W 2011 Pharm Womans Health For Pas

Front 1

Hyperandrogenism
(W Low-Normal FSH)

Back 1

Indications for hormone replacement therapy (HRT)

Front 2

Premature Ovarian Failure
(With High FSH)

Menopause
(With High FSH)

surgical menopause.

Back 2

Indications for hormone replacement therapy (HRT)

Front 3

Breast Ca
Pregnancy
Smoker
Uterine Ca

Back 3

Contraindications for

Estrogen therapy

Nm them?
4ct

Hint 3

Breast Ca
Pregnancy
Smoker
Uterine Ca

Front 4

Nm Type of HRT

For women who still have their uterus
but are going thru or have gone thru menopause

• reduces endometrial hyperplasia

Back 4

Estrogen/Progesterone


~Indicated for what type of Pts
~reduces ?

Hint 4

For women who still have their uterus
but are going thru or have gone thru menopause

• reduces Endometrial Hyperplasia

Front 5

For women who have had a

hysterectomy/
are without a uterus

Back 5

Estrogen

~For women who?

Hint 5

hysterectomy/
are without a uterus

Front 6

Relationship between
HRT
&
the risk of cardiovascular disease
or
stroke

What population is at Risk?

Back 6

Older women w heart Dz

should not be placed on HRT

Transdermal
vaginal
are somewhat more preferred than oral.

Front 7

Unopposed estrogen puts at higher risk for

Back 7

Endometrial hyperplasia as well as DUB

Front 8

Method of Rx?

Does not have to pass through the liver
may cause skin irritation
May decrease fat and increase lean body mass

Has limited absorption.

Back 8

Transdermal HRT

List points?

Hint 8

Does not have to pass through the liver
may cause skin irritation
May decrease fat and increase lean body mass

Front 9

Rx application?

Lotion-like emulsion
does not have to pass through liver.
Also has variable absorption
messy

Back 9

Topical HRT

List points?

Hint 9

Lotion-like emulsion
does not have to pass through liver.
Also has variable absorption
messy

Front 10

Minimizes systemic exposure
but still gives relief especially in atrophy of vagina

Does not have to pass through liver and
causes less
~hypertriglyceridemia and
-prethrombotic effects
than oral.

Preparations include
~rings
~tablets
~creams

Back 10

Vaginal HRT



Preparations include ?

Hint 10

~rings
~tablets
~creams

Front 11

type of application ?

Most are estrogen only
so may need to do short term or
consider progesterone therapy if uterus still intact.

Back 11

Vaginal HRT

Front 12

Scheduled monthly bleeding
Estrogen 25 d
progesterone added last 10 13 days
then no therapy for 5 or 6 days

Back 12

Cyclic hormone therapy


List points
4ct

Hint 12

Scheduled monthly bleeding
Estrogen 25 d
progesterone added last 10 13 days
then no therapy for 5 or 6 days

Front 13

Prevents monthly bleeding

may initially cause unpredictable spotting or bleeding.

Best reserved for women who are 1-2 yrs postmenopausal

No breaks
Estrogen constant
Progesterone added first 10-13 days

Back 13

Continuous hormone therapy

Hint 13

Prevents monthly bleeding

may initially cause unpredictable spotting or bleeding.

Best reserved for women who are 1-2 yrs postmenopausal

No breaks
Estrogen constant
Progesterone added first 10-13 days

Front 14

Inhibits bone loss
but does not reduce
hot flushes
skin wrinkling
breast atrophy.

Does not increase risk of thromboembolism.

Do not need concomitant progesterone therapy


~Nm Class
~Nm Rx

Back 14

~Serms
~Raloxifene



-Selective Estrogen Receptor Modulators-

Hint 14

Inhibits bone loss

but does not reduce

hot flushes
skin wrinkling
breast atrophy.

Does not increase risk of thromboembolism.

Do not need concomitant progesterone therapy

Front 15

For women at risk of osteoporosis who
cannot/will not take HRT.

