Med Review Sheet

Question 1

Estradiol (systemic)

Answer 1

Estrace (oral)

Estrogen derivative

Vasomotor symptoms of menopause

1 mg qd (3 weeks on, 1 week off)

AE: N, HA, bloating, breast tenderness, CHD, stroke, VTE, breast CA, gallbladder dz

CI: thromboembolic dz, breast CA or estrogen-dependent neoplasm, pg, liver dz, undx’d vaginal bleeding, prevention/tx of cardio/cerebrovascular dz or dementia

Question 2

Medroxyprogesterone

Answer 2

Provera

Progestin

HRT

5-10mg qd x 12-14 days of the cycle

AE: nausea, HA, wt gain, bleeding, irritability, depression

CI: thromboembolic dz, breast CA or estrogen-dependent neoplasm, pg, liver dz, undx’d vaginal bleeding, prevention/tx of cardio/cerebrovascular dz or dementia

Question 3

Estradiol transdermal

Answer 3

Alora
Climara
Estraderm
Menostar

Estrogen derivative

HRT

Apply patch (0.025mg/day) once weekly

AE: N, HA, bloating, breast tenderness, bleeding, melasma, increased BP, CHD, stroke, VTE, breast CA, gallbladder dz, erythema, abd pain, skin irritation (less likely to cause nausea, HA, breast tenderness, DVT)

CI: thromboembolic dz, breast CA or estrogen-dependent neoplasm, pg, liver dz, undx’d vaginal bleeding, prevention/tx of cardio/cerebrovascular dz or dementia

Question 4

Estradiol and Norethindrone

Answer 4

CombiPatch

Estrogen and progesterone combination

HRT

Continuous: Apply one patch twice weekly
Sequential: estradiol patch only X 14 days, then one combipatch twice weekly X 14days

AE: estrogen AE – nausea, HA, breast tenderness, bleeding, CHD, stroke, VTE, breast CA, gallbladder dz; progestogen – nausea, HA, weight gain, bleeding, irritability, depression, VTE, decreased BMD

CI: thromboembolic dz, breast CA or estrogen-dependent neoplasm, pg, liver dz, undx’d vaginal bleeding, prevention/tx of cardio/cerebrovascular dz or dementia, hysterectomy

Question 5

Ethinyl estradiol and norgestimate

Answer 5

Sprintec

Contraceptive - combination

Contraception

Take 1 tab qd X 21 days, then 7 days off medication (0.0325/0.25mg)

AE: estrogen AE – nausea, HA, breast tenderness, bleeding, CHD, stroke, VTE, breast CA, melasma, inc BP, gallbladder dz; progestogen – nausea, HA, weight gain, bleeding, irritability, depression, VTE, decreased BMD

CI: thromboembolic dz, stroke or CAD, breast CA or estrogen-dependent neoplasm, pg, liver dz, hx of hepatic tumors, undx’d vaginal bleeding, heavy smokers >35yrs, migraine with focal neuro sxs, postpartum (first 21 days)

Question 6

Raloxifene

Answer 6

Evista

SERM

Osteoporosis, BCA

AE: generally well tolerated; can cause leg cramps and hot flushes; risk for VTE similar to estrogens

CI: Hx/current VTE disorder, pg or breast feeding

Question 7

Alendronate

Answer 7

Fosamax

Bisphosphonate

Osteoporosis

Tx: 10mg qd or 70mg qweek

AE: nausea, heartburn; GI pain, irritation, perforation, ulceration, and/or bleeding; transient flu-like illness, muscle pains; possible risk for atypical femur fx, esophageal CA, black box warning for rare osteonecrosis of the jaw

CI: Hypocalcemia, abnlties of the esophagus which may delay esophageal emptying, inability to stand or sit upright for 30min; increased risk of aspiration

Question 8

Calcium carbonate

Answer 8

Tums, Maalox, Rolaids

Antacid, calcium salt

Osteoporosis

500-600 mg bid

AE: constipation, GI irritation, flatulence, rare kidney stones, hypercalcemia

CI: hypercalcemia, renal calculi, hypophosphatemia, pts with suspected dig toxicity

Question 9

Calcitonin

Answer 9

Fortical, Miacalcin

Hormone

Osteoporosis

AE: rhinitis, epistaxis

CI: hypersensitivity