McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 4 0 Drugs affecting the female reproductive system

Neves-e-Castro, M. (2003). Menopause in crisis post-Women’s Health Initiative? A view based on personal clinical experience. Human Reproduction, 18 , 2512–2518. Parke, A. & Abernethy, K. (2008). Hormone replacement therapy: Risks and benefits. Nurse Prescribing, 6(10) , 433–439. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins.

Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Robinson, G. (2012). Oral contraception for women: A brief overview. Nurse Prescribing, 10(3) , 124–145. U.S. Preventative Services Task Force. (2002). Post-menopausal hormone replacement therapy to prevent chronic conditions: Recommendations. Annals of Internal Medicine, 127 , 1–4.

C H E C K Y O U R U N D E R S T A N D I N G

4. Any person who is taking oestrogens, progestins or combination products should be cautioned to avoid smoking because: a. nicotine increases the metabolism of the hormones, making them less effective. b. the risk for potentially dangerous thromboembolic episodes increases. c. nicotine amplifies the adverse effects of the hormones. d. nicotine blocks hormone receptor sites, and they may no longer be effective. 5. Oxytocin, a synthetic form of the hypothalamic hormone, is used to: a. induce labour by stimulating uterine contraction. b. stimulate milk production in the breastfeeding woman. c. increase fertility and the chance of conception. d. relax the gravid uterus to prevent preterm labour. 6. The use of a prostaglandin drug is contraindicated in a woman: a. who is 15 weeks pregnant. b. who is older than 50 years of age. c. who has a history of four previous caesarean births. d. who is 10 weeks pregnant. 7. A young woman chooses oral contraceptives because she feels that it is not the right time for her to get pregnant. You would evaluate her teaching about the drug to be effective if she tells you which of the following? a. “I shouldn’t smoke for the first month to make sure I don’t react severely to the pills.” b. “If I forget to take a pill, I’ll just start over the next day with a new series of pills.” c. “I may not be able to wear my contact lenses while taking these pills, or I might have to be fitted for a new pair.” d. “If I have to take an antibiotic while I am using these pills, I should take double pills on those days that I am using the antibiotic.”

Answers to the questions in this chapter can be found in Appendix A in the back of this book.

MULTIPLE CHOICE Select the best answer to the following.

1. A postmenopausal woman is to receive short- term hormonal replacement therapy to control her menopausal symptoms. Which of the following would the nurse include when teaching the woman about possible adverse effects of this therapy? a. constipation b. breakthrough bleeding c. weight loss d. persistently elevated body temperature 2. An oestrogen receptor modulator might be the drug of choice in the treatment of postmenopausal osteoporosis in a woman with a family history of breast or uterine cancer. The nurse would instruct the woman that she might experience which of the following? a. constipation and dry, itchy skin b. flushing and dry vaginal mucosa c. hot flushes and vaginal bleeding d. diarrhoea and weight loss 3. Combination oestrogens and progestins are commonly used as oral contraceptives. It is thought that this combination has its effect by: a. acting to block the release of FSH and LH, preventing follicle development. b. directly suppressing the ovaries and preventing ovulation. c. keeping the endometrium constantly lush and blood filled. d. preventing menstruation, which prevents pregnancy.