Quiz 3 Non-diabetes endocrine and supplements Flashcards

Question

Ergocalciferol Indications

Answer 1

1. hypoparathyroidism 2. Refractory rickets (vitaman D resistant rickets) 3. familial hypophosphatemia

Answer 2

After the activation of the vitamin D receptor, some of the biological changes produced by ergocalciferol include mobilization and accretion of calcium and phosphorus in the bone, absorption of calcium and phosphorus in the intestine, and reabsorption of calcium and phosphorus in the kidney

Answer 3

Hypercalcemia, malabsorption syndrome, abnormal sensitivity to the toxic effects of vitamin D, and hypervitaminosis D.

Answer 4

Take by mouth as directed. Best absorbed when taken after a meal, but may be taken with or without food. If using liquid form of this medication, measure the dose using a special measuring device/spoon. Certain medications (bile acid sequestriants) can decrease the absorption of Vitamin D. Take your doses of these medications as far as possible from your doses of Vitaman D - at least 2 hours if possible.

Answer 5

1. Abnormal vasomotor function (moderate to severe) 2. Atrophic vulva or vagina (moderate to severe), menopause 3. Breast cancer, metastatic for palliation only 4. Carcinoma of prostate, advanced, androgen-dependent, for palliation only 5. Decreased estrogen level, secondary to hypogonadism, castration or primary ovarian failutre 6. Postmenopausal osteoporosis, prophylaxis

Answer 6

Estradiol (17β-estradiol; E2) is the most potent of the naturally occurring estrogens and the major estrogen secreted during the reproductive years. Estradiol and other estrogens produce characteristic effects on specific tissues (such as breast), cause proliferation of vaginal and uterine mucosa, increase calcium deposition in bone, and accelerate epiphyseal closure after initial growth stimulation.

Answer 7

Contraindicated

Answer 8

Hypersensitivity to estradiol; history of thromboembolic disorders, breast cancer, any estrogen-dependent neoplasm, known or suspected pregnancy

Answer 9

Endometrial and breast cancer risk, dementia risk; should not be used to reduce CV risk; secondary exposure risk (transdermal solution)

Answer 10

Report abnormal vaginal bleeding or signs/symptoms of a thromboembolic disorder. Do not smoke during therapy, as this increases the risk of thromboembolic events.

Answer 11

Contraceptive, Estrogen

Answer 12

1. Contraception

Answer 13

The contraceptive effect of desogestrel/ethinyl estradiol is based on interaction of various factors, the most important of which is ovulation inhibition and changes in cervical secretion [467]. Desogestrel/ethinyl estradiol is a combination of oral contraceptives that acts by suppressing gonadotropins. This activity leads to inhibition of ovulation, changes in cervical mucus and endometrium, thus, preventing fertilization and implantation [3]. Ethinyl estradiol is a well-known synthetic estrogen. Desogestrel is a synthetic progestogen. After oral administration it has a strong ovulation-inhibiting activity, a strong progestational and anti-estrogenic activity, no estrogenic activity, very weak androgenic/anabolic activity

Answer 14

Contraindicated (I would hope so)

Answer 15

Blood pressure 160mm Hg or greater systolic or 100 mmHg or greater diastolic, persistent. Carcinoma of the breast, known or suspected, or personal history. Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia. Cerebral vascular or coronary artery disease, current or history.Cholestatic jaundice of pregnancy or jaundice with prior hormonal contraceptive use.Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir. Deep vein thrombophlebitis or thromboembolic disorders, past history. Diabetes with vascular involvement. Genital bleeding, undiagnosed abnormal. Headaches with focal neurological symptoms. Smoke, if over age 35. Heavy cigarette smoking. Hepatic adenomas or carcinomas or active liver disease. Hepatocellular disease with abnormal liver function. Hypersensitivity to any component of these products. Hypertension, severe. Major surgery with prolonged immobilization. pregnancy, known or suspected. Thrombophlebitis, valvular heart disease. inherited or acquired hypercoagulopathies

