimulated by the drugs and can become larger
Pregnancy. Due to the potential for serious fetal effects
Idiopathic uterine bleeding
Lactation. Risk of adverse effects on the baby
Thromboembolic disease. Increased risk of thrombus formation
Women with respiratory diseases.
SIDE EFFECT
Greatly increased risk of multiple births and birth defects
Ovarian overstimulation: abdominal plain, distention, ascites, pleural effusion
Others: headache, fluid retention, nausea, bloating, uterine bleeding, ovarian enlargement and gynecomastia
ROUTE
Per Oral
TYPES OF FERTILTY DRUGS
cetrorelix
chorionic gonadotropin
clomiphene
follitropin alfa
follitropin beta
ganirelix
lutropin alfa
menotropins
Uterine Motility Drugs
OXYTOCIN
INDICATION
Prevention and treatment of uterine atony after delivery, thus reducing the risk of postpartum hemorrhage.
TYPES OF OXYTOCIN DRUGS
ergonovine
methylergonovine
oxytocin
CONTRAINDICATION
Allery to oxytocics. Prevent hypersensitivity reactions.
Cephalopelvic disproportion, unfavorable fetal position.
Coronary disease, hypertension.
ROUTE OF ADMINSTRATION
IV
IMI
SIDE EFFECT
uterine hypertonicity and spasm,postpartum hemorrhage, decreased fetal heart rate
Common effects: GI upset, nausea, headache, dizziness
Ergotism caused by ergonovine and methylergonovine: nausea, blood pressure changes, weak pulse, dyspnea, chest pain
Oxytocin has caused severe water intoxication with coma and even maternal death when used for a prolonged period
Abortifacients
INDICATIONS
Evacuation of uterine contents via intense uterine contractions
Approved for use to terminate pregnancy at 12-20 weeks from the date of the last menstrual period.
ROUTE OF ADMINISTRATION
Intravaginal
CONTRAINDICATION
Allergy to abortifacients and prostaglandins. Prevent hypersensitivity reactions
After 20 weeks from the last menstrual period. Too late into the pregnancy for an abortion
Active PID, CV, hepatic, renal, pulmonary disease.
Lactation. Potential for serious effects on the neonate.
Asthma, hypertension, adrenal disease.
Acute vaginitis, scarred uterus.
SIDE EFFECT
Due to exaggeration of desired effects: abdominal cramping, heavy uterine bleeding, perforated uterus, uterine rupture
Others: headache, nausea, vomiting, diarrhea, diaphoresis, backache, rash
TYPES OF ABORTIFACIENTS
carboprost
dinoprostone
mifepristone
MECHANISATION OF ACTION
stimulate uterine activity, dislodging any implanted trophoblasts and preventing implantation of any fertilized egg.