MODULE 2: DRUGS USED FOR COMBINED DRUGS TO PROMOTE FERTILITY

HORMONAL CONTRACEPTIVES, PROMOTE CC ( CLOMIPHENE CITRATE )

FERTILITY, FOR MENOPAUSE – is a selective estrogen that induces ovulation ,
so woman can be capable of releasing matured
DRUGS USED FOR WOMEN AND MEN’S HEALTH ovum for possible union of sperm cell by male
By: Catherine Mae G.Trinidad RN-MAN counterpart.
– This is the most commonly used ovulation
COMBINED HORMONAL CONTRACEPTIVES stimulant.
FIRST GENERATION: – CC is given in a 50 mg oral dose on days 5
1. Norethindrone through 9 of the menstrual cycle.
2. Norethindrone acetate – The dose can be increase to 100 mg and maybe
3. Ethyniodoldiacetate repeated up to 6 cycles.
 These are the earliest progestin formulations
to be used in oral contraceptives PHARMACOKINETICS
– CC is readily absorbed from the GI tract.ptially
SECOND GENERATION: metabolized in the liver and excreted in the
1. Norgestrel feces via biliary elimination.
2. Levonorgestrel – Has a half life of about 5 days

THIRD GENERATION: PHARMACODYNAMICS:

1. Desogestrel MOA - is unknown
2. Norgestimate – Hypothesized to compete with estrogen at
receptor sites.
 The new-generation progestins have a
higher efficacy rating and fewer effects on SIDE EFFECTS
lipid and carbohydrate metabolism 1. Breast discomfort
compared with f1st and 2nd generations. 2. Fatigue
3. Dizziness
DRSP - Drospirenone is a fourth generation 4. Depression
progestin. 5. Nausea
– It can increase K level altering water and 6. Increased appetite
electrolyte imbalance. 7. Dermatitis
8. Urticaria
MECHANISM OF ACTION 9. Anxiety
The estrogen component of Combined 10. Heavier menses
Hormonal Contraceptives inhibits ovulation by preventing 11. Abdominal bloating
the formation of a dominant follicle. When a dominant
follicle does not mature, Estrogen remains at a ADVERSE REACTION
consistent level and is unable to reach the peak level 1. Bloating
needed to stimulate LH (Leutenizing Hormone) surge. 2. Stomach or Pelvic Pain
When the LH surge is suppressed, ovulation is 3. Photophobia
prevented and pregnancy does not occur. 4. Diplopia
5. Decreased visual acuity

ROUTE OF DELIVERY : DRUGS USED FOR MENOPAUSE

Commonly given in ORAL ROUTE in which pill HT ( Hormonal Therapy)
is – Drug of choice for menopause.
ingested daily that is absorbed by the GI – It is used only for the relief of symptoms of
(Gastrointestinal) tract and metabolized by the liver. menopause like:
1. Hot flashes
TRANSVAGINAL 2. Vaginal dryness
3. Sleep disorders
TRANSDERMAL - these are other routes of
administration EPT ( Estrogen – Progestin Therapy)
ADVANTAGE: avoids GI absorption – HT used for women with intact uterus
SE: nausea and vomiting
– Heart and circulatory risk ET ( Estrogen Therapy)
– HT used for women post hysterectomy
COMBINED HORMONAL CONTRACEPTIVES
Are one of the most commonly used methods of PROTOTYPE DRUG FOR MENOPAUSE
reversible contraception in the world.
It has high degree of effectiveness and relatively safe. ESTROGEN REPLACEMENT
ROUTE & DOSAGE:
– PO at 0.3, 0.45,0.675 and 1.25mg/d

PHARMACOKINETICS:
 Absorption: well absorbed PO
 Distribution: widely distributed and bounds to
sex hormone
 Metabolism: unknown
 Excretion: urine and bile

THERAPEUTIC EFFECTS/USES:
1. for moderate to severe symptoms of menopause
and vaginal dryness
2. develops and maintain female genital system

SIDE EFFECTS:
1. nausea and vomiting
2. breast tenderness
3. leg cramps
4. bleeding
DRUGS FOR MEN’S REPRODUCTIVE HEALTH 3. Antihistamines (Dipenhydramine)
By:Catherine Mae G.Trinidad, RN-MAN 4. Antihypertensives (Angiotensin-Converting
Enzymes)
DRUGS RELATED TO MALE REPRODUCTIVE 5. Antipsychotics (Phenothiazines )
DISORDERS 6. Antiulcer (Cimetidine)
7. Sedatives (Alcohol, Coccaine, Cannabis)
TESTOSTERONE (ANDROGEN)
– Controls the development and maintenance of ED ( Erectile Dysfunction)
sexual processes, accessory sexual organs, – is the inability to achieve or maintain an erection
cellular metabolism and bone and muscle satisfactory for sexual performance. It happens
growth. when not enough blood flows to the penis during
sexual stimulation. This maybe caused by
PHARMACOKINETICS: psycho emotional problems, diabetes,
 Absorption: well absorbed in IM hypertension
 Distribution: 98% distributed to system
 Metabolism: 10-100 minutes PHOSPHODIESTERASEINHI
 Excretion: in urine and bile BITORS
– facilitates erection by enhancing blood flow to
PHARMACODYNAMICS: the penis.
 IM:Onset is unknown – The most commonly used treatment for ED.
 Peak: unkown
MOST COMMON PHOSPHODIESTERASE FOR
 Duration: 2-4 weeks
ERECTILE DYSFUNCTION
1. AVANAFIL 50-200 mg (not affected by food)
THERAPEUTIC EFFECTS/USES
 Onset: 15-30 mins
 Develops and maintains male sex organs and
secondary sex characteristics.  Duration: 4-6 hrs
 MOA: Binds to androgen receptors, producing  Use once in 24 hrs
multiple anabolic and androgenic effects.  SE: abdominal symptoms like diarrhea, upset
 S/E: Abdominal pain, nausea, diarrhea, stomach, heartburn
constipation, increased salivation.
2. SILDENAFIL - 20 mg, works best on an empty
ADVERSE REACTIONS: stomach
1. Acne  Onset = 30-60 mins.
2. Urinary urgency  Duration = 4 hours
3. Gynecomastia
4. Red skin 3. VARDENAFIL 10 mg, less effective with a high fat
5. Jaundice meal.
6. Depression  S/E:abdominal symptoms like diarrhea, upset
7. Habituation stomach, heartburn
8. Allergic reaction  Onset : 25-30 mins
 Duration : 4-5 hrs
DRUGS USED IN OTHER MALE REPRODUCTIVE  Use once in 24 hours
DISORDERS

DELAYED PUBERTY
Puberty is considered delayed when testicle
enlargement followed by penile growth and pubic hair
development has not begun by age 14. Delay in growth
maybe a normal part of the maturation process but the
cause could also be androgen deficiency or a deficiency
of growth hormone.
 14 years and up = treatment can be done.
 Testosterone Cyprionate 50 mg / IM every
month for 3-6 months or less before epiphyseal
closure.

SEXUAL DYSFUNCTION IN MALES

DRUGS THAT CAUSES SEXUAL DYSFUNCTIONS IN
MALE:
1. Anticholinergics (ATS04)
2. Antidepressants (Tricyclic)