Answer 16

Oral: Smoking is not advised in women using oral contraceptives. Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age Tablet: Ortho-Cept(R): Cigarette smoking increases the risk of serious cardiovascular side effects from combination oral contraceptive use. This risk increases with age and with the number of cigarettes smoked and is quite marked in women over 35 years of age. Use of combination oral contraceptives is not recommended in women who are over 35 years of age that smoke [5]. Velivet(TM): Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke [9]. Desogen(R): Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs are contraindicated in women who are over 35 years of age, and smoke

Answer 17

Report upcoming elective surgeries, prolonged periods of immunocilization, or recent childbirth as this may increase the risk of blod clots. Side effects may include nausea, vomiting, breakthrough bleeding, weight gain, breast tenderness, headache, and migraine. Caution patient to report symptoms of blood clots, liver tumors, or high blood pressure. Report persistent bleeding. Counsel patient to report changes in vision or difficulty with contact lens wear. Advise patient to report symptoms of fluid retention. Take drug at the same time every day and do not allow mroe than 24 hours between doses. Use a non-hormonal backup form of contraception for the first 7 days. Do not smoke during baby .Encourage to patient not smoke during therapy. Instruct patient that if a single active dose is missed take the tablet as soon as possible and resume a normal schedule. If more than one active dose is missed, contact a physician for instructions. Use of additional nonhormonal methods of contraception may be necessary

Answer 18

Contraceptive, Contraceptive combination

Answer 19

1. Acne (Moderate) - contraception 2. Contraception 3. Contraception - Premenstrual dysphoric disorder

Answer 20

The contraceptive effect of drospirenone/ethinyl estradiol is based on interaction of various factors, the most important of which is ovulation inhibition and changes in the endometrium [485]. Drospirenone/ethinyl estradiol is an combination oral contraceptive (COC) that works primarily by suppressing ovulation. Additionally, COC agents cause cervical mucus changes that block sperm penetration and endometrial changes that reduce the chance of implantation [482][483]. Although the exact mechanism of action in acne is unknown, drospirenone and ethinyl estradiol increase sex hormone binding globulin and decrease free testosterone, which may play a role

Answer 21

Contraindicated

Answer 22

A) Adrenal insufficiency B) Breast cancer or other estrogen or progestin-sensitive cancer, current or past history C) Cerebrovascular disease D) Concomitant use with hepatitis C drug combinations containing ombitasvir, paritaprevir/ritonavir, with or without dasabuvir E) Coronary artery disease F) Deep vein thrombosis or pulmonary embolism, current or past history G) Diabetes mellitus with vascular disease H) Headaches with focal neurological symptoms or migraine headaches with or without aura if over age 35 years I) Hepatic dysfunction J) Hepatic tumors, benign or malignant K) Hypercoagulopathies, inherited or acquired L) Hypertension, uncontrolled M) Pregnancy N) Renal insufficiency O) Smoking and over age 35 years P) Thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, subacute bacterial endocarditis with valvular disease or atrial fibrillation) Q) Uterine bleeding, undiagnosed, abnormal

Answer 23

Cigarette Smoking and Serious Cardiovascular Events Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, COCs should not be used by women who are over 35 years of age and smoke [6][7].

