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NAPLEX 21 > Osteoporosis, menopause & testosterone use > Flashcards

Osteoporosis, menopause & testosterone use Flashcards

1
Q

What patient characteristics can increase osteoporosis risk?

A 
advanced age
ethnicity (white and asians)
family history
females>males
low body weight
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2
Q

What medical conditions and diseases increase osteoporosis risk?

A 
anorexia
diabetes
GERD
hyperthyroidism
hypogonadism in men
menopause
RA, autoimmune diseases
epilepsy, HIV, PD
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3
Q

What lifestyle factors increase osteoporosis risk?

A 
smoking
excessive alcohol
low calcium intake
low vitamin d intake
physical inactivity
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4
Q

What medications can increase osteoporosis risk?

A 
anticonvulsants
aromatase inhibitors
depo-medroxyprogesterone
GnRH
lithium
PPIs
steroids
thyroid hormones in excess
herpain, loops, SSRIs, TZDs
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5
Q

What is the recommended daily intake of elemental calcium for most adults?

A

1000-1200mg elemental (500mg per dose)

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6
Q

Brand: Oscal

A

generic: calcium carbonate

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7
Q

What is a vitamin d deficiency

A

<30

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8
Q

what is vitamin d dose weekly

A

50,000IU

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9
Q

What is first line treatment or prevention in most patients

A

oral bisphosphonates

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10
Q

What is the PO administration of oral bispphosphonates

A

must stay upright for 30 minutes and drink 6-8oz of plain water

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11
Q

What are the side effects of oral bisphosphonates

A

esophagitis
hypocalcemia
gi effects

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12
Q

How often are oral bisphosphonate given

A

monthly or weekly

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13
Q

IV bisphosphonates are given

A

quarterly or yearly

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14
Q

This is an alternate to bisphosphonates, SC, given every 6 months and the side effect is hypocalcemia

A

denosumab (prolia)

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15
Q

These medications are only recommended for very high risk patients only, SC administration daily

A

teriparatide (Forteo)

abaloparatide (Tymlos)

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16
Q

Which osteoporosis drug can cause hypercalcemia?

A

teriparatide (Forteo)
abaloparatide (Tymlos)

the rest cause hypocalcemia

17
Q

these are an alternate to bisphosphonates if high risk of vertebral fractures; however increased risk for VTE/stroke

A

raloxifene (Evista)

Bazedoxifene/estrogens (Duavee)

18
Q

Which drug can be used if low risk VTE or high risk breast cancer?

A

rolexifene (Evista)

19
Q

Which can be used in women with an intact uterus for prevention of osteoporosis

A

Duavee

20
Q

What is used as treatment for vasomotor symptoms in those with an intact uterus

A

Duavee

*inc risk of breast cancer

21
Q

Is estrogen used with progestin for prevention in postmenopausal women with vasomotor symptoms?

A

with or without

Duavee is the one that’s MUST have a uterus (unopposed estrogen = endometrial cancer)

22
Q

What are prevention options for osteoporosis

A

alendronate (Fosamax) PO daily/weekly

Ibandronate (Boniva) PO monthly

Zoledronic acid (Reclast) IV every 2 years

Raloxifene (Evista) - PO daily

Duavee - with a uterus - PO daily

23
Q

What is the most effect treatment for vasomotor symptoms?

A

estrogen

24
Q

what should women with a uterus use for menopause?

A

use estrogen in combination with progesterone because unopposed estrogen increases risk of endometrial cancer

25
Q

What are the progestins

A

norethindrone

levonorgesterol

drospirenone

26
Q

What is considered to be the safer progestin option?

A

Prometrium>medroxyprogestin

27
Q

What is the criteria for hormone therapy in menopause?

A

healthy

symptomatic women who are within 10 years of menopause

<60

no contraindications

28
Q

Local hormone options

A

Estring, Estrace, Vagifem

conjugated equine estrogens - Premarin

29
Q

Brand: Vivelle-Dot

A

generic: estrogen

30
Q

Brand: Alora

A

generic: estrogen

31
Q

Brand: Climara

A

generic: estrogen

32
Q

How can you tell if an option has progestin?

A

“Pro”

33
Q

When do you use progestin again?

A

a women with a uterus!!

34
Q

Natural products for menopause

A

black cohosh

evening primrose oil

red clover

soy

35
Q

What is the name of the non hormonal treatment for moderate to severe vasomotor symptoms associated with menopause?

A

Brisdelle (paroxtine)

36
Q

What schedule is testosterone?

A

III

NAPLEX 21 (60 decks)

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