Drugs to talk about

Question 1

Alendronate

Answer 1

Fosomax (Bisphosphonate)
reduction of vertebral fxs in 40-70% of postmeno women
inhibits osteoclast, 10 year 1/2 life!!
Take 30 minutes before meal with water, can not lay down for 30 mins so contraindicated in those bed bound.
AEs: dysphagia, esophageal erosion, esophagitis, osteonecrosis of jaw,

Question 2

Basal Insulin

Answer 2

Lantus (insulin glargine)
Long acting insulin
Onset 1 hours; duration 24 hours

Question 3

Depo-provera

Answer 3

Progesterone
IM birth control lasts for 3 months
AEs: acne, decrease libido, weight gain, increased lipids
Serious: osteoporosis so max of 2 years of use

Very little or no: CVA/ clot risk

Question 4

Depo-testosterone

Answer 4

Testosterone, longer lasting and less expensive, no risk of pregnant woman coming in contact with.
Not as natural as patch and cream (high level to start and decreases before next shot)
AEs: Prostate and Breast CA, polycythemia,

Question 5

Etonogestrel implant

Answer 5

nexplanon
Good for 3 years,
acne, weight gain, break through bleeding, increased clot risks

Question 6

Finastenide

Answer 6

5 alpha reductase inhibitor, BPH and male pattern baldness (Propecia)
Inhibits the enzyme that metabolizes testosterone into DHT in the prostate gland.
Increase DHT causes baldness (so stops this)
Category X in pregnancy!!!! women can’t even handle this while pregnant!
Falsely lows PSA!
Erectile dysfunction

Question 7

Glipizide

Answer 7

Sulfonylurea: insulin secretagogues 
Can cause weight gain, hypoglycermia
Long term use decreased pancreatic beta cell function. (likely 1-2yrs)
Needs renal adjustment. 
Take with meals, it's cheap
Don't give to the elderly

Question 8

Levonogestrel

Answer 8

Plan B
High dose progesterone, should be given within 72 hours but can try up to 5 days
Slows fallopian motility& thickens cervical mucosa. Not abortifacient!
Side effect: Nausea (good if they keep it down for 1 hour)

Question 9

Levothyroxine

Answer 9

synthroid
Start low and titrate high, recheck TSH in 4 weeks, take 1 hour before eating
AEs: palpitations, anxiety

Question 10

Metformin

Answer 10

Biguanides
reduces microvascular complications with DM, and cardiovascular
weight neural vs weight loss
reduces risk of mortality
Start low and titrate slowly to avoid GI side effects, take with food
Contraindicated in elevated creatinine (1.4) & GFR

Question 11

Mirena IUD

Answer 11

Progesterone

good for 5 years

Question 12

Norgestimate ethinyl estradiol

Answer 12

BCP but also dysmenorrhea, acne, dysfunctional uterine bleeding
All the clot risk stuff
AEs: breast tenderness, HA, nausea, weight changes,

Question 13

Paraguard IUD

Answer 13

Copper IUD, good for 10 year

Question 14

Polyethylene glycol

Answer 14

(Miralax) Hyperosmotic
MOA: very large molecule causes osmotic effect
AEs: bloating, flatulence, cramping, diarrhea
Onset: 1-3 days
Drug interaction: licorice

Question 15

Premarin

Answer 15

HRT: Pregnant Mare Estrogen
Helps to modulate FSH & LH in post meno women, maintains reproductive cycle and secondary sexual characteristics.
Significantly decreases hot flashes and vaginal atrophy.

Question 16

Psyllium

Answer 16

1st line treatment with lifestyle changes (Metamucil, plant derived)
MOA: swells with fluid in the gut
Onset: 12 hours- 3 days.
Adverse rxn: obstruction, flatulence
Should not be taken within 2 hours of taking tetracycline
Drug interaction: licorice

Question 17

Sidenafil

Answer 17

Oral phosphodiesterase type 5 inhibitor, inhibits smooth muscle contraction (causing relaxation) in the corpus cavernosum.
AEs: hypotension, especially with nitrates. Priapism, headache, blue-green vision changes, flushing, nausea, flu-like symptoms

Question 18

Tamsulosin

Answer 18

Flomax: Alpha 1 blocker
Targets bladder and prostatic smooth muscle
AEs: orthostatic hypotension (has some systemic vasodilation), GI distress, decrease libido, HA and dizziness

Question 19

Omeprazole

Answer 19

PPI,
Onset 1-2 hours, Duration 24 hours
Dose: 20-40mg Q day-BID
Adverse Side effect: HA, Nausea, dizziness, bowel changes
Drug Interactions: warfarin, diazepam, digoxin, carbamazepine, clopidogrel.
Long term risks of: malabsorption (B12 deficiencies), infections (pneumonia, C-diff), rebound acid hypersecretion,