Answer 24

Patients over 35 years of age should not smoke during therapy, as this increases the risk of serious cardiovascular side effects. [6][7] Advise patient to practice safe sex. Drug does not prevent disease transmission. [6][7] Discuss potential long-term adverse effects of hormone therapy including myocardial infarction, stroke, thrombophlebitis, dementia, venous thromboembolism (VTE), pulmonary embolism, and breast cancer. Inform patient that risk of VTE is greatest after initially starting therapy or restarting therapy after a 4-week or greater pill-free interval. [6][7] Drug may cause premenstrual syndrome, headache/migraine, breast pain/tenderness/discomfort, nausea/vomiting, fatigue, abdominal pain/tenderness/discomfort, weight gain, and mood changes. [6][7] Instruct patient to report signs/symptoms of serious cardiovascular events, such as myocardial infarction, stroke, and arterial or venous thrombosis. [6][7] Patient should report new headaches that are persistent, severe, or recurrent, abnormal vaginal bleeding, amenorrhea of 2 or more consecutive cycles, or jaundice. [6][7] Patients should report any unexplained partial or complete loss of vision. In addition, patients who wear contact lenses should report visual changes or changes in lens tolerance. [6][7] This drug should be taken every day, at the same time each day, in the exact order noted on the packaging. [6][7] Advise patient to use a nonhormonal back-up form of contraception for the first 7 days if a Sunday-start regimen is initiated or if drug is started postpartum but before menstruation resumes. [6][7] Advise patient that certain drugs may cause oral contraceptives to be less effective and backup contraception may be necessary. Consult healthcare professional prior to new drug use. [6][7] Review with the patient the procedure for handling missed doses. It is very important that the patient follow carefully missed-dose instructions for the particular brand or formulation prescribed in order to prevent pregnancy. [6][7]

Answer 25

Contraceptive, Contraceptive combination

Answer 26

1. Contraception

Answer 27

Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation) [480][481].

Answer 28

Contraindicated

Answer 29

A) Acute viral hepatitis, or severe (decompensated) cirrhosis [6] B) BMI greater than or equal to 30 kg/m(2) C) Carcinoma of the breast, known, suspected, or personal history D) Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia or progestin-sensitive cancer, current or past E) Cerebrovascular or coronary artery disease, current or past history F) Cholestatic jaundice of pregnancy or jaundice with prior pill use G) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir H) Deep vein thrombophlebitis or thromboembolic disorders (eg, pulmonary embolism), current or history of I) Diabetes with vascular disease J) Diabetes mellitus and are over age 35, diabetes mellitus with hypertension or other end-organ damage, or diabetes mellitus of greater than 20 years duration K) Genital bleeding, undiagnosed, abnormal L) Headaches with focal neurological symptoms M) Hepatic adenomas or carcinomas or other liver tumors, benign or malignant N) Hypersensitivity to any of the product components O) Liver disease, active P) Major surgery with prolonged immobilization Q) Migraines with aura R) Migraines with or without aura and older than 35 years S) Pregnancy, known or suspected Smoking and older than 35 years U) Thrombogenic rhythm disorders V) Thrombophilias, hereditary or acquired W) Thrombophlebitis or thromboembolic disorders X) Uncontrolled hypertension or hypertension with vascular disease Y) Undiagnosed abnormal uterine bleeding Z) Valvular heart disease with thrombogenic complications

Answer 30

Oral (Tablet) a) Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptives (COC) use. This risk increases with age, particularly in women older than 35 years, and with the number of cigarettes smoked. Women who use oral contraceptives should be strongly advised not to smoke 2) Transdermal (Patch, Extended Release) a) Warning: Cigarette Smoking and Serious Cardiovascular Events and Contraindicated in Women with BMI greater than or equal to 30 kg/m(2) Cigarette Smoking and Serious Cardiovascular Events Cigarette smoking increases the risk of serious cardiovascular events from combined hormonal contraceptive (CHC) use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, CHCs, including levonorgestrel/ethinyl estradiol, are contraindicated in women who are over 35 years of age and smoke. Contraindicated in Women with a BMI greater than or equal to 30 kg/m(2) Levonorgestrel/ethinyl estradiol is contraindicated in women with a BMI greater than or equal to 30 kg/m(2). Compared to women with a lower BMI, women with a BMI greater than or equal to 30 kg/m(2) had reduced effectiveness and may have a higher risk for venous thromboembolism events (VTEs)[6].

