单词 | depo-provera |
释义 | Depo-ProveraDep·o-Pro·ver·aD5143600 (dĕp′ō-prō-vĕr′ə)Depo-ProveraDepo-Provera/NorplantDefinitionPurposePreparationKey termsRisksNormal resultsResourcesOtherDepo-Provera[de″po-pro-ver´ah]medroxyprogesterone acetatePharmacologic class: Hormone Therapeutic class: Progestin Pregnancy risk category X FDA Box Warning• Injection form may cause significant bone density loss. Loss increases with duration of use and may not be completely reversible. It is unknown if use during adolescence or early adulthood reduces peak bone mass and increases risk for osteoporotic fracture later in life. • Injection form should be used as long-term contraceptive (more than 2 years) only if other contraceptive methods are inadequate. ActionInhibits pituitary gonadotropin secretion, preventing follicular maturation, ovulation, and pregnancy AvailabilitySuspension for depot injection: 150 mg/ml, 400 mg/ml Suspension for depot subcutaneous injection: 104 mg/0.65 ml in prefilled single-use syringes Tablets: 2.5 mg, 5 mg, 10 mg Indications and dosages➣ Secondary amenorrhea Adults: 5 to 10 mg/day P.O. for 5 to 10 days, starting at any time during menstrual cycle ➣ Dysfunctional uterine bleeding; menses induction Adults: 5 to 10 mg/day P.O. for 5 to 10 days, starting on day 16 or 21 of menstrual cycle ➣ To prevent estrogen-related endometrial changes in postmenopausal women Adults: 2.5 to 5 mg/day P.O. given with 0.625 mg conjugated estrogens P.O. (monophasic regimen); or 5 mg/day P.O. on days 15 to 28 of cycle, given with 0.625 mg conjugated estrogens P.O. daily throughout cycle (biphasic regimen) ➣ Management of endometriosis-associated pain Adults: 104 mg (Depot-subcutaneous-Provera) in anterior thigh or abdomen q 12 to 14 weeks ➣ To prevent pregnancy Adults: 150 mg (Depo-Provera) deep I.M. injection q 13 weeks or 104 mg (Depot-subcutaneous-Provera) in anterior thigh or abdomen q 12 to 14 weeks. Give first injection during first 5 days of normal menstrual period or first 5 postpartal days if patient isn't breastfeeding, or during sixth postpartal week if patient is breastfeeding exclusively. ➣ Renal or endometrial cancer Adults: 400 to 1,000 mg I.M.; may repeat weekly. If improvement occurs, decrease to 400 mg q month. Off-label uses• Advanced breast cancer Contraindications• Hypersensitivity to drug or its components • Cerebrovascular or thromboembolic disease • Hepatic dysfunction or disease • Breast or genital cancer • Undiagnosed vaginal bleeding • Known or suspected pregnancy PrecautionsUse cautiously in: • seizure disorder, renal or cardiovascular disease, asthma, diabetes mellitus, depression, migraine • history of hepatic disease. Administration• Before starting therapy, obtain thorough history and physical examination, with emphasis on breast and pelvic organs. Also obtain Pap smear, and repeat annually during therapy. • With contraceptive use, rule out pregnancy before first dose and when more than 14 weeks have passed since previous dose. • For I.M. injection, inject deep into gluteal, deltoid, or anterior thigh muscle. Rotate injection sites. • Be aware that when drug is used to prevent estrogen-related endometrial changes in postmenopausal women, lowest dosage should be used for shortest time, because treatment exceeding 1 year correlates with cancer. (Some combination products have 0.3 mg estrogen/1.5 mg progesterone or 0.45 mg estrogen/1.5 mg progesterone.) Adverse reactionsCNS: insomnia, migraine, nervousness, drowsiness, dizziness, fatigue, depression, mood changes CV: thrombophlebitis, thromboembolism EENT: diplopia, proptosis, retinal vascular lesions, papilledema GI: abdominal pain, bloating GU: amenorrhea, leukorrhea, spotting, cervical secretions, galactorrhea, breast tenderness and secretion, cervical erosions, pelvic pain, infertility Hepatic: jaundice Metabolic: fluid retention, hyperglycemia Musculoskeletal: leg cramps, back pain Respiratory: pulmonary embolism Skin: pruritus, urticaria, rash, acne, alopecia, hirsutism, chloasma, melasma, sterile abscesses, induration at I.M. site Other: weight and appetite changes, edema, angioedema, allergic reactions including anaphylaxis InteractionsDrug-drug. Bromocriptine: decreased bromocriptine efficacy Carbamazepine, phenobarbital, phenytoin, rifampin: decreased contraceptive efficacy Drug-diagnostic tests. Alkaline phosphatase, low-density lipoproteins: increased levels High-density lipoproteins, pregnanediol excretion: decreased levels Thyroid hormone assays: altered results Drug-behaviors. Alcohol use: additive CNS depression Patient monitoring• Monitor patient for fluid retention and for signs and symptoms of thrombophlebitis, including pain, swelling, and redness of lower legs. See Assess for visual disturbances and headache. If ocular exam shows papilledema or retinal vascular lesions, drug should be discontinued. • Evaluate liver function tests. See Watch for abdominal pain, fever, malaise, jaundice, darkened urine, and clay-colored stools. Patient teaching• Advise patient that drug may cause nausea, vomiting, headache, abdominal pain, painful breast swelling, and abnormal bleeding pattern. Instruct her to report these effects if pronounced. See Tell patient to promptly report bloating, swelling, appetite loss, rash, yellowed skin, mood changes or depression, nervousness, dizziness, chest pain, shortness of breath, visual disturbances, or severe headache. • Teach patient how to perform breast self-exams. • Tell patient she must undergo yearly physical examinations with Pap smear. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above. Depo-Provera(dĕp′ō-prō-vĕr′ə)medroxyprogesterone acetateA synthetic progestin, which is chemically similar to androgen. Medroxyprogesterone acetate is used primarily as a contraceptive; it is injected every three months, inhibiting gonadotropin secretion which, in turn, prevents follicular maturation and ovulation, and causes endometrial thinning.Indications Contraceptive, hormone replacement therapy, treatment of endometriosis, anti-androgenic for male sex offenders (causing chemical castration). Adverse effects Acne, dysmenorrhoea, birth defects if taken during pregnancy, headache, breast tenderness, increased facial hair, decreased scalp hair, insomnia, abdominal pain/discomfort, dizziness, asthenia (weakness or fatigue), and weight changes. It also carries an increased risk of coronary heart disease, breast cancer, stroke and pulmonary embolism. Depo-ProveraMedroxyprogesterone, Provera® Endocrinology A synthetic progestin that is structurally an androgen; it is a highly effective contraceptive, given q 3 months; it is also used for ♀ precocious puberty, DUB, dysmenorrhea, endometriosis, threatened abortion, to suppress postpartum lactation Side effects Weight gain, dysmenorrhea, fatigue, vertigo, nervousness, headaches, abdominal pain. See Androcur; Cyproterone.Depo-ProveraA contraceptive, given by DEPOT INJECTION, containing MEDROXYPROGESTERONE. See also CONTRACEPTION. |
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