do not use 4 weeks before a major surgery or prolonged immobilization some

Do not use 4 weeks before a major surgery or

This preview shows page 90 - 94 out of 115 pages.

- do not use 4 weeks before a major surgery or prolonged immobilization. - some studies have linked use of this medicine with increased risk of cervical and breast cancer (Medscape, 2018). Contraindications: Hypersensitivity to drug, known or suspected
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pregnancy, undiagnosed vaginal bleeding Antineoplastic, Progestins, Appetite Stimulants Megace, Megace ES Megestrol Derivative of Progestin having Antiestrogenic properties. This drug interferes with estrogen cycle causing lower levels of Luteinizing Hormone titer. Its antineoplastic properties might stem from a direct effect on the endometrium through the anti-LH effects mediated through the pituitary Breast Cancer, Endometrial Cancer, and Cancer Related Cachexia (off label). Breast Cancer: 40mg PO q6hr Endometrial Cancer: 40-320mg/day PO in divided doses. Max 800mg/day. Cancer related Cachexia: 480-600 mg/day PO. Monitor patients concurrently using Insulin aspart and degludec (Medscape, 2018). Adverse Effects: HTN, insomnia, rash, sweating, amenorrhea, diarrhea, flatulence, nausea, vomiting, weight gain. (Serious SE) DVT, PE, Adrenal Insufficiency, Thrombophlebitis (Medscape, 2018). -Contraindicated in known or suspected pregnancy, thrombotic disorders, breast cancer, abnormal genital bleeding. Pregnancy Category D. Do not use during lactation Antiestrogen n/a in US tamoxifen Competes with estrogen for binding sites in breast and other tissues. Reduces synthesis of DNA and estrogen response - Female breast CA - palliative or adjunct treatment of advanced breast cancer - Metastasis (male and female) - Ductal CA in situ (Female) Initial- Adjunctive therapy- 20mg/day for 5yrs Estrogen receptor positive 10yr treatment Maintenance: 20-80 mg/day Most common: Nausea Hot flashes Other: Confusion Depression Blurred vision Vomiting Vagina bleeding
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- Breast CA risk reduction - Endometrial carcinoma, recurrent, metastatic, or high risk (unlabeled) - Induction of ovulation (unlabeled) - Ovarian CA, advanced, recurrent (unlabeled) - Paget’s disease of breast (risk reduction) Hypercalcemia Leukopenia Thrombocytopenia Stroke Androgen Androderm Androgel Androgel Pump Aveed Depo- Testosteron e First- Testosteron e Testopel Vogelxxo Androderm Testosterone Endogenous androgen that facilitates the growth of the male sex organs and helps sustain secondary sex characteristics in androgen- deficient males Breast cancer (female) Delayed puberty (males) Hypogonadism (males) Breast Cancer: IM: 200-400 mg every 2-4 weeks Delayed Puberty: IM: 50-200 mg every 2- 4 weeks for a 4-6 months Pellet SQ: 150-450 mg every 3-6 months Hypogonadism: IM: 50-400 mg every 2- 4 weeks Or 75- 100 mg/week or 150-200 mg every 2 weeks Intranasal : 11 mg (2 pump or 1 per nostril) Skin blister or pruritus at site PSA increase BPH HTN PVD Emotional lability, anosmia, headache, depression, nervousness, chills, confusion, aggressive behavior Crusted skin, excoriation, bulla, xeroderma, alopecia Decreased HDL cholesterol, HLD, hypokalemia, increased triglycerides, increased TSH, decreased libido, gynecomastia, hot flash, weight gain Testicular atrophy, prostatic disease, dysuria, UTI,
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intranasal 3 times daily (6-8 hours apart) for a total of 33 mg Oral:
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