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NURS 5334 > Module 6 Pharm > Flashcards

Module 6 Pharm Flashcards

1
Q

Which drugs can be used in gestational diabetes? (select all that apply)

a) glucotrol
b) metformin
c) pioglitazone
d) insulin
e) sitagliptin

A

Answer: b) metformin and d)insulin

These are the preferred agents.

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2
Q

What drugs can cause hypoglycemia?

a) sulfonylureas
b) metformin
c) glinides
d) alcohol
e) GLP-1 receptor agonists

A

Answer: sulfonyureas, glinides, alcohol

Insulin also increases risk for hypoglycemia. Amylin mimetics (pramlintide) can also cause hypoglycemia. Beta blockers can block glycogenolysis.

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3
Q

Which is diagnostic for diabetes?

a) fasting glucose 120
b) random glucose 126
c) A1C 6.5+
d) symptoms of diabetes

A

Answer: c) A1C of 6.5+ is considered diagnostic for DM

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4
Q

Which is diagnostic for diabetes (check all that apply)

a) fasting glucose 126
b) random glucose 180+ symptoms of DM
c) A1C 6.4
d) random glucose 200+ without symptoms of DM

A

Answer: a & d

Diagnostic values are A1C 6.5+; random glucose of 200+ with or without symptoms of DM and fasting glucose of 126

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5
Q

Which drug can cause hyperglycemia?

a) sulfonyureas
b) beta blockers
c) thiazide diuretics
d) glucocorticoids
e) statins

A

Answer: c & d

Others include sympathomimetics (mimic the sympathetic nervous system)

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6
Q

A patient concurrently taking a beta-blocker. What does the patient need to be aware of?

a) beta blockers increase glycogenolysis and help the body react to low glucose
b) beta blockers impair glycogenolysis (glycogenolysis is a process by which the body can respond to and counteract a fall in glucose)
c) beta blockers can make the patient more aware of hypoglycemia
d) beta blockers have no effect on glycogenolysis

A

Answer: b) beta blockers impair glycogenolysis (glycogen–> glucose) whereby the patient may experience hypoglycemia and it may go undetected

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7
Q

What is the blood pressure goal for diabetics?

A

140/90 or below

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8
Q

Insulin dosing must be coordinated with what?

A

Carbohydrate intake

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9
Q

What are good drug options to decrease risk of diabetic nephropathy?

a) ACEI
b) statins
c) sulfonureas
d) HCTZ

A

Answer: a) ACEI and ARBS are both good choices

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10
Q

Step 1 of the 4 step approach for DM management involves:

A

Lifestyle change plus metformin

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11
Q

Step 2 of the 4 step approach for DM management involves:

a) TZD
b) DPP-4 inhibitor
c) SGLT-2 inhibitor
d) basal insulin
e) combination insulin

A

Answer: Step 2: Step 1+(TZD,DPP-4 inhibitor, SGLT-2 inhibitor,GLP-1 receptor agonist);

Note: may consider sulfonyurea or basal insulin if goals are not achieved with previously listed drugs for step 2

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12
Q

Step 3 of the 4 step approach for DM management involves:

A

A 3-drug regimen (including metformin)

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13
Q

Step 4 out of the 4 step approach to DM management includes:

A

If step 3 (3 drug) insufficient: use a more complex insulin regimen in conjunction with 1+ noninsulin medicines

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14
Q

Which is a short duration, short acting insulin?

a) lispro (Humalog)
b) glargine (Lantus)
c) Humulin R
d) glulisine (Apidra)

A

Answer: c) Humulin R

These insulins are considered “regular” or natural insulins and include Humulin R and Novolin R

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15
Q

Which is an intermediate acting insulin?

a) lispro (Humalog)
b) glargine (Lantus)
c) Humulin R
d) Humulin N

A

Answer: d) Humulin N

These insulins are NPH insulin (Humulin N & Novolin N)

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16
Q

Long acting insulins include (select all that apply)

a) glulisine (Apidra)
b) glargine (Lantus)
c) Humulin N
d) detemir (Levemir)

A

Answer: b (Lantus) & d (Levemir)

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17
Q

Which is not a side effect of metformin ( select all that apply)?

a) GI upset
b) hypoglycemia
c) medullary thyroid cancer
d) lactic acidosis

A

Answer: b & c

Medullary thyroid cancer is associated with Exenatide (a GLP-1 receptor agonist)

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18
Q

Which patient comorbidities place the patient at high risk for lactic acidosis while taking metformin?

a) CHF
b) CKD
c) cirrhosis
d) hypothyroid

A

Answer: a &b

Lactic acidosis is especially concerning in patients with CKG/CHF

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19
Q

True or false, patients should take metformin on an empty stomach.

