Drugs Affecting The Female Reproductive System

Drugs affecting
the female
reproductive
system
Drugs Used to Treat Disorders of
the Female Reproductive System
Estrogen and Progestins
Estrogen Receptor Modulators
Fertility Drugs
Oxytocics
Abortifacients
Tocolytics
estrogen
Actions
- Protecting the heart from atherosclerosis
- Retaining calcium in the bones
- Maintaining the secondary female sex characteristics
Indications
- Hormone replacement therapy (HRT)
- Palliative and preventive therapy during menopause
estrogen (Cont.)
Pharmacokinetics
- Absorbed through the GI tract and undergoes extensive
hepatic metabolism
- Excreted in the urine
Contraindications
- Allergies and pregnancy
– Idiopathic vaginal bleeding, breast cancer, and
estrogen dependent cancer, thromboembolic disorders
estrogen (Cont.)
Caution
- Breast feeding, metabolic bone disease, renal,
insufficiency, hepatic impairment
Adverse Effects
- GI tract
- Systemic effects of estrogens
Drug-to-Drug Interactions
- Drugs that enhance hepatic metabolism
- Corticosteroids
Prototype Estrogen
Actions
- Modulating effects on estrogen receptors
- Used to stimulate specific estrogen receptors to
increase bone mineral density
Indications
- Postmenopausal osteoporosis
Pharmacokinetics
- Well absorbed in the GI tract, metabolized in the liver
- Excreted in the feces
Estrogen Receptor Modulators (CONT.)
Contraindications
- Known allergy, pregnancy, and lactation
- Patients with history of venous thrombosis or smoking
Adverse Effects
- GI upset
- Changes in fluid balance: headache, dizziness, and
visual changes
- Estrogen receptor stimulation: hot flashes, skin rash,
edema, and vaginal bleeding
(CONT.)
- Cholestyramine
- Highly protein-bound drugs
- Warfarin
Prototype Estrogen Receptor Modulators
Progestins
Actions
- Transform the proliferative endometrium into a secretory endometrium
- Inhibit the secretion of FSH and LH
- Prevent follicle maturation and ovulation
- Inhibit uterine contractions
Indications
- Contraception
- Treatment of primary and secondary amenorrhea
- Fertility protocols
Pharmacokinetics
- Well absorbed, undergo hepatic metabolism and are excreted in the urine
Progestins (CONT.)
Contraindications
- Allergies, pregnancy, idiopathic vaginal bleeding, breast or
genital cancer, history of thromboembolic disorders, PID,
sexually transmitted disease, endometriosis, or pelvic surgery
Adverse Effects
- Varies based on route of administration
- Barbiturates, Carbamazepine, Phenytoin, or Rifampin
Prototype Progestins
Fertility Drugs
Actions
-Directly or by stimulating the hypothalamus to increase
FSH and LH levels, leading to ovarian follicular
development and maturation of ova
Indications
- Infertility in men and women
Pharmacokinetics
- Well absorbed, undergo hepatic metabolism and renal
excretion
Fertility Drugs (cont.)
Contraindications
- Primary ovarian failure
- Thyroid or adrenal dysfunction
- Ovarian cysts
- Pregnancy, idiopathic uterine bleeding, and known
allergy
Caution
- Breast feeding, thromboembolic disease, or respiratory
disease
Fertility Drugs (cont.)
Adverse Effects
- Increase risk of multiple births and birth defects
- Ovarian overstimulation
- Headache, fluid retention, nausea, bloating
- Uterine bleeding, ovarian enlargement
- Gynecomastia
Prototype Fertility Drugs
Oxytocics
Actions
-Affect neuroreceptors sites to stimulate contractions of
the uterus
Indications
- Prevention and treatment of uterine atony after delivery
Pharmacokinetics
- Rapidly absorbed, metabolized in the liver, and excreted
in urine and feces
Oxytocics (cont.)
Contraindications
- Allergy and early pregnancy
- Cephalopelvic disproportion
Caution
- Coronary artery disease, hypertension, lactation, and
previous Cesarean section
Oxytocics (cont.)
Adverse Effects
- Excessive effects: uterine hypertonicity and spasm
- GI upset (nausea)
- Headache
- Blood pressure changes
- Water intoxication
Prototype Oxytocics
Abortifacients
Actions
-Stimulate uterine activity
- Dislodge any implanted trophoblast and preventing
implantation of fertilized egg
Indications
-Termination of pregnancy at 12-20 weeks
Pharmacokinetics
- Well absorbed, metabolized in the liver and excreted in
the urine
Abortifacients (cont.)
Caution
- Asthma, hypertension, or adrenal disease
- Acute vaginitis or scarred uterus
Adverse Effects
- Abdominal cramping
- Heavy uterine bleeding
- Perforated uterus or uterine rupture
- Headache, nausea, vomiting, diarrhea, diaphoresis,
backache, and rash
Prototype Abortifacients
Tocolytics
Uses
- Relax the uterine smooth muscle and prevent
contractions leading to premature labor and delivery
- Usually reserved for use after 20 weeks of gestation;
neonate has a chance of survival outside the uterus
Uses
- Only one in US: Ritodrine (Yutopar); withdrawn because
of serious side effects
Nursing Considerations for Estrogen or
Estrogen Receptor Modulators, Progestins,
Fertility Drugs, Oxytocics, Abortifacients
Assessment: History and Physical Exam

Nursing Diagnosis
Implementation
Evaluation

Drugs Affecting The Female Reproductive System

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Assessment: History and Physical Exam

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