PHARM GROUP 2

Question 1

WHI
WOMENS HEALTH INITIATIVE

Answer 1

1991 FINDINGS:
- HRT ASSOCIATED WITH INCREASED RISKS OF BREAST CANCER, HEART DISEASE, STROKE, AND BLOOD CLOTS
- DECREASED RISK OF HIP FRACTURES AND COLON CANCER

2008 STATEMENT
- HRT CAN BE BENEFICIAL FOR WOMEN CLOSE TO MENOPASUE FOR SYMPTOM RELEIF AND BONE LOSS PREVENTION.
- THE RISK-BENEFIT RATIO DECREASES WITH ADVANCING AGE

Question 2

WHAT ARE THE 3 TYPES OF SYMPATHOMIMETIC DRUGS AND PROVIDE AN EXAMPLE OF EACH

Answer 2

1. DIRECT-ACTING EX) EPINEPHRINE
   - BINDS DIRECTLY TO RECEPTORS
2. INDIRECT-ACTING EX) AMPHETAMINE
   - CAUSES RELEASE OF CATECHOLAMINES
3. MIXED-ACTING EX) EPHEDRINE
   - BOTH DIRECT AND INDIRECT EFFECTS

Question 3

ORAL CONTRACEPTIVE PILLS
TYPES…

Answer 3

MONOPHASIC: FIXED RATIO WITH ESTROGEN TO PROGESTIN THROUGHOUT THE CYCLE

BIPHASIC: FIXED ESTROGEN WITH VARYING PROGESTIN LEVELS

TRIPHASIC: VARYING LEVELS OF ESTROGEN AND PROGESTIN IN 3 PHASES

FOUR PHASIC - VARYING DOSES OF ESTRADIOL VALERATE AND DIENOGEST

Question 4

WHAT CLASS OF MEDS OFTEN DECREASES THE EFFECTIVENESS OF COMBINED HORMONE CONCEPTION ?

Answer 4

ANTIBIOTICS

Question 5

WHERE ARE THE TESTES LOCATED AND WHAT ARE THEIR PRIMARY FUNCTIONS ?

Answer 5

THE TESTES ARE LOCATED IN THE SCROTAL SAC.

PRIMARY FUNCTIONS…
- HORMONE PRODUCTION (TESTOSTERONE)
- SPERMATOGENESIS (SPERM PRODUCTION IN SEMINEFEROUS TUBULES)

Question 6

HERBAL SUPPLEMENTS

Answer 6

SOY, RED CLOVER, BLACK COHOSH
- MAY HELP DECREASE HOT FLASHES, CAUTION IN WOMEN WITH BREAST CANCER OR LIVER DISEASE

VITAMIN E, EVENING PRIMROSE OIL, ST. JOHNS WORT, GINSENG, MELATONIN
- MAY OFFER SYMPTOMATIC RELIEF

Question 7

PRIMARY EFFECTS OF ANTICHOLINERGICS (PARASYMPATHOLYTICS) ?

Answer 7

ANTICHOLINERGICS BLOCK THE ACTION OF ACETYLCHOLINE, CAUSING EFFECTS SUCH AS INCREASED HR, PUPIL DILATION, DECREASED GI MOTILITY, URINARY RETENTION, AND DECREASED BRONCHIAL SECRETIONS

Question 8

MOA FOR POTASSIUM-SPARING DIURETICS

Answer 8

THEY INTERFERE WITH SODIUM-POTASSIUM EXCHANGE IN THE DISTAL TUBULE AND COLLECTING DUCT, PREVENTING EXCESSIVE LOSS OF POTASSIUM

Question 9

TERBUTALINE

Answer 9

• DECREASES UTERINE CONTRACTIONS TO STOP PRE-TERM LABOT
• ONLY USE SQ AND SHORT TERM (<48-72 HRS)

SIDE EFFECTS:
- TACHYCARDIA AND HYPOGLYCEMIA IN MOTHER AND FETUSC

Question 10

COMMON POTASSIUM-SPARING DIURETICS

Answer 10

AMILORIDE (MIDAMOR)

SPIRONOLACTONE (ALDACTONE)

TRIAMTERENE (DYAZIDE)