A

False, they should take with food to minimize GI upset.

The ER version also has less GI effects.

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20
Q

Which of the following is NOT a MOA for metformin?

a) blocks the ATP/K channel which causes membrane depolarization
b) inhibits glucose production in liver
c) confers resistance to DPP-4 inactivation of GLP-1 in the gut
d) reduces glucose absorption in gut
e) sensitizes insulin receptors in target tissue

A

Answer: a & c

Metformin works by inhibiting glucose production by the liver; reduces glucose absorption from gut; sensitizes insulin receptors in target tissue; increases glucose uptake in response to available insulin

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21
Q

Which drug does not cause weight gain?

a) meglitinides
b) metformin
c) sulfonyureas
d) thiazolidinediones

A

Answer: b) metformin

(My Skinny Thighs) - (My Best Form?)

Metformin causes weight loss.

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22
Q

Which drug class can reduce A1C by 1.5%-2.0%?

a) metformin
b) sulfonylureas
c) DPP-4 inhibitors (gliptins)
d) Thiazolidinediones

A

Answer: b) sulfonylureas

Think Sulfonylureas= Super reduction of A1C (they reduce A1C more than any other drug)

Metformin can reduce 1%-2%

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23
Q

What is the drug name prefix for Sulfonylureas?

A

“Gly____” and “Gli_____”

Glypizide, Glyburide, Glimepiride

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24
Q

Meglitinide names have what name component?

A

“_____glinide”

Nateglinide & Repaglinide

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25
Q

Thiazolidinediones (TZDs) can be remembered with what name component?

A

“_____glitazone”

Poglitazone

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26
Q

Which drugs are alpha-glucosidase inhibitors?

a) repaglinide
b) miglitol
c) exanatide
d) acarbose

A

Answer: b) miglitol and d)acarbose

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27
Q

DPP-4 drugs can be remembered with what name component?

A

“______gliptin”

They are sometimes called the Gliptins

Think “griffins” from PicMonic

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28
Q

SGLT-2 inhibitors can be remembered with what name component?

A

“_____agliflozin”

Dapagliflozin & Canagliflozin

Think “flozin” and “urine/kidney flow” which is where these drugs impart their action.

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29
Q

Colesevelam can be used in diabetes and affords what additional benefit?

a) lowers BP
b) raises HDL
c) lowers LDL
d) it is not beneficial for anything but diabetes management

A

Answer: c) lowers LDL and also improves blood sugar

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30
Q

Bromocriptine might be used in which patients (check all that apply):

a) diabetic
b) hypothyroid
c) Alzheimers
d) Parkinsons
e) hyperlipidemia

A

Answer: a) diabetic; d) parkinson’s disease and e) hyperlipidemia

The drug will decrease glucose/TRIGS/FFA and is used in Parkinson’s disease.

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31
Q

Which drug stimulates amylin and reduces insulin?

a) Exanatide
b) Acarbose
c) alogliptin
d) pramlintide

A

Answer: d) pramlintide

Think “AMYlin mimetic” and “prAMLINtide.” Note: it is an injectible.

“Think Princess Bride”

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32
Q

Exenatide is a GLP-1 receptor agonist, what is its’ MOA (select all that apply)

a) blocks the ATP/K channel which causes membrane depolarization
b) inhibits glucose production in liver
c) slows gastric emptying
d) reduces glucose absorption in gut
e) suppresses appetite

A

Answer: c) slows gastric emptying and e)suppresses appetite

Other MOA: stimulates glucose-dependent release of insulin & inhibits postrandial release of glucagon

Choice A refers to either sulfonylureas or meglitinides

Choice B refers to metformin or TZD

Choice D refers to metformin or alpha-glucosidase inhibitors

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33
Q

Main side effects of sulfonylureas are:

a) GI upset
b) hypoglycemia
c) weight loss
d) liver toxicity
e) renal toxicity

A

Answer: b) hypoglycemia, d) liver toxicity and e) renal toxicity

It can also cause weight GAIN.

