Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's Health > Menopause and Osteoporosis Pharmacology > Flashcards

Menopause and Osteoporosis Pharmacology Flashcards

1
Q

Treatment method for mild vulvovaginal symptoms

A

vaginal moisturizers or lubricants → alleviate dryness, burning, itching, dyspareuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment method for moderate to severe vulvovaginal symptoms

A

non-systemic vaginal estrogen product → cream, ring, tablet, insert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oral drugs that is FDA approved for dyspareunia

A

ospemifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ospermifenese is a SERM (selective estrogen receptor modulator) and what is the MOA in helping vulvovaginal symptoms ?

A

activates estrogen pathwaays in some tissues and blocks in others
agonist in endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Adverse effects of ospermifenese

A

may cause vasomotor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the estrogen warnings for ospemifene?

A

endometrial cancer, DVT, stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

vaginal insert that is FDA approved for dyspareunia → “treat painful intercourse due to menopause without FDA boxed safety warning”

A

prasterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

nonpharmacologic methods to treat vasomotor symptoms

A

wear layers, lower room temperatures, decrease intake of spicy food/caffeine/ hot drinks, exercisse, maintain healthy body weight, don’t smoke, relaxation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of vasomotor symptoms as well as preventing endometrial hyperplasia in a patient with intact uterus?
If they had hysterectomy?

A

progestin + estrogen

just estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In treating vasomotor symptoms, which systemic progesterone product has shown better outcomes - medroxyprogesterone acetate (MPA) or micronized progesterone?

A

micronized progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tissue selective estrogen complex approved for moderate to severe vasomotor symptoms and prevent osteoporosis

A

conjugated estrogen + bazedoxifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nonhormonal products that can be used to treat vasomotor symptoms

A

SSRI (paroxetine), SNRI (venlafaxine), clonidine, gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How effective are phytoestrogens (plant compounds, soy, flaxseed, alfalfa) and black cohosh?

A

should not be recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the reality of custom prepared or compounded hormone therapies?

A

lack evidence regarding safety/efficacy/quality
no support saliva testing for adjustments
same risks as traditional therapies
not FDA supported

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lifestyle modifications for healthier bones

A

< 3 drinks/day, exercise, stop smoking, increase dietary calcium intake, lower caffeine intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Receommended calcium intake in women 51 and older and the upper limit of calcium

A

1200 mg

2000 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If your patient is on a PPI what calcium supplement is recommended?

A

calcium citracte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

why is taking calcium carbonate (tums) contraindicated in patients taking PPI?

A

PPI will decrease absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the recommended Vitamin D intake in patients > 70 years?

A

800 units

4,000 units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 main sources of vitamin D?

A

sunlight, diet, supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what organs are involved in creating the metabolically active form of vitamin D (1,25-dihydroxy)?

A

liver and kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What meds increase bone resorption?

A

glucocorticoids
levothyroxine
SGLT2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What meds increase osteoclast and/or decrease osteoblast activity?

A

antiretrovirals
heparin
thiazolidinediones
vitamin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What meds decrease estrogen and sex hormone concentrations?

A

GnRH

DMPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Med that increase renal calcium elimination

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Med that can cause calcium malabsorption

A

PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Med that increases Vitamin D metabolism

A

anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

This is used to identify patients at risk for osteoporosis or osteoporotic fractices and to determine if need further evaluation (DXA scan) or pharmacologic intervention

A

Fracture Risk Assessment Tool (FRAX)

29
Q

What are the two values you receive with FRAX?

A
  1. 10 year probability of ANY major osteoporotic fracture

2. 10 year probability of hip fracture

30
Q

What is the gold standard for BMD measurements?

A

DXA Scan (central dual energy Xray absorptiometry)

31
Q

Who is recommended to receive DXA scan?

A

all women +65 years

32
Q

Why is DXA the gold standard fro BMD?

A

precise and stable calibration, short scan times, low radiation doses

33
Q

T score between -1 and -2.5 indicates

A

osteopenia

34
Q

T score <2.5 indicates

A

osteoporosis

35
Q

If your patients has low trauma vertebral or hip fracture and meets the criteria to get central DXA scan (regardless of the score) what should you recommend?