Answer 31

Inform patient of serious long-term adverse effects of hormone therapy including myocardial infarction, stroke, deep vein thrombosis, pulmonary embolism, dementia, and breast or endometrial cancer [6][19]. Advise patient to report symptoms of pregnancy, including amenorrhea that occurs in 2 or more consecutive cycles, and to discontinue use if pregnancy is confirmed Oral side effects may include elevated blood pressure, headache, migraines, enlarged or tender breasts, dizziness, mood changes, nausea and pancreatitis [19]. Transdermal side effects may include application site disorders, nausea, headache, dysmenorrhea, and increased weight. Tell patient to report persistent or prolonged vaginal bleeding. Instruct patient to report any unexplained partial or complete loss of vision and patient who wears contact lenses to report visual changes or changes in lens tolerance. Advise patient to use a non-hormonal backup form of contraception for the first 7 days of use. Counsel patient to take oral tablets at the same time each day. Instruct patient using transdermal patch to avoid frequent or prolonged water exposure and large amounts of body lotions or oils and to check for partial or complete detachment once daily and also after water exposure. Tell patient to avoid smoking cigarettes during therapy. Instruct patient to avoid St. John's Wort during therapy. Counsel patient to contact healthcare professional for instructions if a dose is missed and that additional contraception may be required in the event of a missed dose.

Answer 32

Contraceptive, Estrogen

Answer 33

Contraception

Answer 34

Combined oral contraceptives suppress gonadotropins to prevent pregnancy. Inhibition of ovulation is the primary mechanism by which pregnancy is prevented. Gonadotropin suppression also changes the cervical mucus, increasing the difficulty of sperm entry into the uterus, and altering the endometrium to reduce the likelihood of implantation

Answer 35

Contraindicated

Answer 36

A)Blood pressure 160 mmHg or greater systolic or 100 mgHg or greater, persistent B) Carcinoma of the breast, known or suspected, or personal history of breast cancer C) Carcinoma of the endometrium or other known or suspected estrogen-dependent neoplasia D) Cerebral vascular or coronary artery disease, current or history E) Cholestatic jaundice of pregnancy or jaundice with prior pill use F) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir G) Deep vein thrombophlebitis or thromboembolic disorders, past history H) Diabetes with vascular involvement I) Genital bleeding, undiagnosed abnormal J) Headaches with focal neurological symptoms K) Hepatic adenomas or carcinomas L) Hepatocellular disease with abnormal liver function, acute or chronic M) Hypersensitivity to any component of the product N) Hypertension, uncontrolled O) Major surgery with prolonged immobilization P) Pregnancy, known or suspected Q) Thrombophlebitis, thromboembolic disorders, or known thrombophilic conditions R) Valvular heart disease with complications

Answer 37

1) Oral (Tablet) Modicon(R), Ortho-Novum(R): Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, combination oral contraceptives, including norethindrone/ethinyl estradiol, should not be used by women who are over 35 years of age and smoke. Ovcon 35(R): Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use. This risk increases with age and with the extent of smoking (in epidemiologic studies, 15 or more cigarettes per day was associated with a significantly increased risk) and is quite marked in women over 35 years of age. Women who use oral contraceptives should be strongly advised not to smoke.

Answer 38

Advise patient to practice safe sex. Drug does not prevent disease transmission. Discuss potential long-term adverse effects of hormone therapy including myocardial infarction, stroke, thrombophlebitis, dementia, pulmonary embolism, or breast cancer. This drug may cause chloasma, change in weight, bloating, nausea, stomach cramps, vomiting, migraine, depression, amenorrhea, breakthrough bleeding, breast tenderness or swelling, or nipple discharge. Tell patient to report persistent/recurrent abnormal vaginal bleeding. Patients should report any unexplained partial or complete loss of vision. In addition, patients who wear contact lenses should report visual changes or changes in lens tolerance. This drug should be taken every day, at the same time each day with not more than 24 h between doses. Advise patient to use a non-hormonal backup form of contraception for the first 7 days if a Sunday-start regimen is initiated. Patients should not smoke during therapy, as this increases the risk of serious cardiovascular side effects. Review with the patient the procedure for handling missed doses. It is very important that the patient follow carefully missed-dose instructions for the particular brand or formulation prescribed in order to prevent pregnancy. In many cases, this will necessitate the use of a back-up method of contraception until the regular schedule has been reestablished. If patient is still unsure of what to do in the event of a missed dose, patient should use a back-up form of contraception and contact healthcare professional for instructions.

