Pharm 2 Pulm Flashcards
Mifepristone
Progesterone Antagonist
Pregnancy termination up to day 70
Hyperglycemia in Cusings PTs who can’t have surgery
Estrogen + Cyclic Progesterone
Continuous daily E, mimics normal female cycle w/ withdrawal bleed each cycle
E on days 1-25
Medro on days 14-25
No hormone day 26-end of month
Estrogen + Continuous P
What are the 6 PO Estrogen products
Daily E and P
No/irregular bleeding for fist 8-12mon
Conjugated x 3
17-B estradiol
Ester
Estro
Estradiol acetate vaginal ring
Transdermal estrogen patches are less likely to cause ?
Mod-Sev vasomotor Sxs from menopause and atrophy
HA/N
Norethindrone Acetate
2* amenorrhea
Ednometriosis
Abnormal bleeding from abnormal hormones
Megasetrol acetate
Appetite stimulant
Metastatic breast CA Tx
Norethindrone
Contraception
Levonorgestresl
Contraception
Heavy bleeding
Progesterone gel
Progesterone deficiency
2* amenorrhea
Micronized Progesterone
Endometrial hyperplasiz in post-menopause and receiving conjugated estrogen
Medroxypyrogesterone acetate
2* amenorrhea
Abnormal bleeding
Ednometrial hyperplasia prevention in post-meonpause and receiving conjugated estrogen
17-B Estradiol/Norethindrone Acetate
Patch form
Bazedoxifene
SERM- agonist and antagonist features
Tx of mod-sev Vasomotor Sxs
Prevention of post-menopause osteoporosis
What are the non-hormonal options for menopause
Lubes
SERMs- Raloxifene
SSRI
SNRI
What are the 3 herbals/phytoestrogens for menopause
Red clover
Soy
Black Cohosh
Ospemifene
SERM
Mod/Sev dyspareunia from atrophy due to menopause
Tamoxifen
Tx of breast cancer and prevention of CA in high risk women
NOT for osteoporosis
Raloxifene
Prevention/Tx of osteoporosis in women w/:
High breast CA risk
Can’t take BisPhosph
50-60y/o and long term concerns of BisPhosph use
Clompiphene
Ovulation inducing
Male infertility
Aromatase inhibitors
Block P450
Adv Tx of E dependent breast CA
Anastrozole, Letrozole, Exemestane
Fluoxymesterone
PO Androgen replacement therapy
Breast CA
Methyltestosterone
PO androgen replacement
Breast CA
Post puberty cryptorchidism
Oxandrolone
PO anabolic androgen
Promotes weight gain when protein break down is an issue
Oxymethalone
PO anabolic androgen
Anemia from deficient RBC production
Danazol
PO active androgen derivative for Tx of endometriosis and fibrocystic breast Dz
Anti-Androgen and Androgen antagonists are used for what 4 issues
Prostate CA
Endometirosis
Adv Breast CA
BPH
Terazosin/Doxazosin
Alfuzosin
Tamsulosin
BPH and HTN
BPH only
A1 selective only for BPH
Finasteride
5a reductase inhibitor for BPH
Stops progression and reduces size of prostate
Women CANT touch this or semen w/ it
PDE5 Inhibitors
ED
Pulmonary artery HTN
BPH
-fil the penis
Sildenafil
PAH/Raynaud’s
Reduce dose for SrCr <30 or Liver Dz
Vardenafil
ED
Avoid in Liver Dz or Hemodialysis
Avanafil
ED
Not for CrCl <30 or Liver Dz
Tadalafil
ED, BPH
Men using if +2/wk
Dec dose for renal dz
PDE5 inhibitor interactions
Nitrate- deadly HOTN
A-Blockers: -zosin; Sx HOTN
FDA approved Androgens for ED
Non-FDA approved drug for ED
Fluoxymesterone Methyl testosterone Testosterone enanthate Testosterone propionate Alprostadil
Yohimbine HCl
Alprostadil
ED Tx from spine injury
Filbanserin
Only drug for female sex dysfunction
What are the fertility awareness methods
When should sex be avoided?
Temp, Mucus, Calendar (Best is combo of all 3) or
Standard- avoid on days 8-19
What is the most common spermicide?
Which implantable contraception device releases both estrogen and progestin?