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34
Q

What is a side effect of alpha-glucosidase inhibitors?

a) liver toxicity
b) GI upset
c) explosive diarrhea
d) medullary thyroid cancer

A

Answer: c) explosive diarrhea

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35
Q

What is a side effect of DPP-4 inhibitors (Gliptins)?

a) liver toxicity
b) GI upset
c) explosive diarrhea
d) UTI

A

Answer: d) UTI

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36
Q

What lab should we consider monitoring prior to the initiation of treatment with dapagliflozin?

a) liver function
b) TSH
c) CBC
d) GFR

A

Answer: d) GFR due to fact that it does not work well in patients with a GFR <45.

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37
Q

Exanatide has what side effects?

a) liver toxicity
b) GI upset
c) explosive diarrhea
d) medullary thyroid cancer

A

Answer: d) medullary thyroid cancer

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38
Q

Which medication should be avoided in patients with a sulfa allergy (select all that apply)?

a) metformin
b) glyburide
c) poglitazone
d) saxagliptin

A

Answer: b)glyburide (a sulfonylurea) & c)poglitazone (a TZD)

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39
Q

What lab would you want to monitor prior to prescribing an SGLT-2 inhibitor?

a) AST
b) ALP
c) GFR
d) CBC
e) LFT

A

Answer: c) GFR

These should not be prescribed if GFR<45

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40
Q

Which medications have UTIs as a potential side effect?

a) meglitinides
b) DPP-4 inhibitors
c) alpha-glucosidase inhibitors
d) SGLT-2 inhibitors

A

Answer: b) DPP-4 inhibitors (gliptins) and d) SGLT-2 inhibitors (“flozins”)

41
Q

To determine if thyroid deficiency is permanent or transient in a child, we would provide replacement therapy for 3 years, then stop it for 4 weeks and measure labs. Which lab(s) would be indicative of a permanent deficiency?

a) normal TSH
b) normal T4
c) elevated TSH
d) low TSH
e) low T4

A

Answer: c)elevated TSH

This indicates thyroid hormone production is low and we know the deficiency is permanent so replacement therapy should resume.

42
Q

Which is not true of dosage guidance for thyroid hormones?

a) adult dosing is 1.6-1.8 mcg/kg/day
b) if overweight, dose at current weight
c) if overweight, dose at ideal weight
d) if underweight, dose at current weight
e) if underweight, dose at ideal weight

A

Answer: b) if overweight, dose at current weight & e) if underweight, dose at ideal weight

The appropriate dosing is 1.6-1.8 mcg/kg/day; if overweight we dose at ideal weight; if underweight we dose at current weight.

43
Q

If a patient returns for reevaluation of their thyroid medication, and the TSH is high, what should we do to the dosage of the thyroid replacement drug?

a) decrease the dosage
b) increase the dosage
c) no change in the dosage

A

Answer: b) increase the dosage

Basically the body is being told there is still a deficiency in the T4/T3 so TSH remains high to compensate.

44
Q

If a patient returns for reevaluation of their thyroid medication, and the TSH is low, what should we do to the dosage of the thyroid replacement drug?

a) decrease the dosage
b) increase the dosage
c) no change in the dosage

A

Answer: a) decrease the dosage

The body realizes that T4/T3 is elevated and so the feedback mechanism decreases TSH to cause a subsequent decrease in T4/T3

45
Q

True or false, levothyroxine (Synthroid) works by T3 converting to T4 in the periphery?