Answer 39

Contraceptive, Endocrine-Metabolic Agent

Answer 40

Acne - Contraception Contraception

Answer 41

Ethinyl estradiol, an estrogen, and norgestimate, a progestin, are a combination product that reduces the possibility of pregnancy primarily via suppression of ovulation; although, other mechanisms may include changes in cervical mucus that inhibit sperm penetration and in the endometrium that reduce the chances of implantation. The exact mechanism involved in the treatment of acne is not established, but may be related to increase of sex hormone-binding globulin and reduction of free testosterone

Answer 42

Contraindicated

Answer 43

A)Arterial or venous thrombotic diseases, patients at high risk B) Breast cancer or other estrogen-or progestin-sensitive cancer, history of or current C) Cerebrovascular disease D) Concomitant hepatitis C drug combinations containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir E) Coronary artery disease F) Diabetes mellitus with vascular disease G) DVT or pulmonary embolism, history of or current H) Headaches with focal neurological symptoms I) Hypercoagulopathies, inherited or acquired J) Hypertension, uncontrolled K) Liver disease or liver tumors, benign or malignant L) Migraine headaches in patients older than 35 years M) Migraine headaches with aura N) Pregnancy O) Smoking, women older than 35 years P) Thrombogenic valvular or thrombogenic rhythm diseases of the heart (eg, atrial fibrillation or subacute bacterial endocarditis with valvular disease) Q) Uterine bleeding, undiagnosed abnormal

Answer 44

1) Oral (Tablet) Cigarette Smoking and Serious Cardiovascular Events Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive use. This risk increases with age, particularly in women over 35 years of age, and with the number of cigarettes smoked. For this reason, combination oral contraceptives are contraindicated in women who are over 35 years of age and smoke

Answer 45

Warn patient to report symptoms of venous or arterial thrombosis. Instruct patient to report symptoms of gallbladder disease or jaundice. Counsel patient to report any irregularities in vaginal bleeding. Side effects may include headache, migraine, abdominal pain, flatulence, vaginal infection, genital discharge, breast discharge, breast pain or enlargement, mood disorders, nervousness, chloasma, and weight changes. Advise patient to take tablet at the same time every day. Instruct patient that if a single active dose is missed, including vomiting or diarrhea within 3 to 4 hours after the active dose, take the tablet as soon as possible and resume a normal schedule. If more than one active dose is missed, contact a physician for instructions. Use of additional nonhormonal methods of contraception may be necessary.

Answer 46

Iron Supplement, Mineral Supplement

Answer 47

Iron deficiency

Answer 48

Ferrous sulphate contains iron and most of the iron in the body is present as haemoglobin. The remainder is present in the storage forms ferritin or hemosiderin, in the reticuloendothelial system or as myoglobin with smaller amounts occurring in haem-containing enzymes or in plasma bound to transferrin

Answer 49

Specific Indications have not been 1) anemia other than iron-deficiency anemia 2) hemochromatosis 3) hemosiderosis 4) hypersensitivity to iron products

Answer 50

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately

Answer 51

Works best when taken on an empty stomach. If there is a stomach ache, try with food. Most people feel better after taking it for 1 week. May take up to 4 weeks to feel full effect. Common side effects include feeling or being sick, constipation, and diarrhoea Do not chew or crush - administer with a full cup of water or juice on an empty stomach. If we miss a dose, take it as soon as you remember. But if it's close to your next dose, skip it and take it when you are usually suppose to

Answer 52

Essential B Vitamin

Answer 53

Folic acid deficiency

Answer 54

Folic acid is required for the conversion of deoxyuridylate to thymidylate, which is a rate-limiting step in DNA synthesis. Folic acid deficiency presents clinically as macrocytic anemia when red blood cells are unable to extrude their nucleus.

Answer 55

Hypersensitivity

Answer 56

May require several weeks for maximum effect. Avoid alcohol as it inhibits the absorption of folic acid.

