Drugs Used in Men’s and Women’s Health

Chapter 41Chapter 41

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Chapter 41

Lesson 41.1

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ObjectivesObjectives

• Identify common organisms known to cause leukorrhea

• Cite the generic and brand names of products used to treat Candida albicans, Trichomonas vaginalis, and Gardnerella vaginalis

• Discuss specific interviewing techniques that can be used to obtain a history of sexual activity

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Objectives (cont’d)Objectives (cont’d)

• Review specific techniques for administering vaginal medications

• Develop a plan for teaching self-care to women and men with sexually transmitted diseases. Include personal hygiene measures, medication administration, methods of pain relief, and prevention of spread of infection or reinfection

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VaginitisVaginitis

• Leukorrhea is not a disease but symptom of an underlying disorder

• Most common cause is infection of the lower reproductive tract Common organisms: Candida albicans,

Trichomonas vaginalis, Gardnerella vaginalis

• Products to treat vaginitis Miconazole (Monistat) Metronidazole (Flagyl) See Table 41-2 for further discussion

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Nursing AssessmentNursing Assessment

• Be aware of increasing frequency of sexual activity among adolescents

• History of current symptoms• Medication history• Psychosocial considerations• Laboratory and diagnostic studies• Physical examination• Proper approach and use of confidential

information will encourage responses during interviews

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Sexually Transmitted DiseasesSexually Transmitted Diseases

• Instructions for adolescents Rate of STDs is high among those who have

unprotected sexual contact with multiple partners

Do thorough assessment of sexual activity and practices

For those sexually active, counsel regarding safe sex practices and voluntary testing

All adolescents should be taught about abstinence and safe sex practices

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Instructions for WomenInstructions for Women

• Teaching self-care regarding STDs Refrain from using irritating vaginal

substances Warm sitz baths may help relieve irritation Discuss good personal hygiene practices Hormonal and surgical contraceptive methods

do not protect against STDs Use chemical and physical barriers such as

condoms Properly apply vaginal medications

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Instructions for MenInstructions for Men

• Teaching self-care regarding STDs Discuss good personal hygiene practices Discuss appropriate interventions for men with

altered sexual function Latex condoms can be effective in reducing

transmission of HIV and some STDs, but are not effective against STDs transmitted by skin-to-skin contact

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Chapter 41

Lesson 41.2

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ObjectivesObjectives

• Compare the active ingredients in the two types of oral contraceptive agents

• Differentiate between the actions and the benefits of the combination pill and the minipill

• Describe the major adverse effects and contraindications to the use of oral contraceptive agents

• Develop specific patient education plans to be used to teach a patient to initiate oral contraceptive therapy with the combination pill and the minipill

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Objectives (cont’d)Objectives (cont’d)

• Identify the patient teaching necessary with the administration of the transdermal contraceptive and the intravaginal hormonal contraceptive

• Describe pharmacologic treatments of benign prostatic hyperplasia

• Describe the pharmacologic treatment of erectile dysfunction

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Drug Class: Oral ContraceptivesDrug Class: Oral Contraceptives

• Actions Estrogens block the pituitary release of FSH;

progestins inhibit pituitary release of LH

• Uses Induce contraception by inhibiting ovulation

• Common adverse effects Nausea, weight gain, depression

• Serious adverse effects Breakthrough bleeding, yeast infection, blurred

vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute abdominal pain

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Drug Class: Oral ContraceptivesDrug Class: Oral Contraceptives

• Types Combination pill – taken for 21 days of the

menstrual cycle; contains estrogen and progestin• Subdivided into three classes: monophasic,

biphasic, triphasic Minipill – taken every day; contains only

progestin Extended and continuous–cycle – 24-day or

84-day cycles followed by a short placebo period

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Drug Class: Drug Class: Transdermal ContraceptivesTransdermal Contraceptives

• Drug: norelgestromin–ethinyl estradiol transdermal system (Ortho Evra)

• Actions Inhibit ovulation

• Uses Estrogen and progestin hormones are in patch

form• Common adverse effects

Nausea, weight gain, depression• Serious adverse effects

Blurred vision, severe headaches, dizziness, leg pain, chest pain, shortness of breath, acute abdominal pain

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Drug Class: Intravaginal Drug Class: Intravaginal Hormonal ContraceptiveHormonal Contraceptive

• Drug: etonogestrel–ethinyl estradiol vaginal ring (NuvaRing)

• Actions Estrogen and progestin inhibit ovulation

• Uses Plastic ring dosage form is inserted into vagina

• Common adverse effects Nausea, weight gain, spotting, depression,

mood changes, headaches, insomnia, fatigue, lack of energy

• Serious adverse effects Leg pain, chest pain, shortness of breath

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Drug Class: Alpha-1 Adrenergic Drug Class: Alpha-1 Adrenergic Blocking AgentsBlocking Agents

• Actions Block alpha-1 receptors on the prostate gland,

causing muscle relaxation, allowing greater urinary outflow

• Uses Reduce mild to moderate urinary obstruction

in men with BPH

• Common adverse effects Drowsiness, headache, dizziness, weakness,

lethargy; tachycardia, fainting

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Drug Class: Antiandrogen AgentsDrug Class: Antiandrogen Agents

• Drug: dutasteride (Avodart)• Actions

Inhibit enzyme 5-alpha reductase, reduce DHT levels

• Uses Treat symptoms of BPH, reduce risks of

urinary retention, minimize need for surgery for BPH

• Common adverse effects Impotence, decreased libido, decreased

volume of ejaculate

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Drug Class: Antiandrogen Agents Drug Class: Antiandrogen Agents (cont’d)(cont’d)

• Drug: finasteride (Proscar)• Actions

Inhibit enzyme 5-alpha reductase, reduce DHT levels

• Uses Treat symptoms of BPH, reduce risks of

urinary retention, minimize need for surgery for BPH, treat male pattern baldness

• Common adverse effects Impotence, decreased libido, decreased

volume of ejaculate

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Drug Class: Drug Class: Phosphodiesterase InhibitorsPhosphodiesterase Inhibitors

• Actions Selective inhibitor of PDE-5 enzyme

• Uses Treat male erectile dysfunction; pulmonary

arterial hypertension

• Common adverse effects Headache, flushing of the face and neck, color

vision impairment

• Serious adverse effects Hypotension, dizziness, angina, loss of vision,

sustained erection

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