Reproductive System Drugs

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.2

Reproductive Hormones

• Gonadotropic

• Androgens

• Estrogens

• Progestins

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3

• Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."

• PHYSICIAL THERAPYWe believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re-injury.

• At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game.

4

Gonadotropic Hormones

• Follicle-stimulating hormone (FSH)

• Luteinizing hormone (LH)

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, ORBack in the Game Chiropractic

5

Androgens

• Male hormones• Stimulate development of male

characteristics• Testosterone- The concept of male

climacteric (andropause) remains controversial. However, growing evidence indicates that some aging men develop reduced testosterone production

• Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

6

Androgens

• Uses- Hypogonadism

• Side effects

• Contraindications and precautions

• Interactions

• Dangers of illegal use of anabolic steroids

• Patient education

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

7

Impotence Agents

• Phosphodiesterase (PDE) inhibitors- Viagra

• Treatment for male erectile dysfunction (ED)– inhibiting phosphodiesterase– increased levels of cyclic GMP cause

relaxation of smooth muscles in penile vessels and this leads to an erection

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

8

Estrogens

• Female sex hormone

• Development of female secondary sexual characteristics

• Affect secretion of FSH and LH

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

9

Hormone Replacement Therapy

• Controversial subject• Women’s Health Initiative (WHI)• Recommendations by the American

College of Obstetricians & Gynecologists

– study had a larger incidence of breast cancer, heart attacks and strokes

• may prevent discomfort caused by diminished circulating estrogen and progesterone hormones

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

10

Estrogen Therapy

• Uses

• Side effects

• Contraindications and precautions

• Other contraindications

• Interactions

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

11

Progestins

• Secreted by corpus luteum and adrenal glands

• Changes in uterine endometrium in second half of the menstrual cycle – Prepares for implantation of fertilized

ovum

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

12

Progestins

• Development of maternal placenta after implantation

• Development of mammary glands

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

13

Progestins

• Functions

• Uses

• Side effects

• Contraindications and precautions

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

14

Contraceptive Agents

• Estrogen-progestin combination

• Suppression of FSH and LH

• Progestin-only contraceptives

• Uses

• Minor side effects

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

15

Contraceptive Agents

• Serious side effects

• Absolute contraindications

• Interactions

• Patient education

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

16

Choices of Contraceptives

• Monophasic

• Biphasic

• Triphasic

• Use smallest dose possible for results

• Progestin-only contraceptives

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

• Progestin-containing intrauterine device

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17

the most recent models of the IUD, ParaGard

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Post Contraceptives

• Unintentional risk of pregnancy

• Must be administered within 72 hours

• Emergency contraceptive kit- "morning after pill”

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

19

Mifepristone (Mifeprex)

• Antiprogesterone drug

• Terminate unwanted pregnancy

• Requires three physician visits

• Side effects

• Contraindications

• Patient education

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

20

Drugs for Labor and Delivery

• Oxytocin– Secreted by posterior pituitary lobe

• Stimulates uterine contraction

• Stimulates release of milk

• Synthetic drugs are called oxytocics

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

21

Labor and Delivery

• Oxytocin-acts at the mammary glands, causing milk to be 'let down' – important for cervical dilation before birth

and causes contractions during the second and third stages of labor

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

• Methylergometrine is a blood vessel constrictor and smooth muscle agonist most commonly used to prevent or control excessive bleeding following childbirth and spontaneous or elective abortion.

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 22

• Terbutaline (trade names Brethine, Bricanyl, or Brethaire) is a β2

-adrenergic receptor agonist

• It is used as a fast-acting bronchodilator (often used as a short-term asthma treatment) and as a tocolytic[1] to delay premature labor

• Same as Magnesium sulfate

Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 23

• Epidural-regional anesthesia• The spinal cord (yellow core) is in intimate contact with the pia mater (blue). The

arachnoid (red) exists superficial to the pia mater, and is attached to it by many trabeculae, giving it a spider-like appearance. This space (light blue) is filled with cerebrospinal fluid (CSF) and is called the subarachnoid space. Superficial to the arachnoid is the dura mater (pink) and although they are unattached, they are kept firmly pressed against one another because of pressure exerted by the CSF. Superficial to the dura mater is a space (pale green), known as the epidural space,

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Infertility Drugs

• Clomiphene citrate (Clomid)– increases production of gonadotropins by inhibiting

negative feedback on the hypothalamus

• Menotropins for injection (Repronex)

• Chorionic gonadotropin (Profasi)

• Urofollitropin for injection (Bravelle)

Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

26Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR

Back in the Game Chiropractic.

Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."

• Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."

• PHYSICIAL THERAPYWe believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re-injury.

• At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game.