Exam 4 Flashcards by Monique Amaya

Estrogen warning and adverse reactions

Category x
Black box warning:
-Endometrial & Breast CA
-Cardiovascular Disorders
-Dementia
-blood clots
Adverse:
Weight gain
Cholasma (melasma) dark skin

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Conjugated estrogen

aka Premarin
-topical & oral
For atrophic vaginitis and epastaxis 👃🏽🩸

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Ethinyl estradiol

aka Estrace
Topical and oral
Commonly in BC 💊

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Estradiol transdermal

aka Duavee, FemPatch
Patch
Lower abd by ovaries
Vasomotor for menopause

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Progestin warnings and adverse reactions

Category X -spontaneous abortion
Black box warning: 🖤
Endometrial & Brease CA
Cardiovascular disorders
Dementia
Adverse effects:
Amenorrhea, spotting
Pyrexia (+body temp)
Depression

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Medroxyprogesterone

aka Amen, Provera, Depo-Provera
Oral, IM,
Contraception
Loss of bone density +2yrs, especially for younger than 25yrs

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Megestrol

aka Megace
Oral
+appetite for CA & AIDS

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Contraception Black box warning

Cardiovascular Disease
Breast & Endometrial CA
Dementia
Cigarette smoking +🩸clots

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When you miss a BC pill you..

Take asap
1 missed pill- back up BC for 1wk
2 missed pills- use back up 1 month

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BC Forms

IM- q 3/m
TD patch- 3wks on 1wk off
NuvaRing- 3wks on 1wk off

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What supplements should you take for Osteoperosis?

Calcium & Vitamin D

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Bisphosphonates
(Osteoperosis)

Inhibit osteoclasts

alendronate (Fosamax) 1/2 life 10yrs
ibandronate (Boniva) PO & IV- back & joint pain
-drink with water
-take in morning
-upright for 30 min due to jaw osteonecrosis

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Monoclonal Antibody (Osteoporosis)

denosumab (Prolia)
mab= + risk for infection/CA
Blocks osteoclasts
Can lead to Jaw ostoonecrosis

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Parathyroid Hormone teriparatide (Osteoperosis)

aka Forteo
Can cause significant Tachycardia

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Selective Estrogen Receptor Module
SERM (Osteoperosis)

raloxifene (Evista)
Gives hot flashes

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Finasteride

aka Propecia
Proscar - BPH reduction
Category X- abortion
-decreased libido
-loss of erection
-gynecomastia

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minoxidil

aka Rogaine
For women and men for alopecia

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causes of erectile dysfunction

Stress
Hyperlipidemia (- 🩸 flow)
Obesity (low T)
DM
Depression
Sleep Apnea
Drug use

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sildenafil

aka Viagra
Take 1hr prior
Interaction with Nitroglicerine
Adverse Reactions:
-Priapism (long boner)
-HA
-Flushing

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Testosterone & Anabolic steroids

Black box warning:
DVT, PE, MI, peliosos Edema
Transdermal Patch
Androderm
Androgel
Axiron- underarm spray
IM

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Isotonic Crystalloids

0.9% NaCl (NS)
Lactate Ringers
Use for dehydration

Hypotonic Crystalloids

0.45% NaCl (Half NS)
used for dehydration with Nl BP

Hypertoniv Crystalloid

D5NS
HIGH RISK
+BP & possible stroke
Mannitol (diuretic) for cerebral edema- doesn’t +BP

Normal Potassium level

3.5 - 5 mEq/L

Hypokalemia

Occurs with loop diuretics Causes dysrhythmia

Potassium replacement

Needs renal assessment first (needs to pee before) PO- eat with food IV- cardiac monitor

Hyperkalemia

❤️ reacts quick to + potassium Dysrhythmia

For potassium toxicity you give

Sodium bicarbonate and calcium gluconate

Normal sodium level

135-145 meq

Level of hyponatremia

Below 120 meq Can cause seizures

Sodium replacement

PO & IV Can cause N/V so take with food

Hypernatremia symptoms

Decreased urine output Water retention Increased thirst

GFR level

90-140 mL

Carbonic Anhydrase Inhibitors

For high altitude sickness Related to sulfonamide (Bactrum) Don't use if renal failure Can cause hypokalemia acetazolamide (Diamox) methazolamide

Loop Diuretics

Don't use if hypokalemia Ok to use for renal failure furosemide (Lasix) bumetanide (Bumex) torsemide (Demadex)

mannitol

aka Osmitrol Osmotic Diuretic (reduces intracranial pressure) Shifts fluids IV only Crystallizes in cold

Potassium sparing diuretics

Used in Peds with ❤️ failure (So potassium doesn't decrease) Adverse reactions: Boobs, no period, kidney stones spironolactone (Aldactone) amiloride (Midamor) triamerene (Dyrenium)

Thiazides (HCTZ)

1st line of defense for HTN “Water pill” -Family to sulfonamide -Renal function decreases -As dose +, hypokalemia & hyperglycemia

Kidney function test

BUN 8-25mg (Buns a 10) GFR >90mL/ min Serum creatinine 0.6-1.5mg (1 Blood) SG 1.001 - 1.030

nitroglycerin (Notrates/Nitrite Meds)

aka (Nitrostat) Sublingual, patch (constant), IV Lay down Absorption of 2-3 min-take a 2nd tab w/no relief No relief of 5 min take 3rd Burning sensation is nl

isosorbide dinitrate (Nitrates)

aka Isordil powerful explosive Rapid sublingual Hard drug to control

isosorbide mononitrate

aka Imdur Sustained release messier to control Constant therapeutic results

Beta blockers for Angina

atenolol (Tenormin) metoprolol (Lopressor) nadolol (Cogard) propranolol (Inderal) Decreases ♥️ rate and BP

Calcium Chanel blockers for Angina

Prevents muscle contraction & causes arterial dilation diltiazem (Cardizem) amlodipine (Norvasc) verapamil (Calan)

What do Andre regicide Blocking drugs do?

Blocks epinephrine (Alpha blockers & Beta blockers)

tamsulosin (Alpha Blocker)

aka Flomax Relaxes vascular in ureters and prostate Treatment of BPH & kidney stones

Other Adrenergic blocking drugs

prazosin (pressure & prostate) alfuzosin (BPH) silodosin (BPH)

propranolol (Beta Blocker)

Decreases ♥️ rate Don’t give to asthmatic or DM (bronchoconstriction) Treatment of HTN, Angina, Migraine, Anxiety

metoprolol (Beta blocker)

aka Lopressor Decreases ♥️ rate Drug of choice for asthma or DM Treatment of HTN & MI

atenolol (Beta blocker)

Decreases ♥️ rate Treatment of HTN, Angina, prevents future MI

esmolol (Beta Blocker)

aka Brevibloc Decreases ♥️ rate Treatment of superventricular tachycardia