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Gynaecology
Gynaecology
F A J A R W A H Y U P R I B A D I
Topics under Gynecological Conditions
• Cervicitis
• Ectopic Pregnancy
• Endometrial Hyperplasia
Endometrial Hyperplasia
• Endometriosis
• Endometritis
• Female Infertility
• Hysterectomy
• Menstrual Disorders
• Oophorectomy
• Ovarian Cysts
• Pelvic Infections
• Polycystic Ovary Syndrome
Polycystic Ovary Syndrome
• Uterine Bleeding
• Uterine Fibroids
• Uterine Leiomyomata
Drugs associated with Cervicitis
What is Cervicitis?
• Cervicitis is an inflammation of the uterine cervix,
Cervicitis is an inflammation of the uterine cervix,
usually caused by infection
Drug name Rx / OTC Preg CSA Alcohol
azithromycin Rx B N
doxycycline Rx D N X
ofloxacin Rx C N
amino acids / Rx N N
urea
Drugs associated with Ectopic
Pregnancy
What is Ectopic Pregnancy:
• An ectopic pregnancy is a pregnancy that occurs
An ectopic pregnancy is a pregnancy that occurs
outside the womb (uterus). It is a life
outside the womb (uterus). It is a life‐threatening
condition to the mother. The baby (fetus) cannot
survive.
Drug name Rx / OTC Preg CSA Alcohol
methotrexateOFF LABEL Rx X N X
Drugs associated with Endometrial
Hyperplasia
What is Endometrial Hyperplasia:
• Endometrial Hyperplasia is abnormal overgrowth of
Endometrial Hyperplasia is abnormal overgrowth of
the cells in the endometrium.
What is Endometriosis:
• Endometriosis is a condition in which the tissue that
normally lines the uterus (endometrium) grows in
other areas of the body, causing pain, irregular
bleeding, and frequently infertility.
• The tissue growth typically occurs in the pelvic area,
outside of the uterus, on the ovaries, bowel, rectum,
bladder, and the delicate lining of the pelvis, but it
can occur in other areas of the body as well.
can occur in other areas of the body as well.
Drug name Rx / OTC Preg CSA Alcohol
norethindrone Rx X N X
medroxyprogesterone Rx X N
danazol Rx X N
ethinyl estradiol / levonorgestrelOFF LABEL Rx X N X
leuprolide Rx X N
progesteroneOFF LABEL Rx/OTC B N
desogestrel / ethinyl estradiolOFF LABEL Rx X N X
ethinyl estradiol / norethindrone Rx X N X
ethinyl estradiol / norgestimate Rx X N X
ethinyl estradiol / norgestrelOFF LABEL Rx X N X
ethinyl estradiol / ethynodiol Rx X N X
goserelin Rx X N
nafarelin Rx X N
etonogestrelOFF LABEL Rx X N
leuprolide / norethindrone Rx X N X
mestranol / norethindrone Rx X N X
Drugs associated with Endometritis
What is Endometritis:
• Endometritis is an inflammation and/or
irritation of the endometrium (lining of
the uterus). (See also pelvic
inflammatory disease.)
inflammatory disease.)
Drug name Rx / OTC Preg CSA Alcohol
ceftriaxone Rx B N
gentamicin Rx D N
cefotaxime Rx B N
piperacillin / tazobactam Rx B N
cefoxitin Rx B N
cilastatin / imipenem Rx C N
ceftazidime Rx B N
Drugs associated with Female Infertility
What is Female Infertility:
• Female Infertility refers to the inability to conceive
Female Infertility refers to the inability to conceive
a child after trying to do so for at least one year.
Drug name Rx / OTC Preg CSA Alcohol
metforminOFF LABEL Rx B N X
clomiphene Rx X N
letrozoleOFF LABEL Rx D N
chorionic gonadotropin (hcg) Rx X N
leuprolideOFF LABEL Rx X N
menotropins Rx X N
urofollitropin Rx X N
Drugs associated with Hysterectomy
What is Hysterectomy:
• The operation of excising the uterus,
performed either through the abdominal
wall or through the vagina.
Piperacillin Rx B N
Drugs associated with Menstrual Disorders
What is Menstrual Disorders:
• Menstrual disorders include painful, heavy or
Menstrual disorders include painful, heavy or
irregular periods.
What is Oophorectomy:
• The removal of an ovary or ovaries.
The removal of an ovary or ovaries. Synonym:
ovariectomy.
Drug name Rx / OTC Preg CSA Alcohol
estradiol Rx X N
conjugated estrogens Rx X N
conjugated estrogens / Rx X N
medroxyprogesterone
estropipate Rx X N
esterified estrogens Rx X N
Drugs associated with Ovarian Cysts
What is Ovarian Cysts:
• An ovarian cyst is a sac filled with fluid that forms
An ovarian cyst is a sac filled with fluid that forms
on or inside of an ovary.
