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GY52 Gynecology
Common Medications
Toronto Notes 2019
Table 32. Common Medications (continued)
Drug Name (Brand Name)
tolterodine (Detrol®)
tranexamic acid (Cyklokapron®)
ulipristalacetate (Fibristal®)
urofollitropin (Metrodin®)
combined oral contraceptive pill (OCP)
intrauterine device (IUD) copper IUD (Nova-T®) progesterone-releasing IUD (Mirena®, Jaydess®)
Action
Anticholinergic
Anti-fibrinolytic, reversibly inhibits plasminogen activation
Selectiveprogesteronereceptor modulator (SPRM)
FSH
Ovulatory suppression by inhibiting LH and FSH Decidualization of endometrium Thickening of cervical mucus to prevent sperm penetration
Copper IUD: mild foreign body reaction in endometrium which is toxic to sperm and alters sperm motility
Progesterone-releasing IUD: decidualization of endometrium and thickening of cervical mucus, may suppress ovulation
Dosing Schedule
Indications
Overactive bladder (urge incontinence)
Menorrhagia
Leiomyoma(pre-operative)
Ovulation induction in PCOS
Contraception
Disorders of menstruation
Same as above
Side Effects (S/E), Contraindications (C/I), Drug Interactions (D/I)
S/E: anaphylaxis, psychosis, tachycardia, dry mouth/ eyes, headache, constipation, urinary retention, chest pain, abdominal pain
C/I: glaucoma, gastric/urinary retention, use with caution if impaired hepatic/renal function
S/E: N/V, diarrhea, dizziness, rare cases of thrombosis, abdominal pain, MSK pain
C/I: thromboembolic disease, acquired disturbances of colour vision, subarachnoid hemorrhage, age <15 yr
S/E: headache,hotflushes,constipation,vertigo, endometrial thickening
C/I: pregnancy, undiagnosed vaginal bleeding, any gyne cancer
S/E: ovarian enlargement or cysts, edema and pain at injection site, arterial thromboembolism, fever, abdominal pain, headache, multiple pregnancy
C/I: primary ovarian failure, intracranial lesion (e.g. pituitary tumour), uncontrolled thyroid/adrenal dysfunction, ovarian cyst (not PCOS), pregnancy, abnormal uterine bleeding
See Tables 8-12
See Table 8-12
1-2 mg PO bid
1-1.5 g tid-qid for first 4 d of cycle
Max 4 g/d
Ophthalmic check if used for several wk
5mgPOODformax3mo;firsttablettaken anytime during first 7 days of menstruation
75 U/d SC x 7-12d
Contraceptive effects last 3 yrs (Jaydess®); up to 5 yr (Copper IUD, Mirena®)