A

False, synthroid converts T4 to T3 (more potent) in the periphery

46
Q

Which formulation is made of desiccated animal thyroid glands?

a) levothyroxine
b) liothyronine
c) liotrix
d) armour thyroid

A

Answer: d) thyroid (Armour thyroid)

47
Q

Which drug would decrease levothyroxine absorption (check all that apply)?

a) PPI
b) Maalox
c) warfarin
d) catecholamines
e) insulin

A

Answer: a) PPI & b) Maalox

Think: drugs that impact stomach/coat stomach, cholesterol drugs, and supplements

Drugs which decrease levothyroxine absorption include: H2 receptor blockers, PPI, sucralfate, cholestyramine, colestipol, Maalox, Mylanta, calcium supplements, iron, magnesium, orlistat (weight loss drug)

48
Q

Which drugs increase levothyroxine metabolism (check all that apply)?

a) PPI
b) phenytoin
c) rifampin
d) orlistat
e) sertraline

A

Answer: b,c,e

Drugs which increase levothyroxine metabolism (requiring a higher dose of Levo) include: phenytoin, carbamazepine, rifampin, sertraline, and phenobarbital

49
Q

Which drugs does levothyroxine accelerate the degradation of (check all that apply)?

a) PPI
b) phenytoin
c) warfarin
d) orlistat
e) sertraline

A

Answer: c) warfarin

Levothyroxine increases the breakdown of vitamin-K dependent clotting factors (Warfarin) such that the effects are Warfarin are increased (may need to reduce Warfarin dosage).

50
Q

A patient taking levothyroxine and a catecholamine (norepinephrine, epinephrine, dopamine) may be at increased risk for what side effect?

a) hepatotoxicity
b) renal injury
c) hypertension
d) dysrhythmias
e) increased LDL/decreased HDL

A

Answer: d) dysrhythmias

51
Q

A patient taking which drug may need a higher dose of insulin (select all that apply)?

a) oral contraceptives
b) bromocriptine
c) warfarin
d) levothyroxine
e) finasteride

A

Answer: a) oral contraceptives and d) levothyroxine

Oral contraceptives can decrease the effect of insulin (thus increasing the requirements for insulin) & levothyroxine can increase the requirements needed for insulin.

52
Q

Which drugs have increased requirements while taking levothyroxine (choose all that apply)?

a) insulin
b) oral contraceptives
c) warfarin
d) digoxin

A

Answer: a) insulin & d) digoxin

These drugs may need higher doses when taken concurrently with levothyroxine.

53
Q

A pregnant patient has HYPERthyroidism, what medication should she be prescribed?

a) levothyroxine
b) PTU
c) Armour Thyroid
d) Methimazole

A

Answer: b) PTU

PTU crosses the placenta less readily and concentrations are less in breast milk.

Methimazole–>DO NOT GIVE in 1st trimester especially

54
Q

Which is a side effect of methimazole (check all that apply)?

a) hepatotoxicity
b) agranulocytosis
c) bradycardia
d) medullary thyroid cancer

A

Answer: b) agranulocytosis

Methimazole DOES NOT cause liver injury (PTU does).

55
Q

What are side effects associated with levothyroxine (check all that apply)?

a) AFib
b) bradycardia
c) heat intolerance
d) bone fractures
e) angina

A

Answer: a)Afib, c) heat intolerance, d)bone fractures & e)angina

Side effects include: tachycardia, angina, tremor, nervous, insomnia, hyperthermia, heat intolerance, sweating; (Afib & bone fractures can occur with chronic overdose)

Also, overdose thyrotoxicosis can occur.

56
Q

A patient with hyperthyroidism should avoid what foods?

a) dairy
b) high protein
c) seafood
d) foods rich in tyramine

A

Answer: c) seafood

57
Q

What is the MOA of PTU?

a) blocks TSH
b) blocks TRH
c) prevents conversion of T4 to T3
d) none of the above

A

Answer: c) PTU blocks the conversion of T4 TO T3 in the periphery (methimazole does not)

58
Q

The first stage of the menstrual cycle is the _____ (follicular/lutenizing) stage where ______ is secreted by the ________ (ovarian follicles/corpus luteum).

A

The first stage of the menstrual cycle is the follicular stage where estrogens are secreted by the ovarian follicles until midcycle when LH is high and the follicles rupture. A corpus luteum is formed during the rupture which then releases estrogen & progesterone for the lutenizing stage.