Question 11

PROGESTIN-ONLY PILLS

Answer 11

INDICATIONS: FOR WOMEN WHO CANNOT TAKE ESTROGEN
EX) HISTORY OF VTE, BREASTFEEDING, OLDER AGE, SMOKING

SIDE EFFECTS: IRREGULAR BLEEDING, FATIGUE, DECREASED LIBIDO, MOOD CHANGES, WEIGHT GAIN

FORMS:
ORAL (MICORNOR, NOR QD, AYGESTIN)
- INJECTABLE (DEPO-PROVERA - ADMINISTERED EVERY 11-13 WEEKS, MAY DECREASE BONE DENSITY)
- IMPLANTABLE - NEXEPLON (UP TO 3 YEARS) CONTAINS BARIUM FOR DETECTION NOT RECOMMENDED FOR BMI > 30

Question 12

MOA OF SPIRONOLACTONE (ALDACTONE)

Answer 12

SYNTHETIC STEROID THAT BLOCKS ALDOSTERONE RECEPTORS, REDUCING SODIUM REABSORPTION AND INCREASING POTASSIUM RETENTION

Question 13

HOW DO DIURETICS LOWER BP ?

Answer 13

BY PROMOTING SODIUM EXCRETION WHICH LOWERS BLOOD VOLUME AND VASCULAR RESISTANCE

Question 14

INTERACTIONS OF THIAZIDE DIURETICS

Answer 14

CORTICOSTEROIDS
DIGOXIN
LITHIUM
NSAID’S
ORAL HYPOGLYCEMIC DRUGS

Question 15

WHERE IS TESTOSTERONE PRODUCED IN THE MALE BODY ?

Answer 15

TESTOSTERONE IS PRODUCED BY INTERSTITIAL CELLS LOCATED BETWEEN THE SEMINEFEROUS TUBULUES IN THE TESTES

Question 16

HOW DOES METALAZONE DIFFER FROM OTHER THIAZIDE DIURETICS ?

Answer 16

• MORE POTENT ESPECIALLY IN PATIENTS WITH RENAL INSUFFICIENCY
• OFTEN USED IN COMBINATION WITH LOOP DIURETICS FOR SEVERE CHF

Question 17

WHAT IS BETHANECHOL (URECHOLINE) USED FOR, AND HOW DOES IT WORK ?

Answer 17

USED TO TREAT POST-OP AND POSTPARTUM NONOBSTRUCTIVE URINARY RETENTION, AND NEUROGENIC ATONY OF THE BLADDER. IT STIMULATES CHOLINERGIC RECEPTORS, PROMOTING BLADDER CONTRACTION, GI PERISTALSIS, AND BRONCHOCONSTRICTION

Question 18

WHICH ORGANS AND SYSTEMS ARE RESPONSIBLE FOR REGULATING BP AND HOW ?

Answer 18

KIDNEYS:
CONTROL FLUID VOLUME VIA INFILTRATION AND INFLUENCE BP BY RELEASING RENIN, ACTIVATING THE RAAS.
THIS SYSTEM INCREASES BP THROUGH VASOCONSTRICTION AND SODIUM/WATER RETENTION

BLOOD VESSELS:
ARTERIAL TONE (CONSTRICTION VS DILATION) DETERMINES PERIPHERAL RESISTANCE, IMPACTING BP

HORMONES: CATECHOLAMINES (EPINEPHRINE AND NOREPINEPHRINE), ADH, AND ALDOSTERONE REGULATE BP

Question 19

WHAT SHOULD BE MONITORED WHEN ADMINISTERING DIURETICS ?

Answer 19

INTAKE AND OUTPUT

BP

ELECTROLYE LEVELS (POTASSIUM AND SODIUM)

SIGNS OF ORTHOSTATIC HYPOTENSION

Question 20

WHAT IS DEPO-PROVERA AND WHAT ARE ITS SIDE EFFECTS AND LONG TERM CONSIDERATIONS ?

Answer 20

AN INJECTABLE PROGESTIN-ONLY CONTRACEPTIVE GIVEN EVERY 11-13 WEEKS

CAN LEAD TO DECREASED BONE DENSITY AFTER 2 YEARS, SO CALCIUM AND VITAMIN D SUPPLEMENTATION IS RECOMMENDED

SIDE EFFECTS
- WEIGHT GAIN
- FATIGUE
- IRREGULAR BLEEDING
- MOOD CHANGES