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Dispensing Final 2013 > Hormones Section Final > Flashcards

Hormones Section Final Flashcards

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1
Q

How do oral contraceptive work?

A

Inhibit ovulation and alter cervical mucus to decrease sperm penetration

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2
Q

estrogen in oral contraceptives?

A

ethinyl estradiol

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3
Q

progestins in oral contraceptives?

A

levonorgestrel, desogestrel, norethindrone, norgestimate, drospirenone, and norgestrel

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4
Q

Drospirenone details?

A

o Drospirenone is derived from spironolactone → can raise serum K+ levels
• Cautiously prescribed in women taking ACE inhibitors, ARBs, K+ sparing diuretics and potassium supplements

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5
Q

Birth control counseling (2), adverse effects?

A
  • If taking for the first time, use an additional method of birth control for the first seven days or through the first cycle
  • Antibiotics decrease the effectiveness of oral contraceptives, so use second method of birth control
  • Adverse effects: alveolar osteitis, hirsutism, weight gain, and nausea
  • Increased risk of CVD for women who smoke; smoking is not recommended
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6
Q

3 classes of oral contraceptives?

A

monophasic, biphasic, triphasic

all dosed qday

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7
Q

Monophasic OC details?

A

Monophasic delivers a fixed dose of estrogen and progestin throughout the cycle

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8
Q

Monophasic trades (11)?

A 
o	Apri
o	Aviane
o	Gianvi
o	Levora
o	Loestrin 24
o	Lo Ogestrel
o	Microgestin
o	Sprintec
o	Yasmin
o	Yaz: acne and PMDD
o	Zarah
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9
Q

Biphasic OC details?

A

delivers a fixed dose of estrogen and progestin for the first 21 days of the cycle → estrogen dosage decreases and progestin is discontinued

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10
Q

Biphasic OC trades?

A

o Kariva
o Mircette
o Seasonique

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11
Q

Triphasic details?

A

estrogen dose stays the same or varies and the progestin dose varies

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12
Q

Triphasic trades?

A 
o	Estrostep: acne
o	Ortho Tri-Cyclen: acne
o	TriNessa
o	Tri-Sprintec
o	Trivora
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13
Q

non-oral contraceptive trades?

A

Ortho Evra, NuvaRing, Depo-Provera

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14
Q

Ortho Evra generic and details?

A

ethinyl estradiol, norelgestromin

qweekly, transdermal system

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15
Q

NuvaRing generic and details?

A

ethinyl estradiol, etonogestrel
• qmonth
• Wear continuously for 3 weeks, then remove for 1 week → period starts in 2-3 days
• Refrigerate in the pharmacy
• Ring must be reinserted within 3 hours if expelled

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16
Q

Depo-Provera generic and details?

A

medroxyprogesterone
• q3months
• Suspension for injection → must be shaken to ensure a uniform suspension

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17
Q

Hormone Replacement Therapy indications?

A
  • Treat vasomotor symptoms, vaginal atrophy, and osteoporosis
  • Atrophic vaginitis occurs when estrogen levels decrease during menopause → dyspareunia
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18
Q

Hormone Replacement Therapy Trades?

A

Evista, Premarin (tab, cream), Prempro,
Vagifem, Vivelle-Dot, Estrace Vaginal Cream,
Activella, Femhrt, Delestrogen

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19
Q

Evista generic and details?

A

raloxifene
• qday
• Selective estrogen receptor modulator
• Indicated for osteoporosis and prevention of breast cancer

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20
Q

Premarin generic and details?

A

conjugated equine estrogens
• qday
• Tablet
• Indicated for VM, VA, and O

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21
Q

Premarin Vaginal Cream generic and details?

A 
conjugated equine estrogens
•	Twice weekly
•	0.625 mg/g vaginal cream
•	Indicated for VA
•	Applicator is calibrated in 0.5 gram increments; max of 2 grams
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22
Q

Prempro generic and details?

A

conjugated equine estrogens, medroxyprogesterone
• qday
• Indicated for menopausal symptoms

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23
Q

Vagifem generic and details?