59
Q

What metabolic impact does endogenous estrogen have systemically (check all that apply)?

a) raise HDL
b) decreases blood coagulation
c) glucose homeostasis
d) promote ovarian cancer
e) CV protective

A

Answer: a,c,e

Metabolic actions of estrogen include: block bone reabsorption, decreases LDL and raises HDL, promote blood coagulation, protect brain, glucose homeostasis, and CV protective by decreasing vasoconstriction of smooth muscle/favorable lipid actions.

(note it can increase thromboembolic events though)

60
Q

Adverse effects of estrogen (select all that apply)?

a) breast cancer
b) CV events
c) bone breakdown
d) altered lipids (increased LDL and decreased HDL)
e) endometrial hyperplasia

A

Answer: a,b,e

Estrogen adverse effects include: endometrial hyperplasia, endometrial cancer;breast cancer; CV thromboembolic events (in all women and especially menopausal women)/ gallbladder disease, jaundice, headache; nausea, fluid retention, and chloasma

61
Q

Which is not a therapeutic use for estrogen?

a) female hypogonadism
b) acne
c) cancer palliation
d) gender affirmation therapy for transgender women
e) menopausal hormone use

A

Answer: All of the above are appropriate uses for hormone therapy

62
Q

Which patient would be at most risk for drug interactions while taking oral estrogens?

a) a transgender woman
b) a patient with renal impairment
c) a patient with seizures
d) a patient who has had a hysterectomy

A

Answer: c) a patient with seizures as estrogens are at risk

Estrogens are major substrates of CYP1A2 & CYP3A4 (which interact with seizure meications)

63
Q

Which choice would not be appropriate for bone health in post-menopausal women?

a) raloxifene
b) alendronate
c) calcitonin
d) estrogen

A

Answer: d) estrogen

Use of estrogen alone for bone health in post-menopausal women is not an indicated therapeutic use. The other choices are appropriate.

64
Q

Which drug is not a SERM?

a) tamoxifen
b) toremifene
c) raloxifene
d) Duavee

A

Answer: THEY ARE ALL SERMS :)

65
Q

True or false, SERMs have the benefit of activating estrogen receptors in some tissues and blocking them in others.

A

True.

66
Q

Which is true of SERM drugs (check all that apply)?

a) protect against osteoporosis
b) reduce HDL
c) maintain urogenital tract
d) promote breast cancer

A

Answer a,c

SERMs: protect against osteoporosis, maintain urogenital tract, reduce LDL and avoid the drawbacks of traditional estrogen (depending on the drug, some avoid the promotion of breast cancer, uterine cancer, and thromboembolism)

67
Q

Tamoxifen (SERM) can treat _____ cancer but increases the chance for _____ cancer.

A

Answer: tamoxifen can treat breast cancer but it activates receptors in endometrium so it can increase the chance for endometrial cancer.

68
Q

True or false, raloxifene is similar to tamoxifen but does not carry risk of endometrial cancer.

A

True

69
Q

Side effects of tamoxifen include (choose all that apply):

a) increased risk of endometrial cancer
b) thromboembolism
c) hot flashes
d) increased risk of breast cancer

A

Answer: a,b,c

Tamoxifen (SERM) is used to treat breast cancer but can increase risk of endometrial cancer, thromboembolism, and hot flashes

70
Q

Duavee is designed to address what concerns:

a) breast cancer
b) vasomotor symptoms of menopause
c) unplanned pregnancy
d) dysfunctional uterine bleeds

A

Answer: b) vasomotor symptoms of menopause

Duavee combines an estrogen agonist/antagonist and helps with vasomotor symptoms, osteoporosis in postemenopausal women (with a uterus). It decreases the risk of endometrial cancer.

71
Q

Duavee is contraindicated with what other drug(s):

a) seizure medications
b) progesterone
c) estrogens
d) chemotherapy

A

Answer: c) estrogens

72
Q

Which is not a short w/ rapid onset (rapid acting) insulin?

a) glulisine
b) aspart
c) lispro
d) novolog

A

Answer: they are all short w/ rapid onset (15-20 min onset) insulins which provide good mealtime coverage, and duration is 3-5 hours.