Does not increase risk of breast CA

Back 15

Raloxifene

Trade Nm?

List Points?

Hint 15

Evista

For women at risk of osteoporosis who
cannot/will not take HRT.

Does not increase risk of breast CA

Front 16

Reduces incidence of vertebral Fx by 37%. Higher doses needed in winter months. 800-2000 IU daily - may be more in winter or pts with prolonged hospitalization.

Back 16

Vitamin D


Reduces incidence of vertebral Fx by

Hint 16

37%

Front 17

Has not reduced Fx in otherwise healthy
postmenopausal women.

Recommended mostly for people with diets low in the nutrient

Back 17

Calcium

Front 18

Prevent bone resorption by inhibiting osteoclast activity. Prevention of attachment of osteoclast to bone.

............(FOR)................
~Hypercalcemia
~Osteoporosis
~Osteolytic bone lesions of metastatic Ca
~Paget's Dz

Back 18

~Alendronate

Nm Class?


............(FOR)................
4ct

Hint 18

Bisphosphonates

............(FOR)................
~Hypercalcemia
~Osteoporosis
~Osteolytic bone lesions of metastatic Ca
~Paget's Dz

Front 19

Orally administered can cause
Esophageal erosion
-need to remain upright.

GI distress.
Mild nausea
diarrhea
constipation occasionally.

Back 19

Bisphosphonates

Nm Rx

Hint 19

~Aendronate

What Class?

Front 20

Nm Rx?

Inhibits bone loss

but does not reduce
hot flushes
skin wrinkling
breast atrophy.

Bone density increases about 1% over 2 years

Back 20

~Raloxifene

Nm Class?

Hint 20

(SERM)

Front 21

Risk of Breast CA reduced by 76% in women taking

Back 21

Raloxifine

What risk was reduced
what %

Hint 21

Risk of Breast CA reduced by 76% in women taking

Front 22

Causes reduction of LDL
but
No rise in HDL.
Reduces vertebral Fx by 40%
but not in non vertebral Fx.

Back 22

Raloxifene

Reduces what ?
No increase in what?
reduces what type of Fx
what %?

Hint 22

Causes reduction of LDL
but
No rise in HDL.
Reduces vertebral Fx
by 40%
but not in non vertebral Fx.

Front 23

For Tx of:

Hypercalcemia
Osteoporosis
Paget’s Dz


Usually used in women who cannot tolerate other tx.

Back 23

Calcitonin

Txs what?
3ct

Hint 23

Hypercalcemia
Osteoporosis
Paget’s Dz


Usually used in women who cannot tolerate other tx.

Front 24

Five years of therapy increase bone by 2-3% and reduces Vertebral Fx.

Tx immediately in
post fracture period
useful because
Rx's ability to reduce bone Px

Back 24

Calcitonin

Reduces what?
Increases what? ....
...by what %?
Post Fx helps w what?

Hint 24

~Vertebral Fx

~Increase bone by 2-3%

~Bone Px
Tx immediately in
post fracture period
useful because
Rx's ability to reduce bone Px

Front 25

Indicated for tx of post-menopausal women with osteoporosis that are at high risk for bone fracture includes women with a history osteoporotic Fx.

Back 25

Teriparatide

Front 26

Increase bone mass in hypogonadal men who are at risk for Fx
such as those having gnrh therapy for prostate cancer

Back 26

Teriparatide

Front 27

~Abnormal facial features
~Neural tube defect


It is an Anticonvulscant Rx

Back 27

Carbamazepine

A/E
2ct

Hint 27

~Abnormal facial features
~Neural tube defect

Nm Rx?

