Female Reproductive Medications - Pharmacology - Reproductive System | @LevelUpRN

Summary

In this Level UP RN video, Cathy covers reproductive system medications, including estrogens, progestins, uterine stimulants, and tocolytic agents. She discusses their uses, side effects, and contraindications, emphasizing the risks of blood clots and bone loss. Key points include monitoring contractions during oxytocin use and the short-term use of terbutaline for pre-term labor. A quiz tests viewers' understanding of the material.

Takeaways

• 🔴 Estrogen medications, including conjugated estrogen and estradiol, are used for contraception, postmenopausal osteoporosis, dysmenorrhea, and prostate cancer.
• ⚠️ Estrogen use increases the risk of blood clots, hypertension, weight gain, edema, and certain types of cancer, making it contraindicated for smokers, those with hypertension, or increased blood clot risk.
• 💊 Progesterone medications like medroxyprogesterone and norethindrone are used for contraception and dysmenorrhea treatment, with similar risks as estrogens, including blood clots and breast cancer.
• 🚫 Injectable medroxyprogesterone (Depo-Provera) carries a black box warning for bone loss, necessitating increased calcium and vitamin D intake.
• 🤰 Uterine stimulants such as oxytocin and dinoprostone are used to induce and enhance labor, with side effects like painful contractions and uterine rupture.
• 👶 Oxytocin is also used to treat postpartum hemorrhage and should be monitored closely for appropriate contraction frequency and duration.
• 💊 Methylergonovine is a uterine stimulant used for postpartum hemorrhage, with side effects like abdominal pain, nausea, and hypertension.
• 🛫 Tocolytic agent terbutaline is used to delay pre-term labor, working by activating Beta-2 receptors for bronchodilation and uterine relaxation, but it has many side effects and a black box warning for long-term use.
• 🚫 Terbutaline should be used for short-term (under 48 hours) and in pregnancies under 37 weeks to prevent maternal and fetal distress.
• 📚 Other tocolytic agents for pre-term labor include magnesium sulfate and nifedipine, a calcium channel blocker.

Q & A

What are estrogens used for?

Estrogen medications are used for contraception, postmenopausal osteoporosis, dysmenorrhea, and prostate cancer.

What are the key side effects of estrogens?

Key side effects of estrogens include embolic effects such as blood clots, hypertension, weight gain, edema, and increased risk of certain types of cancer.

Why are estrogens contraindicated in certain patients?

Estrogens are contraindicated in patients who smoke, have hypertension, or are at increased risk for blood clotting.

What are progesterone medications used for?

Progesterone medications are used for contraception, either alone or in combination with estrogen, and in the treatment of dysmenorrhea.

What side effects are associated with progesterone medications?

Side effects of progesterone include an increased risk for embolic events or blood clots, menstrual changes, edema, and an increased risk for breast cancer.

Why is injectable medroxyprogesterone associated with a risk of bone loss?

Injectable medroxyprogesterone, also known as Depo-Provera, carries a black box warning due to the risk of decreased bone mineral density.

What are uterine stimulants and what are they used for?

Uterine stimulants, such as oxytocin and dinoprostone, are used in the induction and enhancement of labor, and oxytocin is also used in the treatment of postpartum hemorrhage.

What are the side effects of uterine stimulants?

Side effects of uterine stimulants can include painful contractions and uterine rupture.

How should healthcare providers monitor contractions in patients receiving oxytocin?

Contractions should be monitored to ensure they are between 60 and 90 seconds in duration and occur every two to three minutes.

What is the role of magnesium sulfate in the context of uterine stimulants?

Magnesium sulfate can be used to help relax the uterus if there is hyper-stimulation due to oxytocin.

What is the primary use of terbutaline as a tocolytic agent?

Terbutaline is used in the treatment of pre-term labor to delay labor, although it will not prevent it.

What are the side effects of terbutaline?

Side effects of terbutaline include tachycardia, restlessness, and tremor.

What is the significance of the black box warning associated with terbutaline?

The black box warning for terbutaline indicates a risk for significant maternal and fetal distress if it's used for over 48 hours.