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Genitourinary meds

[q] Medroxyprogesterone

[a] To regulate ovulation and menustration, treat endometriosis and cancer of uterus

[q] Medroxyprogesterone adverse effect

[a] Breast cancer (perform regular breast self-examinations and get mammograms), Thromboembolic events -MI, pulmonary embolism, thrombophlebitis, stroke (Discourage clients from smoking, Monitor for pain, swelling, warmth, or erythema of lower legs, notifychest pain or shortness of breath), Breakthrough bleeding, Edema, Jaundice (monitor LFT), Migraine headaches

[q] Medroxyprogesterone nurse note

[a] Anticipate withdrawal bleeding 3 to 7 days after stopping the medication. Stop taking the medication immediately if pregnancy is suspected. Conception should be delayed for 3 months following use.

[q] Oral contraceptives

[a] stop conception by preventing ovulation

[q] Oral contraceptives adverse effect

[a] Thromboembolic events (MI, pulmonary embolism, thrombophlebitis, stroke), Hypertension, breakthrough bleeding, Breast cancer

[q] Oral contraceptives contraindication

[a] Smokers and over the age of 35, Have a history of thrombophlebitis and cardiovascular events, Have a family history or risk factors for breast cancer, Are experiencing abnormal vaginal bleeding.

[q] Oral contraceptives drug interaction

[a] Oral contraceptive effectiveness decreases with use of carbamazepine (Tegretol); phenobarbital; antibiotics, especially penicillins and cephalosporins; phenytoin (Dilantin); and rifampin. Oral contraceptives decrease the effects of warfarin and oral hypoglycemics.

[q] Oral contraceptives Nurse Note

[a] Instruct clients to take pills at the same time each day. Instruct clients to take medication for 21 days followed by 7 days of no medication (or inert pill). For the traditional 28-day cycle OCs, begin the sequence on the fifth day after the onset of menses. For one missed dose, instruct clients to take two together at the next scheduled dose. Encourage clients who smoke to quit.Advise client to report swelling or redness in legs, shortness of breath or severe headache (?? thromoelbolic events)

[q] Finasteride

[a] Reduction of the prostate size, increases sclap hair growith (help with male baldness)

[q] Finasteride Side Effect

[a] Decreased libido, Gynecomastia, Orthostatic hypotension

[q] Finasteride nurse note

[a] Therapeutic effects may take 6 months or longer. Pregnant women should not handle crushed or broken medication. Advise clients not to donate blood unless medication has been discontinued for at least 1 month.

[q] Tamsulosin

[a] decrease mechanical obstruction of the urethra by relaxing smooth muscles, decreased blood pressure

[q] Tamsulosin side effect

[a] Hypotension, dizziness, nasal congestion, sexual dysfunction. Take 30 min after a meal at the same time each day. Monitor BP

[q] sildenafil, tadalafil, vardenafil (-fil meds)

[a] for erectile dysfunction in male

[q] Adverse effects of “-fil” meds (sildenafil, tadalafil, vardenafil )

[a] MI, sudden death, Priapism (erection lasts more than 4 hr), Fatal hypotension when taken with nitroglycerin

[q] Nurse notes for “-fil” meds (sildenafil, tadalafil, vardenafil )

[a] Ask about use of -fil med before giving nitro. Do not give nitro within 4-6 hours of taking -fil meds. Grapefruit juice, and some meds (ketoconazole, erythromycin, cimetidine increase plasma concentrations of med leading to toxicity)

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