Front 28

Cardiac
cleft palate
growth retardation

Back 28

Anti-cancer drugs

S/E
3ct

Hint 28

Cardiac
cleft palate
growth retardation

Front 29

Hypoplasia of teeth enamel and teeth staining

Back 29

Tetracycline

Front 30

Cardiac
CNS
spina bifida

defects

Back 30

Valproate

S/E
3ct

Hint 30

Cardiac
CNS
spina bifida

defects


(Class - Antiepileptic)

Front 31

Effects Female and Male offspring differently

- effects gonads though coumarin-fetal warfarin syndrome

Back 31

Diethylstilbestrol

Front 32

Fetal warfarin syndrome

~chondrodysplasia punctata
~ malformation of ears or eyes
~mental retardation
~nasal hypoplasia
~ optic atrophy
~skeletal deformities

Back 32

Coumarin

Causes What?
7ct

Hint 32

~Fetal warfarin syndrome :

~chondrodysplasia punctata
~malformation of ears or eyes
~mental retardation
~nasal hypoplasia
~optic atrophy
~skeletal deformities

Front 33

Deafness
heart
limb abnormal

Back 33

Thalidomide

Front 34

Spontaneous abortions
Malformation


~Of particular concern for what population?

Back 34

Retinoids

A/E
2ct

Hint 34

Spontaneous abortions
Malformation

(Retin-A (tretinoin) an anti-acne)

Front 35

Deafness
heart defects
limb abnormalities
renal abnormalities
other

Back 35

Thalidomide

Front 36

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Back 36

Pregnancy Category A

Front 37

Hyperandrogenism (With Low-Normal FSH)

Back 37

Indications for hormone replacement therapy (HRT)

Front 38

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women

Back 38

Preg category B

Front 39

Premature Ovarian Failure
(With High FSH)

Menopause
(With High FSH)

Surgical menopause

Back 39

Indications for hormone replacement therapy (HRT)

Nm Indications?
3ct

Hint 39

Premature Ovarian Failure
(With High FSH)

Menopause
(With High FSH)

Surgical menopause

Front 40

Animal studies have shown an adverse effect
but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Back 40

Preg category B

Front 41

Pregnancy
uterine or breast cancer
smoker

Back 41

Contraindications for estrogen therapy

Front 42

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans
but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Back 42

Pregnancy Category C

Front 43

For women who still have their uterus but are going thru or have gone thru menopause • reduces endometrial hyperplasia

Back 43

Estrogen/Progesterone

Front 44

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans
but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Back 44

Pregnancy Category D

Front 45

For women who have had a hysterectomy/are without a uterus

Back 45

Estrogen

Front 46

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience
and the risks involved in use of the drug in pregnant woman.

Back 46

Pregnancy Category X

Front 47

Relationship between HRT and the risk of cardiovascular disease or stroke

Back 47

Older women with heart disease should not be placed on HRT. Transdermal and vaginal are somewhat more preferred than oral.

Front 48

Unopposed Estrogen

Higher risk for

Back 48

Endometrial Hyperplasia
DUB

is caused by what?



(dub Dysfctn Uterine Bleeding)

Hint 48

Unopposed Estrogen

Front 49

Does not have to pass through the liver
may cause skin irritation. May decrease fat and increase lean body mass. Has limited absorption.

Back 49

Transdermal HRT

Front 50

Lotion-like emulsion does not have to pass through liver. Also has variable absorption and is messy.

Back 50

Topical HRT

Front 51

Minimizes systemic exposure but still gives relief especially in atrophy of vagina. Does not have to pass through liver and causes less hypertriglyceridemia and prethrombotic effects than oral. Preparations include
rings
tablets
and creams.

Back 51

Vaginal HRT

Front 52

Most are estrogen only so may need to do short term or consider progesterone therapy if uterus still intact.

