T/F: Women with an intact uterus going through menopause must be treated with both estrogen and progestin.
TRUE. Women who have had a hysterectomy are treated with unopposed estrogen only.
What are the estrogen-progestin producst available?
Femhrt
Activella
Prempro
Premphase
What is the role of Estrogen in Contraceptives? What is the role Progestin?
Estrogen: prevents development of dominant follicle by suppressing FSH.
Progesetin: blocks ovulation. Causes production of thick cervical mucus and atrophy of endometrium.
What are extended cycle OCs?
They delay menstruation. Occurs around every 3 months or not at all.
Loestrin-24 FE
Seasonale
Jolessa
Yaz
Which OC is a continuous-cycle OC?
Lybrel
Which contraceptive is in a transdermal system?
Ortho Evra
Which contraceptive is a subdermal rod? An injection? An IUD?
Implanon
Depo-Provera (medroxyprogesterone)
Mirena (x 5 years)
SE such as breast tenderness, fullness, nausea, blaoting, HTN, skin discoloration (melasma), HA are usually associated with ______ excess.
Estrogen
SE such as acne, depression, irritability, hypomenorrhea, increased appetite and weight agin, fatigue, constipation is usually associated with ____________ excess.
Progestin
Early breakthrough bleeding is associated with _________ deficiency, while late breakthrough bleedining is associated with _________ deficiency.
estrogen; progestin
What is Type I and Type II osteoporosis?
Type I: Postmenopausal (most common)
Type II: Age related
After completing a DEXA scan, a T score of -1.0 to -2.5 standard deviations below young adult mean is considered to be __________.
Osteopenia
After completing a DEXA scan, a T score below -2.5 standard deviations below young adult mean is considered to be __________.
Osteoporosis
Calcium Citrate (24% calcium content)
Citracal
Calcium Carbonate (40% calcium content)
Caltrate
Titralac
Tums
Viactiv chews
Mylanta Supreme liquid
Calcium phosphate tribasic (39% calcium content)
Posture, Posture-D
What is the MOA of bisphosphonates?
Bind to bone (hydroxyapatite) and incorporate into bone to increase and stablize bone mass. They also inhibit osteoclasts have have very long half-life in the bone.
Alendronate - brand/dosing?
Fosamax
Prevention: 5 mg/day or 35mg/wk
Treatment = x 2 of prevention
Risedronate - brand/dosing?
Actonel
Prevention: 5 mg/day
Treatment: 5 mg/day
OR 35 mg/wk
OR75 mg/day x 2 days/month
OR 150 mg/month
Ibandronate - brand/dosing?
Boniva
2.5 mg/day, 150 mg/month, 3 mg IV Q3 months
Zoledronic Acid - brand/dosing?
Reclast
5 mg IV infusion over 15 minutes QYEAR
Calcitonin
Miacalcin - INTRANASAL - qd alternating nostrils or SQ or IM QOD
*Calcitonin inhibits bone resorption by binding to osteoclast receptors.
Teriperatide (PTH hormone)
Forteo
Injection daily - increases rate of bone formation by stimulating osteoblasts.