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Drugs Affecting Reproduction

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by

Jennifer Thankachan

on 28 March 2016

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Transcript of Drugs Affecting Reproduction

The Female Reproductive Cycle
Oral Contraceptives
*daily PO hormone therapy aimed at preventing the adult ovulating female from achieving pregnancy (nearly 100% effective at this, although some concurrent drug therapies interfere)

*some unpleasant adverse effects: nausea, weight gain, etc.

**increased risk for adverse health events: forming blood clots (especially in patients who smoke while on oral contraceptives), stroke, MI
Menopause
progressive decrease in estrogen secretion by ovaries
leads to cessation of menses
natural consequence of aging
s/s: hot flashes, night sweats, irregular bleeding, etc.
many women opt for HRT, although tx has been linked to increased incidence of MI, stroke, breast CA, etc.

Emergency Contraception
*oral contraceptive drugs may also be used incidentally in order to
prevent
unwanted pregnancy when it is believed likely to occur (Plan B, which is OTC and Ella, which is prescription)
Drugs Affecting Reproduction
Jennifer Thankachan, RN, MSN
Pharmacologic Abortion
*use of drugs to remove an embryo after implantation has occurred (prescription only)
Male Reproductive Issues
center around
testosterone production
testosterone insufficiency cause may be:
primary/direct or
secondary/indirect
regardless of the cause, low testosterone levels lead to issues with male fertility, libido and sexual function
Treating Testosterone Insufficiency
low testosterone can be replaced, however, this hormone therapy is not always well tolerated
cannot be taken PO; must be given IM or transdermally, although implantable pellets and buccal routes are available
many adverse effects possible
transdermal application can cause extreme irritation and burning of the skin
Erectile Dysfunction
incidence increases with age
may be associated with disease processes or psychogenic in nature
smoking increases the risk
impotence is also an adverse effect of many commonly prescribed medications (thiazides, SSRIs, ACE inhibitors, etc.)
Treating ED
prior to the discovery of Viagra, the mainstay for treating ED was implantable penile devices
when Viagra went on the market in 1998, it broke all sales records for new drugs in U.S. History
acts by relaxing smooth muscle in the penis to allow for increased blood flow
does not cause erection, but can enhance it
***cannot be taken with nitrates (deadly combo.)
three additional drugs of the same class quickly emerged following Viagra's warm reception (Cialis, Levitra, Stendra)
Benign Prostatic Hyperplasia (BPH)
enlargement of the prostate
can hinder/obstruct outflow of urine
s/s: increased urinary frequency, increased urgency to urinate, post-void leakage, nocturia, decreased force of urine stream, incomplete bladder emptying
potential complications: infection, renal failure
Treating BPH with Medications:
alpha1 blockers
selective alpha1 blockers relax smooth muscle of the GU system and some are therapeutic for HTN as well (often a co-morbidity to BPH):
doxazosin & terazosin treat both BPH & HTN
alfuzosin & tansulosin treat only BPH
adverse effects: HA, fatigue, dizziness for all; ejaculatory dysfunction with tamsulosin; relfex tachycardia possible with all alpha1 blockers
Treating BPH with Medications: 5-alpha reductase inhibitors
these drugs promote shrinkage of enlarged prostates by inhibiting metabolism of testosterone
adverse effects: mild & rare; can cause sexual dysfunction
***special considerations due to hormone manipulation:
pregnant women should not handle this drug as it could absorb through the skin and harm the fetus
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