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Dispensing Final 2013 > Hormones Section Final > Flashcards

Hormones Section Final Flashcards

1
Q

How do oral contraceptive work?

A

Inhibit ovulation and alter cervical mucus to decrease sperm penetration

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2
Q

estrogen in oral contraceptives?

A

ethinyl estradiol

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3
Q

progestins in oral contraceptives?

A

levonorgestrel, desogestrel, norethindrone, norgestimate, drospirenone, and norgestrel

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4
Q

Drospirenone details?

A

o Drospirenone is derived from spironolactone → can raise serum K+ levels
• Cautiously prescribed in women taking ACE inhibitors, ARBs, K+ sparing diuretics and potassium supplements

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5
Q

Birth control counseling (2), adverse effects?

A
  • If taking for the first time, use an additional method of birth control for the first seven days or through the first cycle
  • Antibiotics decrease the effectiveness of oral contraceptives, so use second method of birth control
  • Adverse effects: alveolar osteitis, hirsutism, weight gain, and nausea
  • Increased risk of CVD for women who smoke; smoking is not recommended
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6
Q

3 classes of oral contraceptives?

A

monophasic, biphasic, triphasic

all dosed qday

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7
Q

Monophasic OC details?

A

Monophasic delivers a fixed dose of estrogen and progestin throughout the cycle

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8
Q

Monophasic trades (11)?

A 
o	Apri
o	Aviane
o	Gianvi
o	Levora
o	Loestrin 24
o	Lo Ogestrel
o	Microgestin
o	Sprintec
o	Yasmin
o	Yaz: acne and PMDD
o	Zarah
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9
Q

Biphasic OC details?

A

delivers a fixed dose of estrogen and progestin for the first 21 days of the cycle → estrogen dosage decreases and progestin is discontinued

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10
Q

Biphasic OC trades?

A

o Kariva
o Mircette
o Seasonique

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11
Q

Triphasic details?

A

estrogen dose stays the same or varies and the progestin dose varies

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12
Q

Triphasic trades?

A 
o	Estrostep: acne
o	Ortho Tri-Cyclen: acne
o	TriNessa
o	Tri-Sprintec
o	Trivora
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13
Q

non-oral contraceptive trades?

A

Ortho Evra, NuvaRing, Depo-Provera

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14
Q

Ortho Evra generic and details?

A

ethinyl estradiol, norelgestromin

qweekly, transdermal system

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15
Q

NuvaRing generic and details?

A

ethinyl estradiol, etonogestrel
• qmonth
• Wear continuously for 3 weeks, then remove for 1 week → period starts in 2-3 days
• Refrigerate in the pharmacy
• Ring must be reinserted within 3 hours if expelled

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16
Q

Depo-Provera generic and details?

A

medroxyprogesterone
• q3months
• Suspension for injection → must be shaken to ensure a uniform suspension

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17
Q

Hormone Replacement Therapy indications?

A
  • Treat vasomotor symptoms, vaginal atrophy, and osteoporosis
  • Atrophic vaginitis occurs when estrogen levels decrease during menopause → dyspareunia
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18
Q

Hormone Replacement Therapy Trades?

A

Evista, Premarin (tab, cream), Prempro,
Vagifem, Vivelle-Dot, Estrace Vaginal Cream,
Activella, Femhrt, Delestrogen

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19
Q

Evista generic and details?

A

raloxifene
• qday
• Selective estrogen receptor modulator
• Indicated for osteoporosis and prevention of breast cancer

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20
Q

Premarin generic and details?

A

conjugated equine estrogens
• qday
• Tablet
• Indicated for VM, VA, and O

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21
Q

Premarin Vaginal Cream generic and details?

A 
conjugated equine estrogens
•	Twice weekly
•	0.625 mg/g vaginal cream
•	Indicated for VA
•	Applicator is calibrated in 0.5 gram increments; max of 2 grams
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22
Q

Prempro generic and details?

A

conjugated equine estrogens, medroxyprogesterone
• qday
• Indicated for menopausal symptoms

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23
Q

Vagifem generic and details?

A 
estradiol
•	Vaginal tablet
•	Indicated for VA
•	Initial: 1 tablet qday x 2 weeks
•	Maintenance: 1 tablet twice weekly
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24
Q

Vivelle-Dot generic and details?

A

estradiol
• Twice weekly
• Transdermal

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25
Q

Estrace Vaginal Cream generic and details?