Note aspart=Novolog

73
Q

Which is a short duration/short acting insulin?

a) glulisine
b) aspart
c) lispro
d) novolin R

A

Answer: d)novolin R is a regular (short duration/short acting insulin)

Onset is 30 minutes and duration is ~10 hours.

74
Q

Afrezza is considered what type of insulin?

a) inhaled
b) short-acting
c) rapid-acting
d) intermediate-acting

A

Answer: a&c

Afrezza has a rapid onset of 10-15 minutes and duration of 2.5-3.0 hours. It is inhaled.

75
Q

Which insulin can have allergic reactions as a possible side effect?

b) aspart
c) lispro
d) novolin R
d) Novolin N

A

Answer: d) Novolin N

Novolin N is an NPH insulin and the longer duration is due to the addition of a protein to the insulin, which can cause an allergic reaction in the patient.

76
Q

True or false, amiodarone can cause hyperthyroidism and hypothyroidism.

A

True. Due to its’ high iodine content and direct toxic effect on the thyroid.

77
Q

What is the only long-term indicated use for progestin?

a) preventing bone breakdown in post-menopausal women
b) prevention of endometrial cancer
c) IVF
d) breast cancer suppression

A

Answer: b) prevention of endometrial cancer

78
Q

Beyaz and Safyral have what added benefit?

a) less breakthrough bleeding
b) does not cause potassium retention
c) have levomefolate
d) can eliminate periods while on the medication

A

Answer: c) have levomefolate which is a metabolite of folic acid

Good to help prevent spina bifida

79
Q

Which of the following are benefits of Natazia (choose all that apply)?

a) contain levomefolate
b) do not cause potassium retention
c) bleeding is lighter and shorter
d) periodic missed doses will not significantly impact its’ efficacy

A

Answer: b&c

Natazia is good for someone with heavy and prolonged periods as it has shorter/lighter withdrawal bleeding. It also does not cause potassium retention.

80
Q

Depot medroyprogesterone acetate has what possible side effect?

a) reversible bone loss
b) liver toxicity
c) renal toxicity
d) tissue necrosis at site of injection

A

Answer: a) reversible bone loss

So it should not be used for more than 2 years, and it can take up to 9 months after cessation to become pregnant.

81
Q

What drug is used for abortions (choose all that apply)?

a) mifepristone
b) ulipristal
c) misoprostol
d) medroxyprogesterone acetate

A

Answer: a&c

82
Q

What labs should be obtained prior to initiation of testosterone replacement therapy (choose all that apply)?

a) CBC
b) BMP
c) LFT
d) GFR

A

Answer: a&c

Labs should include: testosterone, CBC, lipid panel, LFT, PSA

83
Q

What drugs should be avoided with patients taking PDE-5 inhibitors (Sildenafil)?

a) alpha blockers
b) beta blockers
c) diuretics
d) nitrates

A

Answer: a) alpha blockers & d) nitrates

These may exacerbate hypotension.

84
Q

What is a side effect of PDE-5 inhibitors (____afil)?

a) sudden hearing loss
b) hypertension
c) nonarteritic ischemic optic neuropathy
d) constipation
e) exacerbation of obstructive sleep apnea

A

Answer: a) sudden hearing loss; c) nonarteritic ischemic optic neuropathy; e) exacerbation of obstructive sleep apnea

These drugs are used for erectile dysfunction

85
Q

Which drugs are injected into the penis tissue?

a) papaverine
b) vardenafil
c) alprostadil
d) finasteride

A

Answer: a)papaverine plus phentolamine and c) alprostadil

Used for erectile dysfunction

86
Q

What BPH drugs address mechanical obstruction issues?

a) terazosin
b) silodosin
c) alprostadil
d) finasteride

A

Answer: d) finasteride

The 5-alpha reductase inhibitors (finasteride & dutasteride) both help with mechanical obstruction which is an overgrowth of epithelial cells of the prostate.

87
Q

Which BPH drugs can be helpful for addressing blood pressure issues?

a) terazosin
b) afluzosin
c) alprostadil
d) finasteride

A

Answer: a) terazosin & b)afluzosin

The alpha-1 adrenergic antagonists which can impact blood pressure as well as BPH concerns end in “zosin.”