A 
estradiol
•	Vaginal tablet
•	Indicated for VA
•	Initial: 1 tablet qday x 2 weeks
•	Maintenance: 1 tablet twice weekly
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24
Q

Vivelle-Dot generic and details?

A

estradiol
• Twice weekly
• Transdermal

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25
Estrace Vaginal Cream generic and details?
estradiol • 0.1 mg/g vaginal cream • Indicated for VA • Initial: qday x 2 weeks → after 2 weeks use ½ dose qday x 2 weeks • Maintenance: 1-3x/week • Applicator calibrated in 1 gram increments; max of 4 grams
26
Endogenous androgens generic and details?
testosterone • Responsible for development of the male sex organs and for maintenance of secondary sexual characteristics • Men normally produce 5 mg of testosterone daily • Male hypogonadism is a condition characterized by low serum concentration of testosterone --> Impotence, decreased sexual desire, fatigue, and osteoporosis
27
testosterone Trade and details?
AndroGel • qday • Indicated for male hypogonadism • Topical gel • Single dose packet: 2.5 gram and 5 gram • Metered dose pump: 1% (4 pumps), 1.62% (2 pumps)
28
Diabetes definition and types?
o Diabetes mellitus – disorder of carb metabolism caused by an insufficient secretion of insulin or inadequate utilization of insulin by body tissues (insulin resistance) • Type I – do not make enough insulin; unpreventable; must use insulin shots • Type II – body does not produce enough insulin or it cannot use the insulin that is produced; preventable
29
Insulin definition and syringe details?
hormone synthesized in the pancreas, essential for utilization of glucose in the body •Should be administered with insulin syringes • 3/10 mL syringe --> 30 units of insulin • ½ mL & 1 mL --> 50 to 100 units, respectively
30
Goal of insulin therapy? Glucagon therapy?
``` control hyperglycemia (hypoglycemia is potential adverse effect Treat hypoglycemia with glucagon for injection (IV, IM, SQ) to induce liver glycogen to make glucose • Infusion of glucose and insulin produces a shift of potassium into the cells → lowers serum K+ levels ```
31
OTC insulin generics?
insulin regular insulin NPH (neutral protamine hagedorn) combo of the two
32
insulin regular Trades and details?
Humulin R, Novolin R •Rapid acting •OTC
33
insulin NPH Trades and details?
Humulin NPH, Novolin NPH •Intermediate acting •OTC •Also known as isophane insulin
34
Insulin OTC combination product?
Humulin 70/30, Novolin 70/30 NPH (70%), regular (30%) intermediate acting OTC
35
Rx only insulin Trades?
Humalog, Novolog, Apidra Humalog Mix 75/25, Novolog Mix 70/30 Lantus. Levemir Humulin R U-500
36
Humalog, Novolog, Apidra generics and details?
``` Humalog -insulin lispro Novolog -insulin aspart Apidra -insulin glulisine • Insulin analog • Rapid acting • Rx only ```
37
Humalog Mix generic and details?
Humalog Mix 75/25 insulin lispro protamine (75%), insulin lispro (25%) • Intermediate acting • Rx only
38
Novolog Mix generic and details?
Novolog Mix 70/30 insulin asaprt protamine (70%), insulin aspart (30%) intermediate acting Rx only
39
Lantus, Levemir generics and details?
``` Lantus - insulin glargine Levemir - insulin detemir • Long acting • Used to give basal insulin level • Rx only ```
40
Humulin R U 500
insulin regular 500 units/mL | indicated for patients requiring more than 200 units/day
41
List of antidiabetic classes (7) | make thingy
``` Sulfonylureas Metglitinides Biguanides Alpha-glucosidase inhibitors Thiazolidinediones Incretin Mimetics Dipeptidyl Peptidase-4 inhibitorsmake ```
42
Sulfonylurea generics?
glipizide glimepiride glyburide chlorpropamide
43
glipiziade Trade?
Glucotrol Glucotrol XL Sulfonylurea
44
glimepiride Trade?
Amaryl | Sulfonylurea
45
glyburide Trade?
Diabeta Glynase PresTab Sulfonylurea
46