Answer 57

Thyroid supplements

Answer 58

1. Hypothyroidism 2. Thyroid-stimulating hormone suppression, pituitary

Answer 59

Levothyroxine sodium is a synthetic thyroid hormone. The endogenous thyroid hormones, T3 and T4, diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins.

Answer 60

Compatible

Answer 61

Hypersensitivity, nontoxic diffuse goiter or nodular thyroid disease, thyrotoxicosis, AMI, treatment of obesity or weight loss, uncorrected adrenal insufficiency; may precipitate acute adrenal crisis

Answer 62

Not for weight reduction

Answer 63

May require 6-8 wk for symptomatic improvement. Avoid abrupt discontinuation. Take on an empty stomach, with water at least 30 min before food. Avoid antacids and iron within 4 h of dose.

Answer 64

Thionamides, Antithyroid Agents

Answer 65

1. Hyperthyroidism 2. Graves disease, Thyrotoxicosis 3. Patients with toxic multinodular goiter who are poor candidates for surgery or radioactive iodine therapy. 4. Thyrotoxicosis, Drug-induced

Answer 66

It is used to treat overactive thyroid (hyperthyroidism). It prevents the thyroid gland from making too much thyroid hormone. It interferes with the step that causes the iodination of tyrosine residues in thyroglobulin, mediated by the enzyme thyroid peroxidase, thus preventing the synthesis of thyroxine (T4) and triiodothyronine(T3) Methimazole, a thyroid hormone synthesis inhibitor, is used in the treatment of hyperthyroidism. Its actions are similar to propylthiouracil although it does not inactivate the existing thyroxine and triiodothyronine stored in the thyroid or in the blood

Answer 67

Fetal risk cannot be ruled out

Answer 68

Hypersensitivity

Answer 69

Immediately report any symptoms of agranulocytosis. Prompty report symptoms of vasculitis (e.g. new rash, hematuria, decreased urine output, dyspnea, or hemoptysis). Side effects may include urticaria, nausea, vomitting, epigastric distress, arthralgia, paresthesia, loss of taste, abnormal loss of hair, myalgia, headache, pruritus, drowsiness, neuritis, edema, vertigo, and skin pigmentation. Instruct patient to report symptoms of hepatotoxicity, hypothyroidism, drug fever, a lupus-like syndrome, or insulin autoimmune syndrome

Answer 70

Errin, Camila, Golivette, Lyza, Nora-BE, Nor-QD, Ortho Micronor

Answer 71

Contraceptive, Progestin

Answer 72

1. Pregnancy Prevention (oral contraceptive) 2. Women with secondary amenorrhea (absence of menstral period in women who have previously had a menstrual period who are not pregnant), endometriosis, and irregular menstrual periods cause dby hormonal imbalance

Answer 73

Norethindrone is a progestin contraceptive that prevents ovulation, inhibits sperm penetration by thickening the cervical mucus, reduces the midcycle luteinizing hormone and follicle-stimulating hormone peaks, delays the movement of ovum through the fallopian tube, and alters the endometrium lining [4]. Norethisterone has progestational action similar to those of progesterone, but is a more potent inhibitor of ovulation and has weak oestrogenic and androgenic properties. It is used to treat a number of disorders of the menstrual cycle

Answer 74

Contraindicated

Answer 75

Abnormal and diagnosed genital bleeding, acute liver disease, benign or maligant liver tumors. Carcinoma of the breast, hypersensitivitity to any component of the product, pregnancy.

Answer 76

Side effects include nausea, dizziness, headache, breast, tenderness, or irregular periods. Tell patient to report persistent or recurrent abnormal vaginal bleeding, amenorrhea, or severe abdominal pain. Advise patient to take drug every day, at the same time of day, with no more than 24 hours between doses, including durin bleeding episodes. Avoid smoking during therapy as this increases the risk of heart attack or stroke. Use an alternative non-hormonal or back-up method of contraception while taking St. John's wort and for 28 days after discontinuing St. John's wort. If a dose is missed by 3 hours or more, take the missed pill as soon as remembered, then resume normal schedule, and use a backup method (eg, condom and spermicide) for 48 hours

Answer 77

Electrolyte, potassium

Answer 78

Hypokalemia, Hypokalemia, prophylaxis

Answer 79

Potassium is an electrolyte required for maintenance of the excitatory properties of neuromuscular tissues, and the resting membrane potential of cells is related to potassium concentrations, varying directly with the ratio of intracellular to extracellular potassium level.