A

estradiol
• 0.1 mg/g vaginal cream
• Indicated for VA
• Initial: qday x 2 weeks → after 2 weeks use ½ dose qday x 2 weeks
• Maintenance: 1-3x/week
• Applicator calibrated in 1 gram increments; max of 4 grams

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26
Q

Endogenous androgens generic and details?

A

testosterone
• Responsible for development of the male sex organs and for maintenance of secondary sexual characteristics
• Men normally produce 5 mg of testosterone daily
• Male hypogonadism is a condition characterized by low serum concentration of testosterone –> Impotence, decreased sexual desire, fatigue, and osteoporosis

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27
Q

testosterone Trade and details?

A

AndroGel
• qday
• Indicated for male hypogonadism
• Topical gel
• Single dose packet: 2.5 gram and 5 gram
• Metered dose pump: 1% (4 pumps), 1.62% (2 pumps)

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28
Q

Diabetes definition and types?

A

o Diabetes mellitus – disorder of carb metabolism caused by an insufficient secretion of insulin or inadequate utilization of insulin by body tissues (insulin resistance)
• Type I – do not make enough insulin; unpreventable; must use insulin shots
• Type II – body does not produce enough insulin or it cannot use the insulin that is produced; preventable

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29
Q

Insulin definition and syringe details?

A

hormone synthesized in the pancreas, essential for utilization of glucose in the body
•Should be administered with insulin syringes
• 3/10 mL syringe –> 30 units of insulin
• ½ mL & 1 mL –> 50 to 100 units, respectively

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30
Q

Goal of insulin therapy? Glucagon therapy?

A 
control hyperglycemia (hypoglycemia is potential adverse effect
Treat hypoglycemia with glucagon for injection (IV, IM, SQ) to induce liver glycogen to make glucose
•	Infusion of glucose and insulin produces a shift of potassium into the cells → lowers serum K+ levels
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31
Q

OTC insulin generics?

A

insulin regular
insulin NPH (neutral protamine hagedorn)
combo of the two

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32
Q

insulin regular Trades and details?

A

Humulin R, Novolin R
•Rapid acting
•OTC

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33
Q

insulin NPH Trades and details?

A

Humulin NPH, Novolin NPH
•Intermediate acting
•OTC
•Also known as isophane insulin

34
Q

Insulin OTC combination product?

A

Humulin 70/30, Novolin 70/30
NPH (70%), regular (30%)
intermediate acting
OTC

35
Q

Rx only insulin Trades?

A

Humalog, Novolog, Apidra
Humalog Mix 75/25, Novolog Mix 70/30
Lantus. Levemir
Humulin R U-500

36
Q

Humalog, Novolog, Apidra generics and details?

A 
Humalog	-insulin lispro
Novolog	-insulin aspart
Apidra	-insulin glulisine
•	Insulin analog 
•	Rapid acting
•	Rx only
37
Q

Humalog Mix generic and details?

A

Humalog Mix 75/25
insulin lispro protamine (75%), insulin lispro (25%)
• Intermediate acting
• Rx only

38
Q

Novolog Mix generic and details?

A

Novolog Mix 70/30
insulin asaprt protamine (70%), insulin aspart (30%)
intermediate acting
Rx only

39
Q

Lantus, Levemir generics and details?

A 
Lantus - insulin glargine
Levemir - insulin detemir
•	Long acting
•	Used to give basal insulin level
•	Rx only
40
Q

Humulin R U 500

A

insulin regular 500 units/mL

indicated for patients requiring more than 200 units/day

41
Q

List of antidiabetic classes (7)

make thingy

A 
Sulfonylureas
Metglitinides
Biguanides
Alpha-glucosidase inhibitors
Thiazolidinediones
Incretin Mimetics
Dipeptidyl Peptidase-4 inhibitorsmake
42
Q

Sulfonylurea generics?

A

glipizide
glimepiride
glyburide
chlorpropamide

43
Q

glipiziade Trade?

A

Glucotrol
Glucotrol XL
Sulfonylurea

44
Q

glimepiride Trade?

A

Amaryl

Sulfonylurea

45
Q

glyburide Trade?

A

Diabeta
Glynase PresTab
Sulfonylurea

46
Q

Sulfonylurea class MOA and counseling?

A
  • Stimulate insulin release from pancreas and increase tissue sensitivity to insulin
  • Can cause severe hypoglycemia so avoid alcohol
47
Q

Metglitinide class MOA and counseling

A
  • Stimulate insulin release from pancreas

* Can cause severe hypoglycemia so avoid alcohol

48
Q

Metglitinide Trades and generics?

