Brainscape's Knowledge GenomeTM

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


See full index

NAPLEX Review > Osteoporosis, Menopause, and Testosterone Use > Flashcards

Osteoporosis, Menopause, and Testosterone Use Flashcards

1
Q

In what patient population is osteoporosis most common in?

A

Postmenopausal women

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

What medications are used as calcium supplements? What % elemental calcium is in each?

A 
Calcium carbonate (Os-Cal, Tums) - 40%
Calcium Citrate (Calcitrate, Citracal) - 21%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much elemental calcium is in each gram of calcium carbonate and calcium citrate?

A

Calcium carb: 400mg elemental calcium

Calcium citrate: 210 mg elemental calcium

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

What medications are approved for prevention and treatment of osteoporosis?

A

Prevention: Bisphosphonates and Raloxifene
Treatment: bisphosphonates, denosumab, PTH analogs, and calcitonin

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

Criteria for initiating treatment of osteoporosis and osteopenia

A

Osteoporosis: postmenopausal women or men >50 with BMD T-score -2.5 or less OR presence of fragility fracture
Osteopenia: T-score -1 to -2.5 AND FRAX score indicates a 10-year probability of major osteoporosis-related fracture 20% or more or 10 year hip fracture probability of 3% or more

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

What medications are bisphosphonates?

A

Oral : Alendronate (Fosamax), Risedronate, Ibandronate

Injectable: Ibandronate (Boniva), Zoledronic acid (Reclast)

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

Oral bisphosphonate CI, warnings, and SE

A

CI: Hypocalcemia, inability to sit or stand upright for at least 30 minutes
Warnings: osteonecrosis of jaw, atypical femur fractures, esophagitis, esophageal ulcers, erosions, hypocalcemia, renal impairment (do not use if CrCl <30 or 35 (alendronate)
SE: dyspepsia, dysphagia, heartburn, N/V, hypocalcemia

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

Injectable bisphosphonates CI, warnings, notes

A

CI: hypocalcemia; zolendronic acid <35 mL/min
Warnings: renal impairment
Notes: preferred if esophagitis is present
Ibandronate q3m
Zoledronic acid q1-2years

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

What medications are estrogen agonist/antagonist-containing products?

A

Raloxifene

Conjugated estrogens/bazedoxifene (Duavee)

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

Raloxifene MOA

A

decreases bone resorption

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

Raloxifene and conjugated estrogens/bazedoxifene (Duavee) indication

A

Raloxifene: prevention and treatment
Duavee: prevention (postmenopausal women with a uterus)

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

Raloxifene BBW, CI, SE

A

BBW: increased risk of FTE and risk of death due to stroke
CI: VTE, pregnancy
SE: hot flashes, peripheral edema, arthralgia, leg cramps

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

Conjugated estrogens/azedoxifene (Duavee) BBW, CI, warnings

A

BBW: endometrial cancer, increased risk of DVT and stroke
CI: breast cancer, pregnancy, undiagnosed uterine bleeding, hx or active VTE
Warnings: increased risk of breast cancer and ovarian cancer

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

Calcitonin MOA

A

inhibits bone resorption by osteoclasts

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

Calcitonin warnings and notes

A

Warnings: hypocalcemia, increased risk of malignancy, hypersensitivity reactions to salmon-derived products
Notes: rarely used for osteoporosis treatment

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

What medications are analogs of human parathyroid hormone? MOA? How long should they be used?

A

Teriparatide (Forteo)
Abaloparatide (Tymlos)
MOA: stimulates osteoblast activity and increase bone formation
Use for MAX of 2 years

17
Q

Teriparatide and abaloparatide BBW, warnings, SE, and notes

A

BBW: osteosarcoma (bone cancer)
Warnings: hypercalcemia
Side effects: Arthralgias, leg cramps, nausea, orthostasis/dizziness
Notes: keep refrigerated; forteo protect from light

18
Q

What medications are RANKL inhibitors?

A

Denosumab (Prolia)

19
Q

RANKL inhibitor MOA

A

binds to RANKL and blocks its interaction with RANK to prevent osteoclast formation that leads to decreased bone resorption and increased bone mass

20
Q

Denosumab CI, warnings, SE, dosing

A

CI: hypocalcemia, pregnancy
Warnings: Osteonecrosis of jaw, atypical femur fractures, hypocalcemia
SE: HTN, fatigue, edema, dyspnea, HA, N/V/D, decreased PO4
Dosing: 60mg SQ every 6 months

21
Q

Romosuzumab indication and MOA

A

Indication: postmenopausal females with hx of osteoporotic fracture or multiple risk factors
MOA: inhibits sclerostin, protein that blocks bone formation

22
Q

When is menopause officially reached?

A

When the last menstrual period was over 12 months ago

23
Q

Menopause physiology

A

Decrease in estrogen and progesterone causes an increased in FSH causing vasomotor symptoms

24
Q

What hormone therapies are used for menopause?

A

Estrogen and progestin

25
Q

What does unopposed estrogen increase the risk of?

A

Endometrial cancer

26
Q

What are common local hormone therapies for menopause symptoms?

A

17-beta-estradiol (vaginal cream, ring, tablet, insert)

Conjugated equine estrogens (vaginal cream - Premarin)

27
Q

What are common systemic hormone therapies

A 
Estradiol
17-beta-estradiol
Conjugated equine estrogens
Medroxyprogesterone
Micronized progesterone
28
Q

Systemic hormone therapies BBW, CI, warnings

A

BBW: endometrial cancer, dementia, increased risk of VTE and stroke, breast cancer
CI: estrogen-containing products: breast cancer, undiagnosed uterine bleeding, active VTE, pregnancy
Warnings: increased risk of breast cancer

29
Q

What non-hormonal therapies can be used in women for menopause symptoms?

A

SSRIs and ospemifene

30
Q

What SSRI is used in menopause?

A

Paroxetine

31
Q

Paroxetine notes

A

Dose lower than depression
7.5mg qhs
Do not use with warfarin (increased INR) or tamoxifen (decreased tamoxifen efficacy)

32
Q

Ospemifene class and indication

A

Class: oral estrogen agonist/antagonist
Indication: dyspareunia (painful intercourse)

33
Q

What medications cause low testosterone in males?

A

Methadone
Chemotherapy
Cimetidine
Spironolactone

34
Q

FDA Warning for testosterone use

A

CV risks

Only use to treat low testosterone levels

35
Q

Testosterone BBW, SE

A

BBW: secondary exposure in children - wash hands and cover application site
SE: Increased appetite, acne, edema, hepatotoxicity, reduced sperm count, irritation at application site

NAPLEX Review (79 decks)

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