Answer 80

Compatible

Answer 81

Hypersensitivity to potassium, acute renal failure, structural, pathologic, or pharmacologic causes that delay tablet passage through the GI tract, hyperkalemia, Addison disease, acute dehydration

Answer 82

Take with food. Take the powder, granule, or oral liquid only after mixing in 4 oz of water or juice. Crush or break only specifically designed extended-release formulations. Capsules may be opened, sprinkled on apple sauce, and ingested immediately. Completely dissolve effervescent tablets in liquid and sip slowly over a 5-10 min period.

Answer 83

Prometrium

Answer 84

Progestin Hormone

Answer 85

1. Prevention of estrogen-induced endmetrial hyperplasia 2. Secondary physiologic amenorrhea 3. Assisted reproduction for infertile women

Answer 86

Progesterone transforms proliferative endometrium into secretory endometrium. Parenterally administered progesterone inhibits gonadotropin production, which in turn prevents follicular maturation and ovulation.

Answer 87

Weight risks and benefits

Answer 88

Abnormal vaginal bleeding, history of estrogen- or progesterone-dependent neoplasia, active or history of DVT or PE, known or suspected pregnancy (oral only)

Answer 89

Cardiovascular disorders, breast cancer, dementia risk, risk versus benefits

Answer 90

Menstrual bleeding should occur 3-7 d after last dose. Report if menstruation does not occur within 7 d after last dose. For vaginal formulation, avoid using other vaginal drugs within 6 h before or 6 h after using progesterone.

Answer 91

Androgen, C-III

Answer 92

Hypogonadism

Answer 93

Testosterone is an endogenous androgen. Androgens are responsible for normal growth and development of male sex organs. Testosterone is involved in the growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution; laryngeal enlargement; vocal cord thickening; alterations in body musculature; and fat distribution.

Answer 94

Contraindicated

Answer 95

Hypersensitivity to testosterone; men with breast or prostate cancer; women who are pregnant, who may become pregnant, or who are breast-feeding

Answer 96

Secondary Exposire

Answer 97

Gel to be applied to clean, dry, intact skin of the shoulders and upper arms and/or abdomen but should not be applied to genitals. Gel should be allowed to dry well; swimming and showering should be avoided for 5-6 h after application. Patients should keep application site covered, as direct skin contact can transfer drug to others. Virilization has been reported in children who were secondarily exposed to testosterone gel (coming in contact with bare skin around gel application site). Male patients should report too frequent or persistent erections. Female sexual partners of patients using drug should report male-like changes. Do not use higher doses than you have been prescribed, or combine with other anabolic steroids, serious adverse effects can occur. Seek medical attention if chest pain, shortness of breath, signs of stroke, or behavioral changes.

Answer 98

Armour Thyroid

Answer 99

Thyroid supplements

Answer 100

Hypothyroidism

Answer 101

Thyroid hormone is a naturally derived thyroid replacement containing both levothyroxine (T4) and liothyronine (T3). The endogenous thyroid hormones, T3 and T4, diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins.

Answer 102

Compatible

Answer 103

Hypersensitivity to thyroid, nontoxic diffuse goiter or nodular thyroid disease, thyrotoxicosis, AMI, treatment of obesity or weight loss, uncorrected adrenal insufficiency; may precipitate acute adrenal crisis

Answer 104

Ineffective and potentially toxic when used for weight loss

Answer 105

May require 6-8 wk before symptoms improve. Do not stop using this medicine suddenly without asking your doctor; may need to slowly decrease dose before stopping it completely. Take on an empty stomach, with water.