| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Chlorotrianisene (TACE), estrogen—PO 12–50 mg | Prostatic cancer; menopause | Nonsteroidal synthetic estrogen | Rare after one course of treatment; thromboembolism; impotence and gynecomastia in men |
| NURSING IMPLICATIONS: Supply client with package insert; contraindicated in blood coagulation disorders |
| Diethylstilbestrol (DES)—PO, IM 0.2–5.0 mg daily; vaginal suppository 0.1–0.5 mg at bedtime | Prostate carcinoma; menopausal symptoms; osteoporosis; pain; mammary carcinoma; atrophic vaginitis | Synthetic nonsteroidal compound with estrogenic effects on pituitary, ovaries, myometrium, endometrium, and other tissues | Anorexia, nausea, vomiting, headache, diarrhea, dizziness, fainting—many side effects with long-term use |
| NURSING IMPLICATIONS: Never give if woman is pregnant—predisposes to vaginal cancer in female offspring at puberty |
| Estradiol—PO 1–2 mg for replacement therapy; up to 10 mg for cancer daily and up to 3 times daily; cyclic (on 3 wk, off 1 wk) | Menopausal symptoms; osteoporosis; hypogenitalism; sexual infantilism; breast and prostatic carcinoma | Inhibits release of pituitary gonadotropins; promotes growth of female genital tissues | Anorexia, nausea, vomiting, diarrhea, fluid retention; mental depression; headache, thromboembolism; feminization in men |
| NURSING IMPLICATIONS: Baseline VS; weigh daily; encourage frequent physical checkups to check serum lipids; teach breast self-examination |
| Medroxyprogesterone (Provera)—PO 2.5–10.0 mg; IM 400–1,000 mg weekly | Amenorrhea; functional uterine bleeding; threatened abortion; dysmenorrhea; adjunctive and palliative with renal cancer and endometriosis; premenstrual syndrome (PMS) | Similar to progesterone, but can be taken orally; thickens uterine decidua | Drowsiness; cyclic menstrual withdrawal bleeding; GI upset; headache; edema; breast congestion |
| NURSING IMPLICATIONS: Teach client regarding self-administration; breast self-examination for possible breast changes |
| Menotropins (Pergonal)—IM 1 ampule (FSH + LH)/day for 9–12 days (followed by 5,000–10,000 units human chorionic gonadotropin (HCG); if ovulation does not occur, repeat with 2 ampules) | Infertility use: treatment of secondary anovulation; stimulation of spermatogenesis | Human gonadotropic responses; induces ovulation; sperm stimulation | Abortions occur in 25%; failure rate 55%–80% of clients: possible multiple births; ovarian enlargement; gynecomastia in men |
| NURSING IMPLICATIONS: Assist in collection of urine to assess estrogen levels; counsel regarding couple’s need to have daily intercourse from day of HCG injection until ovulation |
| Progesterone—Subcu, IM 5–10 mg daily; sublingual 5–10 mg | Amenorrhea; dysmenorrhea; endometriosis; habitual abortion | Converts endometrium into secreting structure; prevents ovulation; stimulates growth of mammary tissue | Nausea, vomiting; dizziness, edema, headache; protein metabolism |
| NURSING IMPLICATIONS: Give deep IM and rotate sites; weigh daily to ascertain fluid retention |
| Testosterone—PO 5–10 mg daily; IM 25–50 mg 2–3 times/wk; 200–400 mg IM q2–4 wk for breast cancer | Hypogonadism; eunuchism; impotence, advanced cancer of breast | Growth of sex organs and appearance of secondary male sex characteristics; counteracts excessive amounts of estrogen | Nausea, dyspepsia; masculinization; hypercalcemia; menstrual irregularities; renal calculi; Na+, K+, and H2O retention |
| NURSING IMPLICATIONS: Observe for edema; weigh daily; I&O push fluids for clients who are bedridden, to prevent renal calculi |
| Vasopressin (Pitressin)—IM, Subcu 5–10 mcg 2–4 times daily; IM, Subcu 2.5–5 mcg 2–3 times daily for chronic therapy | Diabetes insipidus | Antidiuretic | Nausea, flatus; tremor; pounding in head; water intoxication |
| NURSING IMPLICATIONS: Monitor fluid balance, vital signs |