Dynamic obstruction (overgrowth of smooth muscle) is addressed by blocking alpha 1 in the bladder neck/prostate capsule which facilitates urinary flow increasing.

Note: drugs ending “sin” in this family will address BPH but will do little to address blood pressure.

88
Q

What is a side effect of both 5-alpha reductase inhibitors (finasteride) & selective alpha-1 blockers (silodosin) used for BPH?

a) hypertension
b) abnormal ejaculation
c) floppy-iris syndrome during cataract sx
d) hypotension

A

Answer: b) abnormal ejaculation

Nonselective alpha-1 blockers (____zosin) for BPH can cause hypotension

Floppy-iris syndrome during cataract surgery is seen only with selective alpha-1 blockers (used in BPH) such as silodosin & tamsulosin.

89
Q

Side effects of progestins include:

a) GI upset
b) teratogenicity
c) hepatotoxicity
d) breast cancer
e) depression

A

Progestins act like progesterone.

Answer: b, d,e
Progestins can cause teratogenicity, gynecologic, breast cancer, depression, breast tenderness, bloating

90
Q

Which patient can receive estrogen only for postmenopausal hormone therapy?

a) a woman with a uterus
b) a woman without a uterus

A

Answer: b) a woman without a uterus

Estrogen cannot be given UNOPPOSED to a postmenopausal woman with a uterus. The estrogen could lead to endometrial hyperplasia and endometrial cancer. So, progestin must be given concurrently in postmenopausal women with a uterus.

91
Q

Which is not an indicated use for progestins?

a) postmenopausal hormone therapy
b) amenorrhea
c) breast cancer
d) prematurity prevention
e) infertility

A

Answer: c) breast cancer

All other options are indicated uses. Other uses include prevention of endometrial carcinoma/hyperplasia, and dysfunctional uterine bleeding.

92
Q

Benefits of menopausal hormone therapy include:

a) relief of vasomotor symptoms
b) prevention of osteoporosis
c) glycemic control
d) prevention of altered lipid metabolism

A

Answer: all of the above

93
Q

Side effects of menopausal hormone therapy include:

a) cardiovascular events
b) constipation
c) dysrhythmias
d) ovarian/endometrial cancer
e) dementia

A

Answer: a,d,e

Side effects include: CV events (stroke, MI, PE, DVT), endometrial/ovarian/breast cancer, gallbladder disease, dementia, urinary incontinence.

94
Q

Drugs which reduce the effects of oral contraceptives include:

a) rifampin
b) insulin
c) antiepileptic drugs
d) warfarin

A

Answer: a) rifampin & c) antiepileptic drugs

Other drugs which reduce the effects of OCs include: Ritonavir & St. John’s wort

95
Q

What drug effects are decreased by oral contraceptives?

a) St. John’s wort
b) insulin
c) warfarin
d) rifampin

A

Answer: b)insulin & c)warfarin

Other drugs whose effects are decreased by OCs include oral hypoglycemics

“INSide WARs You Don’t want to Get pregnant?”

96
Q

Which drug effects are increased by oral contraceptives?

a) theophylline
b) insulin
c) warfarin
d) TCAs

A

Answer: a)theophylline & d)TCAs

Note: other drugs whose effects are increased by OCs include diazepam, and chlordiazepoxide

97
Q

Which of the following is not a therapeutic use for testosterone?

a) female hypogonadism
b) replacement therapy in women
c) post-vasectomy
d) AIDS
e) anemia

A

Answer: a) female hypogonadism & c)post-vasectomy

Therapeutic uses for testosterone include: male hypogonadism, replacement therapy (men & post-menopausal women), delayed puberty, AIDS, and anemia

98
Q

Side effects of testosterone therapy include:

a) premature epiphyseal closure
b) renal toxicity
c) prostate cancer
d) edema
e) abuse potential

A

Answer: a,c,d,e

Side effects of testosterone therapy include: virilization in women/girls/boys, premature epiphyseal closure, hepatotoxicity, decrease HDL/increase LDL, prostate cancer, edema, abuse potential (athletes)

NURS 5334 (12 decks)

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