Nonoxynol-9
Vaginal ring
Injectable birth control consists of an injection of ?
What was the first birth control pill proven to help w/ heavy monthly periods?
Medroxyprogesteron
Natazia
Very low dose estrogen = ?mch
Low dose = ?
High dose =?
<30mcg
<30-50mg
50mcg or more
Sinecatechins 15% ointment
Genital/Perianal wart prevention/gene suppression
Podofilox/Podophyllum
Mortality of gential/perianal wart cells
Imiquimod cream
Induces cytokines for cutaneous/genital/perianl warts
What are the 2 vaccinations for prevention/treatment of warts?
Cervarix
Gardasil
Physical destruction of wart tissue is most commonly used w/ ?
Keratolytic agents: Salicyclic acid Podofilox Podophyllum Imiquimod Duct tape
What are the most effective biologic agents against psoriasis?
What can they be combines w/ to improve efficacy?
Adalimumab
Infliximab
Etancercept
Ustekinumab
Methotrexate, Acitretin
Methotrexate
Reversal agent?
Inhibits purine synthesis
Severe Dz of palms, soles, scalp or more than 10% of body surface
Leucovorin
Apremilast
PDE4 inhibitor
Mod-sev psoriasis in PTs that are candidates for photo/systemic therapy
Cyclosporin
What can it be combined w/?
Sandimmune- IR capsule
Neoral- microemulsion
Dz refractory/too extensive for topicals
W/ Vit D3 analogs or topical CCS
TIMS
Atopic dermatitis and chronic inflammatory dz (mild plaque psoriasis)
Alternative to topical CCS
1st line steroid sparing agent for atopic derm/psoriasis of face/flexurs/genitals
Calcinuerin inhibitors
AKA TIMS
Inhibit T cell activation
Pimecrolimus
Tacrolimus
Acitretin
Oral retinoid- reduces inflammation by inhibitin neutrophil/monocyte chemotaxis
Monotherapy ror adjunct for severe/refractory or too extensive for topicals
Less risk of organ toxicity than methotrexate of cyclosporines
Tazaotene
Topical retinoid
Mild plaque psoriasis and acne vulgaris
NOT for genitals or skin fold
Vit D3 Analogs
Mild psoriasis or combo’d w/ CCS for mod-severe cases
Calcitriol
Coal Tar
Mild-mod plaque psoriasis but less effective than topicals
For PTs that can’t afford Rx options
Topical CCS
First line choice for Moderate psoriasis
Combined w/ or alternated w/ Vit D anaologs, Tazarotene or emolients to inc efficacy
PO agents for psoriasis treatment
Biologics that can be used?
Acitretin
Cyclosporine
Apremilast
Methotrexate
Adalimumab, Infliximab, Etanercept
How is psoriasis classified
Mild-Mod: <5%, start w/ topical therapies and combine w/ phototherapy
Mod-Sec: 5-10%
Topicals and phototherapy or Systemic Tx
Brimondine
Selective A2 agonist
Tx of persistent erythema rosacia in 18+y/o
Azelaic Acid
Rosacia w/ minimal toxicity
Can cause hypopigmentation in dark complex PTs
PO Retinoids
Only effective agent against severe cystic acne vulgaris
Preg X, test required 2wks prior to use
Must use 2 forms of protection during Tx and for 1mon after Tx
Topical retinoids
Tretinoin
Used in combo w/ ABX/Benzoyl Peroxide for inflammatory acne
Better tolerated and faster than Tretinoin
Tazarotene
Best efficacy for psoriasis
Gel form is more irritating that tretinoin
What systemic ABX can be used for acne vulgaris
Tretracycline/Erythromycin- rarely used
Minocycline/Doxycycline- most common
Sulfamethoxazole/Trimethoprim- in PTs w/ acne resistant to Erythromycin/Tetracyclines but Mino/Doxy are preferred
What are the topical ABX used for acne?
Clindamycin
Erythromycin
Combo: Clindamycin/Benzoyl Peroxide or Erythromycin/Benzoyl Peroxide
Topical tx for severe acne vulgaris and off label use for rosacia
Benzoyl Peroxide reduces risk of resistence
Benzoyl Peroxide
Releases oxygen and causes epithelial turnover
For inflamm/non-inflamm acne vulgaris
The MOST effective acne Tx
Enhanced when combined w/ topical erythromycin
