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36 Cards in this Set
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when to initiate prescription treatment for osteoporosis
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postmenopausal women who have experienced a fragility or low impact fracture
postmenopausal women with bone mineral density score less than -2 by centrual DXA in the absence of risk factors women with T scores less than -1.5 in the presence of one or more risk factor |
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prevention options for osteoporosis
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adequate clacium and vitamin D intake through diet or supplementation is recommended for everyone (calcium 1000-1500mg daily plus 400-800IV vitamin D daily)
lifestyle modifications are recommended: weight bearing exercise smoking cessation limited EtOH intake prescription drug therapy should be initated on an indivudial basis considering risk factors, bone mineral density, fracture hixstory and concomitant diseases and medications |
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bisphosphonates consultation
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bisphosphonates must be taken with a full glass of water (8oz) 30 min prior to the first meal of the day
remain in an upright position for at least 30min following ingestion take medication on a regularly scheduled basis compliance may be increased by once-weekly dosing |
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bisphosphonates prevention regimens
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fosamax: 5mg qd or 35mg wkly
actonel prevention: 5mg qd boniva prevention 150mg monthly |
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bisphonsphonate tx regimens
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fosamax tx 10mg qd or 70mg qkly
actonel tx: 5mg qd or 30mg wkly boniva tx: 150mg monthly |
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recommended dosage range of daily calcium intake for an adult
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1-1.5g/d
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what ostoeoporsis product is available in injectable product and nasal spray
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calcitonin; miacalcin
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what ostoeoporosis product is available only as an injectable product
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teriparatide (Forteo)
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what medications increase the risk of osteoprosis
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anticonvulsants (phenobarbital, phenytoin)
cytotoxic drugs glucocorticodids immunosuppressants lithium long-term heparin use progesterone, parenteral long acting supraphysiologic thyroxine doses tamoxifen (premenopausal) |
cd PPPG is LT lth
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what is the recommended dose of raloxifene in the prevention and treatment of postmenopaual osteoprosis
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Tamoxifene 60mg qd
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what products could a lactating mother take to prevent pregnancy
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progestin only oral tab:
ortho micronor Errin, Nor-Qd, Nora-BE, Camila, Ovrette progestin only injections: depo-provera progestin only IU: progestasert, mirena |
4 girls, CONE
OMN DP PM |
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bisphasic oral contraceptives
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ortho-Novum 10/11
Necon 10/11 |
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Triphasic OC: changing EE changing progestin include
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enpresse, tri-levlen, triphasil, trivora
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triphasic OC: nonchanging EE changing progestin
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Tri-Norinyl, Necon 7/7/7 ortho-Novum 7/7/7 cyclessa, ortho tricyclen Lo
ortho Tricyclen |
T-N
the 2 7's 3 cycles |
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triphasic oc: changing EE nonchanging progestin
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estrostep 21, estrostep Fe
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the 2 step
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what is the highest dose of EE offered in oral contraceptive
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50mcg
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what is the lowest dose of EE offered in oral contraceptive
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20mcg
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a progestin only OC would be preferred in what type of pts
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smoker over 35yrs
lactating mother hx of thromboembolic disease |
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what is the appropriate therapy for a women suffering from menopausal sx who has an intact uterus
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estrogen and progestin product
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what is the appropriate therapy for a women suffering from menopausal sx post op hysterectomy
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estrogen alone
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what are the combined estrogen-progestin products for menopause
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activella
femhrt prempro premphase |
AFPP
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CI for HRT in postmenopasual women
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abnormal undiagnozed genital bleeding
breat cancer DVT or PE estrogen-dependent neoplasia pregnancy stroke or MI in the last year thromboembolic disorder thrombophlebitis |
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DDI with OC that will decrease response
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ampicillin, griseofluvin, sulfonamides, tetracycline, anticonsulsants (barbs, CBZ, felbamate, phenytoin, topiramate)
non-nucleoside revere transciptase inhibitors protease inhibitors pioglitazone phenytoin protease inhibitors rifampin theophylline |
ABX: AGST
BCFPT NRTI PI TZD RT |
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DDI with OC that can increase response
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atorvastatin
vitamin C CYP 3a4 inhibitors |
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ADR associated with estrogen
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breast tenderness
heavy bleeding HA Nausea |
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ADR associated with progestin
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depression
HA irritability |
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ortho evra dosing
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replace patch qwk
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Nuva ring dosing
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replace ring q3w, leave out for 1wk then insert another ring for 3wk
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estradiol transderm product for menopause
dosing |
ap to skin twice wkly
once wkly for climara |
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estrogen injectable formulations for menopause dosing
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dosed q3-4wks
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estrace vaginal cream dosing instruction
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2-4g qd for 1-2wks md: 1g 1-3x/wk
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ogen vaginal cream
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2-4g qd
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premarin vaginal cream
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.5-2g qd for 3wk then 1wk off
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estring vaginal ring
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ring remains in for 3 months
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vagifem vaginal tab
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1tab qd for 2wks; md: 1tab biw
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premphase
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2wks estrogen alone 2wks combo
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