A

bone healthy lifestyle
Calcium (1,000-1,2000/day)
Vitamin D (800-1,000/day)

36
Q 
If your patient has:
low trauma hip or vertebral fx
osteoporosis
FRAX risk >20% 
FRAX risk for hip >3% + osteopenia
what should you give and when should get next DXA?
A

prescription therapy

DXA in 2 years

37
Q

First line prescritpion therapy for osteoporosis

A

alendronate, risedronate, zoledronic acid, denosumab

38
Q

Second line prescription therapy for osteoporosis

A

ibandronate, raloxifene, teriparatide, abaloparatide

39
Q

Third line prescription therapy for osteoporosis

A

calcitonin

40
Q

What are the two types of agents approved for treating osteoporosis?

A

anti-resorptive and anabolic therapies/formation agents

41
Q

Which three bisphosphonates are first line in preventing the breakdown of bone and decreasing the risk of hip fractures?

A

risedronate, alendronate, zoledronic acid

42
Q

Which bisphosphonate is not considered first line since the decrease in risk of hip fractures has not been proven?

A

ibandronate

43
Q

What is important about when to take bisphosphonate?

A

take prior to food/other meds

44
Q

Which bisphosphonate should be taken immediately after breakfast (unlike the others)?

A

risedronate (atelvia)

45
Q

two recommendations to decrease the side effects seen when taking bisphosphonates

A

take with water and remain upright after taking → decreases reflux

46
Q

contraindications for taking bisphosphonates

A

CrCl < 30-35
pregnancy
uncorrected hypocalcemia

47
Q

Rare ADE seen in bisphosphonates

A

MSK pain, osteonecrosis of jaw, typical (subtrochanteric) femur fractures

48
Q

contraindications and ADE of oral bisphosphonates

A

serious GI conditions or can’t sit/stand after dose

GI complaints

49
Q

When should you consider a “drug holiday” for oral bisphosphonates?

A

after 5 years (3 years if on IV)

50
Q

Your patient can go on “drug holiday” if they meet what criteria?

A

no significant fracture history, hip BMD T score < 2.5, fracture risk isn’t high

51
Q

This drug is antiresorptive → prevents osteoclast formation by binding to nuclear factor kappa ligant (RANKL)

A

denosumab → rank ligand inhibitor

52
Q

This is secreted by osteoblasts and normally activates osteoclast precursors → promoting osteolysis and increasing serum calcium levels

A

RANKL

53
Q

What is the difference between Prolia and Xgeva?

A

Prolia is first line and Xgeva is not indicated for osteoporosis

54
Q

Contraindications for denosumab (prolia)

A

uncorrected hypocalcemia or pregnancy

55
Q

This is the prefered antiresorptive treatemtn in patients with renal failure

A

denosumab (prolia)

56
Q

Antiresorptive that decreases bone resorption by acting as estogen agonist in bone → second line

A

raloxifene

57
Q

contraindications of ratoxifene

A

history or current VTE, pregnancy, use of other SERMs

58
Q

Adverse effects of ratoxifene → why its 2nd line

A

thromboemolic events, hot flashes, increase risk of fatal stroke

59
Q

These anabolic agents mimic the effects of endogenous hormones to stimulate osteoblast function and increases rate of bone formation

A

PTH analogs → teriparatide or abaloparatide

60
Q

This is recombinant form of endogenous PTH that mimics endocrine effects of endogenous PTH

A

teriparatide

61
Q

analog of PTH related protein that mimics paracrine effects of endogenous PTH rP

A

abaloparatide

62
Q

How are PTH analogs efficatious?

A

low intermittent concentrations of PTH for short period actually INCREASES bone formation

63
Q

contraindications for PTH analogs

A

increased risk of osteosarcoma

64
Q

ADE of PTH analogs

A

orthostatic hypotension and hypercalcemia, urolithiasis, increased uric acid, osteosarcoma

65
Q

Last line in treating osteoporosis

A

calcitonin

66
Q

Antiresorptive that inhibits osteoclastic bone resorption by antagonizing the effects of PTH (similar to human calcitonin)

A

calcitonin

67
Q

contraindication for calcitonin

A

hypersensitive to salmon derived products

68
Q

ADE of calcitonin

A

hypocalcemia, hypersensitivity reactions, nausea, flushing, local inflammation, rhinitis, epistaxis

Women's Health (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions