Women's Health Flashcards
What are the different classes of meds used to manage osteoporosis?
Bisphosphonates, SERMS, Denosumab (Prolia), and Teriparatide (Forteo)
Bisphosphonates MOA
Clinical evidence indicates that bisphosphonates can ..
Inhibit osteoclast-mediated bone resorption, thus preventing bone loss
- Clinical evidence indicates that bisphosphonates can reverse lost bone mass and reduce fracture risk
Suffix of Bisphosphonate drugs
-nate
ex:
alendronate (Fosamax), orally, once a day/week
ibandronate (Boniva), orally, once a month
risedronate (Actonel), orally, once a day/week
also:
zoledronic acid (Reclast), infusion, one a year
Patient teaching with bisphosphonates:
Oral: must sit upright and take on an empty stomach with water only
Do not lay down for 30-60 minutes after taking the medication (remain upright to facilitate passage to the stomach and minimize risk of esophageal irritation)
Bisphosphonates increase the risk for
- Esophageal burns if medication lodges in esophagus
- Osteonecrosis of the jaw (w/ tooth extraction)
SERMS MOA
MOA: Stimulates estrogen receptors on the bone and increases bone density
- Acts like estrogen on the bone, but not on the uterus or breast
- Reduces the risk of invasive breast cancer and spine fractures
Denosumb (Prolia)
MOA: Blocks osteoclast activation by targeting a specific protein needed by osteoclast
Teriparatide (Forteo)
- Only drug that stimulates _____ _____
- Used for those with..
- Only drug that stimulates bone formation
- Used for those with high risk of fractures
Therapeutic effect of Teriparatide (Forteo)
↑ bone mineral density with reduced risk of fractures.
Adverse effects for oral contraceptives
Thrombosis
Hypertension
Edema
Nausea & Vomiting
GI Cramps; Constipation
Dizziness; Migraines; Stroke
Menstrual Irregularities
Breast Change
Contraindications of oral contraceptives:
Pregnancy (category X), breast cancer,
Estrogen-dependent neoplasia,
Unidentified uterine bleeding
Oral contraceptives will have high risk factors for _____ _____ in pts. with…
High risk factors for venous thrombosis: stroke or MI, liver dysfunction, smokers, uncontrolled HTN)
Pt. education:
When should patients start taking oral contraceptives?
Tell them if it’s discontinued, they will..
- First day of Menstrual Cycle OR
- Sunday Start (First Sunday After Menstrual Cycle OR)
- Immediate Start (Need to use backup protection for at least 1 week after staring)
If discontinued:
◦ Will return to fertility within 1 to 2 cycles
If a pt misses one pill (for oral contraceptives)
take immediately
If a pt misses two pills in a row (for oral contraceptives)
Take 2 immediately; then 2 the next day; then resume pack