Back 52

Vaginal HRT

Front 53

Scheduled monthly bleeding
progesterone added last 10 13 days
then no therapy for 5 or 6 days

Back 53

Cyclic hormone therapy

Front 54

Prevents monthly bleeding may initially cause unpredictable spotting or bleeding. Best reserved for women who are 1-2 years postmenopausal. No breaks
progesterone added first 10-13 days

Back 54

Continuous hormone therapy

Front 55

Inhibits bone loss
but does not reduce hot flushes
skin wrinkling
breast atrophy. Does increase risk slightly for thromboembolism. Do not need concomitant progesterone therapy

Back 55

Serms -Selective Estrogen Receptor Modulators- Raloxifene

Front 56

For women at risk of osteoporosis who cannot/will not take HRT. Does not increase risk of breast CA

Back 56

Raloxifene which is Evista

Front 57

Reduces incidence of vertebral Fx by 37%. Higher doses needed in winter months. 800-2000 IU daily - may be more in winter or pts with prolonged hospitalization.

Back 57

Vitamin D

Front 58

Has not reduced Fx in otherwise healthy postmenopausal women. Recommended mostly for people with diets low in the nutrient

Back 58

Calcium

Front 59

Prevent bone resorption by inhibiting osteoclast activity. Prevention of attachment of osteoclast to bone. Osteoporosis
paget's disease
hypercalcemia
osteolytic bone lesions of metastatic cancer

Back 59

Bisphosphonates
alendronate

Front 60

Orally administered can cause esophageal erosion - need to remain upright. GI distress. Mild nausea diarrhea
constipation occasionally.

Back 60

Bisphosphonates
alendronate

Front 61

Inhibits bone loss
but does not reduce hot flushes
skin wrinkling
breast atrophy. Bone density increases about 1% over 2 years

Back 61

Selective estrogen receptor modulators (SERM) (representative drug
raloxifene)

Front 62

Risk of Breast CA reduced by 76% in women taking

Back 62

Raloxifine

Front 63

Causes reduction of LDL but not rise in HDL. Reduces vertebral Fx by 40% but not non vertebral Fx.

Back 63

Raloxifene

Front 64

For Osteoporosis
paget’s disease
hypercalcemia Usually used in women who cannot tolerate other tx.

Back 64

Calcitonin

Front 65

Five years of therapy increase bone by 2-3% and reduces the incidence of vertebral Fx. Tx immediately in the post fracture period is useful because of drugs ability to reduce bone pain

Back 65

Calcitonin

Front 66

Indicated for tx of post-menopausal women with osteoporosis that are at high risk for bone fracture includes women with a history osteoporotic Fx.

Back 66

Teriparatide

Front 67

Increase bone mass in hypogonadal men who are at risk for Fx
such as those having gnrh therapy for prostate cancer

Back 67

Teriparatide

Front 68

Abnormal facial features
neural tube defect.

Back 68

Carbamazepine

Front 69

Cardiac
cleft palate
growth retardation

Back 69

Anti-cancer drugs

Front 70

Hypoplasia of teeth enamel and teeth staining

Back 70

Tetracycline

Front 71

Cardiac defects
CNS
spina bifida

Back 71

Valproate

Front 72

Effects in female offspring and male different - effects gonads though coumarin-fetal warfarin syndrome

Back 72

Diethylstilbestrol

Front 73

Fetal warfarin syndrome (chondrodysplasia punctata
malformation of ears or eyes
mental retardation
nasal hypoplasia
optic atrophy
skeletal deformities)

Back 73

Coumarin

Front 74

Deafness
heart
limb abnormal

Back 74

Thalidomide

Front 75

Spontaneous abortions
malformation

Back 75

Retinoids

Front 76

Deafness
heart defects
limb abnormalities
renal abnormalities
other

Back 76

Thalidomide

Front 77

Pregnancy Category

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Back 77

Pregnancy Category A

Front 78

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women

Back 78

Preg category B

Front 79

Animal studies have shown an adverse effect
but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Back 79

Preg category B

Front 80

Pregnancy Category

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans
but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Back 80

Pregnancy Category C

Front 81

Pregnancy Category

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans
but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Back 81

Pregnancy Category D

Front 82

Pregnancy Category

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience
and the risks involved in use of the drug in pregnant woman.

Back 82

Pregnancy Category X