1. Reproductive System Drugs

2. Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic. 2 Reproductive Hormones Gonadotropic Androgens Estrogens Progestins

3. Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.3 Back in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."Back in the Game PHYSICIAL THERAPY We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re- injury.PHYSICIAL THERAPY At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game.

4. 4 Gonadotropic Hormones Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic

5. 5 Androgens Male hormones Stimulate development of male characteristics Testosterone- The concept of male climacteric (andropause) remains controversial. However, growing evidence indicates that some aging men develop reduced testosterone production Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

6. 6 Androgens Uses- Hypogonadism Side effects Contraindications and precautions Interactions Dangers of illegal use of anabolic steroids Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

7. 7 Impotence Agents Phosphodiesterase (PDE) inhibitors- Viagra Treatment for male erectile dysfunction (ED) –inhibiting phosphodiesterase –increased levels of cyclic GMP cause relaxation of smooth muscles in penile vessels and this leads to an erection Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

8. 8 Estrogens Female sex hormone Development of female secondary sexual characteristics Affect secretion of FSH and LH Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

9. 9 Hormone Replacement Therapy Controversial subject Women’s Health Initiative (WHI) Recommendations by the American College of Obstetricians & Gynecologists –study had a larger incidence of breast cancer, heart attacks and strokesbreast cancerheart attacksstrokes may prevent discomfort caused by diminished circulating estrogen and progesterone hormonesestrogen progesteronehormones Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

10. 10 Estrogen Therapy Uses Side effects Contraindications and precautions Other contraindications Interactions Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

11. 11 Progestins Secreted by corpus luteum and adrenal glands Changes in uterine endometrium in second half of the menstrual cycle –Prepares for implantation of fertilized ovum Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

12. 12 Progestins Development of maternal placenta after implantation Development of mammary glands Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

13. 13 Progestins Functions Uses Side effects Contraindications and precautions Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

14. 14 Contraceptive Agents Estrogen-progestin combination Suppression of FSH and LH Progestin-only contraceptives Uses Minor side effects Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

15. 15 Contraceptive Agents Serious side effects Absolute contraindications Interactions Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

16. 16 Choices of Contraceptives Monophasic Biphasic Triphasic Use smallest dose possible for results Progestin-only contraceptives Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

17. Progestin-containing intrauterine device Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.17 the most recent models of the IUD, ParaGard ParaGard

18. 18 Post Contraceptives Unintentional risk of pregnancy Must be administered within 72 hours Emergency contraceptive kit- "morning after pill” Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

19. 19 Mifepristone (Mifeprex) Antiprogesterone drug Terminate unwanted pregnancy Requires three physician visits Side effects Contraindications Patient education Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

20. 20 Drugs for Labor and Delivery Oxytocin –Secreted by posterior pituitary lobe Stimulates uterine contraction Stimulates release of milk Synthetic drugs are called oxytocics Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

21. 21 Labor and Delivery Oxytocin-acts at the mammary glands, causing milk to be 'let down'mammary glands –important for cervical dilation before birth and causes contractions during the second and third stages of laborcervical dilationlabor Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

22. Methylergometrine is a blood vessel constrictor and smooth muscle agonist most commonly used to prevent or control excessive bleeding following childbirth and spontaneous or elective abortion. Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.22

23. Terbutaline (trade names Brethine, Bricanyl, or Brethaire) is a β 2 - adrenergic receptor agonisttrade namesβ 2 - adrenergic receptor agonist It is used as a fast-acting bronchodilator (often used as a short- term asthma treatment) and as a tocolytic [1] to delay premature labor bronchodilator tocolytic [1]premature labor Same as Magnesium sulfate Copyright © 2007 by Thomson Delmar Learning. ALL RIGHTS RESERVED.23

24. Epidural-regional anesthesiaregional anesthesia The spinal cord (yellow core) is in intimate contact with the pia mater (blue). The arachnoid (red) exists superficial to the pia mater, and is attached to it by many trabeculae, giving it a spider-like appearance. This space (light blue) is filled with cerebrospinal fluid (CSF) and is called the subarachnoid space. Superficial to the arachnoid is the dura mater (pink) and although they are unattached, they are kept firmly pressed against one another because of pressure exerted by the CSF. Superficial to the dura mater is a space (pale green), known as the epidural space,pia mater cerebrospinal fluidsubarachnoid spacedura mater 24

25. 25 Infertility Drugs Clomiphene citrate (Clomid) –increases production of gonadotropins by inhibiting negative feedback on the hypothalamusgonadotropins negative feedback Menotropins for injection (Repronex) Chorionic gonadotropin (Profasi) Urofollitropin for injection (Bravelle) Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic.

26. 26 Edited by Dr. Ryan Lambert Bellacov, chiropractor in West Linn, OR Back in the Game Chiropractic. Back in the GameBack in the Game Sports Medicine is a clinic dedicated to the treatment of physical injuries to the body. Caring for an injured body involves more than making the diagnosis; it's about understanding and treating the cause to prevent future injuries. The clinic addresses variety of injuries to the body whether it be from a car accident to over-use trauma. When injuries occur, it is no longer enough for people to "take it easy for awhile" or "work through it."

27. Back in the Game PHYSICIAL THERAPY We believe that the true goal of physical therapy involves restoration of function through neuromuscular re-education and specialized manual techniques. These techniques restore movement, balance and quality of life. At Back in the Game, we go a step further and instruct people how to keep their bodies stronger and healthier. We do this by teaching proper body mechanics and developing personalized exercises that will help prevent re- injury.PHYSICIAL THERAPY At Back In The Game, it's all about you. You're the reason we're here. The entire visit is centered around giving you an experience uncommon in today's impersonal medical world. We recognize that you are a unique human being with specific needs which require talented people who truly care and we strive to deliver this care in a professional, yet comfortable environment. Dr. Lambert, a state licensed Chiropractic Physician, who has training in sports medicine, heads Back In The Game.