Sulfonylurea class MOA and counseling?
* Stimulate insulin release from pancreas and increase tissue sensitivity to insulin * Can cause severe hypoglycemia so avoid alcohol
47
Metglitinide class MOA and counseling
* Stimulate insulin release from pancreas | * Can cause severe hypoglycemia so avoid alcohol
48
Metglitinide Trades and generics?
nateglinide | repaglinide (TID)
49
nateglinide Trade?
Starlix | Metglitinide
50
repaglinide Trade?
Prandin (TID) | Metglitinide
51
Biguanide MOA?
Only increase tissue sensitivity to insulin; helps with insulin resistance
52
Biguanide generic?
metformin
53
metformin BID Trade?
Glucophage (tablet) | biguanide
54
metformin qday Trade?
All ER Tablets (biguanides): Glucophage XR Fortamet Glumetza
55
Alpha-glucosidase inhibitors MOA and counseling?
* Delay digestion of ingested carbs, which results in a smaller increase of blood glucose after meals * Take at first bite of each main meal * Side effect: increased flatulence
56
Alpha-glucosidase inhibitor Trades and generics?
Precose - acarbose | Glyset - miglitol
57
Thiazolidinedione MOA and counseling?
* Increase tissue sensitivity to insulin * BBW: may cause or exacerbate heart failure * Monitor patients for congestive heart failure * Dyspnea-difficulty breathing
58
Thiazolidinedione generics?
pioglitazone | rosiglitazone
59
pioglitazone Trade?
Actos | thiazolidinedione
60
rosiglitazone Trade?
Avandia | thiazolidinedione
61
Incretin Mimetic MOA?
* Incretin hormones are released in the intestine in response to meals and stimulate insulin release from the pancreas * Only used in Type II
62
Incretin Mimetic generics?
exenatide, liraglutide
63
exenatide BID Trade and details?
Byetta - exenatide •BID; 1 hour before breakfast and 1 hour before dinner •5 mcg, 10 mcg SQ injection •Refrigerate; can be stored at room temperature for 6 days (Incretin Mimetic)
64
exenatide Qweekly Trade and details?
``` Bydureon - exenatide • qweekly • SQ injection • Inject any time independent of meals • Refrigerate (Incretin Mimetic) ```
65
liraglutide Trade and details?
``` Victoza - liraglutide • qdaily • 0.6, 1.2, 1.8 mg SQ injection • Independent of meals • Refrigerate; can be stored at room temperature for 30 days (Incretin Mimetic) ```
66
Dipeptidyl Peptidase-4 inhibitors MOA?
DPP4 is enzyme needed to metabolize the incretin hormones • Incretin hormones are released in the intestine in response to meals → stimulate insulin release from pancreas • If inhibited, incretin will work longer and stimulate more insulin
67
Dipeptidyl Peptidase-4 inhibitor generics?
sitagliptin, saxagliptin
68
sitagliptin Trade?
Januvia - sitagliptin | DPP4 inhibitors
69
saxagliptin Trade?
Onglyza - saxagliptin
70
Combination Antidiabetic Trades?
``` Metaglip Avandamet Actoplus Met Glucovance Janumet ```
71
Metaglip generic?
glipizide, metformin
72
Avandamet generic?
rosiglitazone, metformin
73
Actoplus Met generic?
pioglitazone, metformin
74
Glucovance generic?
glyburide, metformin
75
Janumet generic?
sitagliptin, metformin
76
Thyroid hormone indications, origins, ratios?
o Indicated as replacement or supplemental therapy in hypothyroidism o Natural products are derived from beef and pork → difficult to standardize so synthetic products are preferred • Armour Thyroid tablets are derived from porcine thyroid glands; have a strong smell o T-3 is 4x as potent as T-4 on a microgram per microgram basis
77
Thyroid hormone generics?
liotrix levothyroxine liothyronine
78
liotrix Trade and details?
Thyrolar | 4:1 mixture of T-4 to T-3
79
levothyroxine Trade and details?
Synthroid, Levoxyl • qday tablet • Take on empty stomach • T-4
80
liothyronine Trade and details?
Cytomel • qday tablet • Take on empty stomach • T-3

Dispensing Final 2013 (3 decks)

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