A

nateglinide

repaglinide (TID)

49
Q

nateglinide Trade?

A

Starlix

Metglitinide

50
Q

repaglinide Trade?

A

Prandin (TID)

Metglitinide

51
Q

Biguanide MOA?

A

Only increase tissue sensitivity to insulin; helps with insulin resistance

52
Q

Biguanide generic?

53
Q

metformin BID Trade?

A

Glucophage (tablet)

biguanide

54
Q

metformin qday Trade?

A

All ER Tablets (biguanides):
Glucophage XR
Fortamet
Glumetza

55
Q

Alpha-glucosidase inhibitors MOA and counseling?

A
  • Delay digestion of ingested carbs, which results in a smaller increase of blood glucose after meals
  • Take at first bite of each main meal
  • Side effect: increased flatulence
56
Q

Alpha-glucosidase inhibitor Trades and generics?

A

Precose - acarbose

Glyset - miglitol

57
Q

Thiazolidinedione MOA and counseling?

A
  • Increase tissue sensitivity to insulin
  • BBW: may cause or exacerbate heart failure
  • Monitor patients for congestive heart failure
  • Dyspnea-difficulty breathing
58
Q

Thiazolidinedione generics?

A

pioglitazone

rosiglitazone

59
Q

pioglitazone Trade?

A

Actos

thiazolidinedione

60
Q

rosiglitazone Trade?

A

Avandia

thiazolidinedione

61
Q

Incretin Mimetic MOA?

A
  • Incretin hormones are released in the intestine in response to meals and stimulate insulin release from the pancreas
  • Only used in Type II
62
Q

Incretin Mimetic generics?

A

exenatide, liraglutide

63
Q

exenatide BID Trade and details?

A

Byetta - exenatide
•BID; 1 hour before breakfast and 1 hour before dinner
•5 mcg, 10 mcg SQ injection
•Refrigerate; can be stored at room temperature for 6 days
(Incretin Mimetic)

64
Q

exenatide Qweekly Trade and details?

A 
Bydureon - exenatide
•	qweekly
•	SQ injection
•	Inject any time independent of meals
•	Refrigerate
(Incretin Mimetic)
65
Q

liraglutide Trade and details?

A 
Victoza - liraglutide
•	qdaily
•	0.6, 1.2, 1.8 mg SQ injection
•	Independent of meals
•	Refrigerate; can be stored at room temperature for 30 days 
(Incretin Mimetic)
66
Q

Dipeptidyl Peptidase-4 inhibitors MOA?

A

DPP4 is enzyme needed to metabolize the incretin hormones
• Incretin hormones are released in the intestine in response to meals → stimulate insulin release from pancreas
• If inhibited, incretin will work longer and stimulate more insulin

67
Q

Dipeptidyl Peptidase-4 inhibitor generics?

A

sitagliptin, saxagliptin

68
Q

sitagliptin Trade?

A

Januvia - sitagliptin

DPP4 inhibitors

69
Q

saxagliptin Trade?

A

Onglyza - saxagliptin

70
Q

Combination Antidiabetic Trades?

A 
Metaglip
Avandamet
Actoplus Met
Glucovance
Janumet
71
Q

Metaglip generic?

A

glipizide, metformin

72
Q

Avandamet generic?

A

rosiglitazone, metformin

73
Q

Actoplus Met generic?

A

pioglitazone, metformin

74
Q

Glucovance generic?

A

glyburide, metformin

75
Q

Janumet generic?

A

sitagliptin, metformin

76
Q

Thyroid hormone indications, origins, ratios?

A

o Indicated as replacement or supplemental therapy in hypothyroidism
o Natural products are derived from beef and pork → difficult to standardize so synthetic products are preferred
• Armour Thyroid tablets are derived from porcine thyroid glands; have a strong smell
o T-3 is 4x as potent as T-4 on a microgram per microgram basis

77
Q

Thyroid hormone generics?

A

liotrix
levothyroxine
liothyronine

78
Q

liotrix Trade and details?

A

Thyrolar

4:1 mixture of T-4 to T-3

79
Q

levothyroxine Trade and details?

A

Synthroid, Levoxyl
• qday tablet
• Take on empty stomach
• T-4

80
Q

liothyronine Trade and details?

A

Cytomel
• qday tablet
• Take on empty stomach
• T-3

Dispensing Final 2013 (3 decks)

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