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NAPLEX > osteoporosis menopause testosterone > Flashcards

osteoporosis menopause testosterone Flashcards

1
Q

osteoporosis is most common in

A

postmenopausal females

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2
Q

what patient characteristics are associated with osteoporosis risk

A

adv age, caucasian or asian, family history, female, low body weight

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3
Q

what medical diseases/conditions are associated with osteoporosis risk

A

diabetes, eating disorder, GI diseases, hyperthyroidism, hypogonadism in men, menopause, RA or autoimmune disease (also epilepsy, HIV/AIDS, PD)

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4
Q

what lifestyle factors are associated with osteoporosis risk

A

smoking, excessive alcohol, low calcium, low vit D, physical inactivity

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5
Q

what medications are associated with osteoporosis risk

A

anticonvulsants, aromatase inhibitors, DMPA, Li, GnRH agonists, PPI, steroids (>5mg prednisone), thyroid hormone (also loop diuretics, SSRI, TZDs)

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6
Q

gold standard for measuring BMD

A

DXA scan

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7
Q

when should you have BMD measured

A

65 yo females, 70 yo males (earlier if history of fractures after 50yo)

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8
Q

FRAX estimates

A

risk of osteoporosis fracture in next 10 years

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9
Q

calcium absorption is aided by

A

vitamin D

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10
Q

vitamin D deficiency causes

A

rickets in kids, osteomalacia in adults

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11
Q

recommended calcium intake in adults is

A

1000-1200 mg

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12
Q

calcium carbonate contains what percent of elemental calcium

A

40%

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13
Q

calcium citrate contains what percent of elemental calcium

A

21%

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14
Q

important counseling points for calcium carbonate

A

take with food (requires acidic environment), do NOT use with PPI

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15
Q

cholecalciferol

A

D3

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16
Q

ergocalciferol

A

D2

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17
Q

how much cholecalciferol is recommended for vitamin D deficiency

A

5000-7000 IU daily

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18
Q

how much ergocalciferol is recommended for vitamin D deficiency

A

50000 IU weekly

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19
Q

tums

A

calcium carbonate

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20
Q

major side effect of calcium supplement

A

constipation

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21
Q

which drugs are indicated for prevention of osteoporosis

A

All bisphosphonates except ibandronate IV (PO okay), estrogen-based therapy, ralosifene, Duavee

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22
Q

which drugs are indicated for treatment of osteoporosis

A

bisphosphonates, denosumab, PTH analogs, calcitonin

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23
Q

important counseling for bisphosphonates

A

remain upright for 30 min (60 for ibandronate) and drink 6-8oz water

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24
Q

denosumab route of administration

A

SC

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25
Q

Side effects of bisphosphonates

A

esophagitis, hypocalemia

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26
Q

side effect of denosumab

A

hypOcalcemia

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27
Q

how frequently is denosumab dosed

A

every 6 months

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28
Q

teriparatide is given how and how often

A

SC daily

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29
Q

which osteoporosis treatment can cause hypERcalcemia

A

teraparatide, abaloparatide

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30
Q

bisphosphonate contraindication

A

hypOcalcemia, cannot sit upright for 30 min

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31
Q

a patient requires prevention of osteoporosis regimen. 60 yo female. Ca is 9 mg/dL and healthy. CrCl is 36 mL/min. the doctor wants to know which oral bisphosphonate to recommend?

A

alendronate (do not use if CrCl<35; risedronate and ibandronate <30)

32
Q

boniva

A

ibandronate

33
Q

fosamax

A

alendronate

34
Q

actonel, altevia

A

risendronate

35
Q

reclast

A

zoledronic acid

36
Q

zolendroic acid contraindications

A

hypOcalcemia, CrCl<35

37
Q

which injectable bisphosphonate takes the longest to administer

A

zoledronic acid (15 min vs boniva which is 15-30 sec)

38
Q

risendronate can be given how often in females

A

daily, weekly, or monthly

39
Q

risedronate can be given how often in males

A

weekly

40
Q

boniva PO is given how often

A

monthly

41
Q

Boniva IV injection is given how often

A

every 3 months

42
Q

Reclast for treatment is given how often

A

yearly

43
Q

reclast is given how often

A

every 2 years

44
Q

what bisphosphonate should be recommended in a patient with esophagitis

A

injectables (boniva or reclast)

45
Q

raloxifene MOA

A

SERM, dec bone resorption

46
Q

duavee can only be used in female patients with

A

a uterus

47
Q

evista contraindications

A

VTE, pregnancy

48
Q

duavee contraindications

A

VTE, pregnancy, uterine bleeding, breast cancer

49
Q

calcitonin MOA

A

inhibit bone resorption by osteoclasts

50
Q

administration route for calcitonin

A

nasal spray, SC, IM

51
Q

calcitonin has a warning against hypersensitivity to

A

salmon-derived products

52
Q

teriparatide is indicated when

A

very high risk of fracture

53
Q

denosumab binds to

A

RANKL

54
Q

prolia

A

denosumab

55
Q

denosumab is indicated when

A

very high risk of fracture

56
Q

denosumab is contraindiacted in

A

pregnancy (bc antibody) and hypOcalcemia

57
Q

denosumab may dec levels of which chemical

A

PO4

58
Q

romosozumab duration of therapy

A

12 months

59
Q

which bisphosphonate is administered as an oral solution

A

binosto

60
Q

parathyroid hormones may cause

A

dizziness, orthostasis

61
Q

astroglide is used as

A

lubricant for dyspareunia

62
Q

local estrogen products

A

estrace, estring, vagifem, premarin

63
Q

estradiol patch brand names

A

alora, climara, vivelle dot

64
Q

a patient with dementia should not use

A

systemic hormone therapies

65
Q

vivelle dot is applied how often

A

twice weekly

66
Q

climara is applide how often

A

once weekly

67
Q

medroxyprogesterone brand

A

provera

68
Q

micronized progesterone brand

A

prometrium

69
Q

where should estrogen progestin patch be applied

A

lower abdomen

70
Q

what natural products may help with menopause

A

black cohosh, evening primrose oil, red clover, soy

71
Q

non-hormonal drug used to treat menopause

A

paroxetine

72
Q

ospemifene is indicated in

A

dyspareunia

73
Q

which medications can lower testosterone

A

opioids, chemotherapy, cimetidine, spironolactone

74
Q

testosterone side effects

A

baldness, acne, gynecomastia

75
Q

what is the least preferred testosterone formulation

A

injection (painful, inc hematocrit)

76
Q

boxed warning for topical testosterone

A

secondary exposure causing early virilization

NAPLEX (10 decks)

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