Drug name Rx / OTC Preg CSA Alcohol
ethinyl estradiol / Rx X N X
levonorgestrelOFF LABEL
ethinyl estradiol / Rx X N X
norgestimateOFF LABEL
Drugs associated with Pelvic Infections
• What is Pelvic Infections:
– An infection of the female reproductive organs
often referred to as Pelvic inflammatory disease
(PID).
Drug name Rx / OTC Preg CSA Alcohol
ertapenem Rx B N
cilastatin / Rx C N
imipenem
Drugs associated with Polycystic Ovary
Syndrome
What is Polycystic Ovary
Syndrome:
• Polycystic ovary syndrome is a condition in
which a woman has an imbalance of female
sex hormones. This may lead to menstrual
cycle changes, cysts in the ovaries, trouble
getting pregnant, and other health changes.
getting pregnant, and other health changes.
Rx /
Drug name Preg CSA Alcohol
OTC
metforminOFF LABEL Rx B N X
desogestrel / ethinyl Rx X N X
estradiolOFF LABEL
ethinyl estradiol / Rx X N X
levonorgestrelOFF LABEL
ethinyl estradiol / Rx X N X
norethindroneOFF LABEL
drospirenone / ethinyl Rx X N X
estradiol / levomefolate
calciumOFF LABEL
drospirenone / ethinyl Rx X N X
estradiolOFF LABEL
Drugs associated with Uterine Bleeding
• What is Uterine Bleeding:
– Most women have uterine bleeding cycles
between 24 and 34 days apart. Dysfunctional
uterine bleeding (DUB) is abnormal bleeding from
the vagina that is due to changes in hormone
levels. Some women may have too much estrogen
or not enough progesterone.
Progesterone Rx/OTC B N
Drugs associated with Uterine
Fibroids
• What is Uterine Fibroids:
– Uterine fibroids are noncancerous tumors that
develop within or attach to the wall of the uterus.
Leuprolide Rx X N
Ulipristal Rx X N
OFF LABEL
Drugs associated with Uterine
Leiomyomata
• What is Uterine Leiomyomata:
– Uterine leiomyomata are noncancerous tumors
that develop within or attach to the wall of the
uterus.
leuprolide Rx X N
Legend
Off Label
• This medication may not be approved by the
FDA for the treatment of this condition.
Prescription Only / Over the Counter
• Rx = Prescription Only
• OTC = Over the Counter
Over the Counter
• Rx/OTC = Prescription or Over the Counte
Prescription or Over the Counte
Pregnancy
A
• Adequate and well‐controlled studies have failed to demonstrate a
controlled studies have failed to demonstrate a
risk to the fetus in the first trimester of pregnancy (and there is no
evidence of risk in later trimesters).
B
• Animal reproduction studies have failed to demonstrate a risk to
Animal reproduction studies have failed to demonstrate a risk to
the fetus and there are no adequate and well
the fetus and there are no adequate and well‐controlled studies in
pregnant women.
C
• Animal reproduction studies have shown an adverse effect on the
Animal reproduction studies have shown an adverse effect on the
fetus and there are no adequate and well
fetus and there are no adequate and well‐controlled studies in
humans, but potential benefits may warrant use of the drug in
pregnant women despite potential risks.
pregnant women despite potential risks.
D
• There is positive evidence of human fetal risk based on
adverse reaction data from investigational or marketing
experience or studies in humans, but potential benefits may
warrant use of the drug in pregnant women despite potential
risks.
X
• Studies in animals or humans have demonstrated fetal
abnormalities and/or there is positive evidence of human fetal
risk based on adverse reaction data from investigational or
marketing experience, and the risks involved in use of the drug
in pregnant women clearly outweigh potential benefits.
N
• FDA has not classified the drug.
FDA has not classified the drug.
Controlled Substances Act Schedule
N
• The drug is not subject to the Controlled Substances Act.
1
• The drug has a high potential for abuse. The drug has no currently accepted medical use in treatment in the
United States. There is a lack of accepted safety for use of the drug under medical supervision.
2
• The drug has a high potential for abuse. The drug has a currently accepted medical use in treatment in the
United States or a currently accepted medical use with severe restrictions. Abuse of the drug may lead to
severe psychological or physical dependence.
3
• The drug has a potential for abuse less than the drugs in schedules 1 and 2. The drug has a currently accepted
medical use in treatment in the United States. Abuse of the drug may lead to moderate or low physical
dependence or high psychological dependence.
4
• The drug has a low potential for abuse relative to the drugs in schedule 3. The drug has a currently accepted
medical use in treatment in the United States. Abuse of the drug may lead to limited physical dependence or
psychological dependence relative to the drugs in schedule 3.
5
• The drug has a low potential for abuse relative to the drugs in schedule 4. The drug has a currently accepted
medical use in treatment in the United States. Abuse of the drug may lead to limited physical dependence or
psychological dependence relative to the drugs in schedule 4.
psychological dependence relative to the drugs in schedule 4.
Alcohol
X
•Interacts with Alcohol
Interacts with Alcohol
Comparison of Vaginal Spermicides
Comparison of Vaginal
Common Combined Oral Contraceptive Drugs Interactions
Common Combined Oral Contraceptive Drugs Interactions