Uterine, Thyroid, Osteoporosis - Indications, etc

Question 1

DOC to induce labor at term. can prevent PPH

Answer 1

oxytocin

Question 2

2nd line to decrease uterine bleeding

Answer 2

ergot alkaloids:

Ergonovine Maleate

Question 3

What must occur before administration of Ergonovine Maleate?

Answer 3

uterine massage, oxytocin

Question 4

Induces expulsion of uterine contents in fetal death, miscarriage, elective abortion…

Answer 4

Syth. PGs:

Dinoprostone/Carboprost/Misoprostol

Question 5

Which synthetic PG can be used for cervical ripening at term?

Answer 5

Dinoprostone

Question 6

3rd line for PPH after massage, oxytocin and ergots…

Answer 6

Syth. PGs:

Dinoprostone/Carboprost/Misoprostol

Question 7

What uterine drug?

Reduce PPH by 20-30%

Tx of Uterine Bleeding via fibroids, non-partum causes.

Answer 7

Tranexamic Acid

Question 8

What is the 1st line tocolytic to delay labor?

Answer 8

Magnesium Sulfate

Question 9

What are two other indications for magnesium sulfate administration?

Answer 9

prevent pre-eclampsia convulsions

treat eclampsia

Question 10

Which tocolytic is becoming 1st line to prevent pre-term labor/contractions?

Answer 10

indomethacin

Question 11

Which tocolytic?

Use w. High-risk pregnancy w. Hx of preterm birth

Answer 11

Progesterone

Question 12

Is progesterone an effective acute tocolytic therapy?

Answer 12

no

Question 13

When is progesterone effective as a tocolytic agent?

Answer 13

given prophylactically from 16-37th week until delivery

Question 14

The following are three adverse effects of…?

water intoxication, uterine rupture, fetal sinus bradycardia

Answer 14

oxytocin

Question 15

What are two adverse effects of ergot alkaloids?

Answer 15

transient HTN, Angina/MI

Question 16

What drugs have the following adverse effects?

N/V/Diarrhea
Fever/Chills/HA

Answer 16

Dinoprostone/Carboprost/Misoprostol

Question 17

Which uterine drug can cause intravascular thrombosis?

Answer 17

Tranexamic Acid

Question 18

the below are adverse effects of…

Flushing/Diaphoresis/Hypotension

Decreased DTRs/Paralysis/Weakness

Circulatory collapse/Cardiac/CNS/Respiratory Depression

Answer 18

Magnesium Sulfate

Question 19

What is a major adverse effect of indomethacin?

Answer 19

partial closure of fetal ductus arteriosis

Question 20

The below are 4 C/I for…

malpresentation
cephalopelvic disproportion
uterine/cervical scarring
unengaged head

Answer 20

Oxytoxcin

Question 21

2 major contraindications for ergot alkaloid administration…

Answer 21

never to induce labor

PAD/CAD

Question 22

The below are C/Is for what drugs?

Acute Cardio/Pulm/Renal/Hepatic Disease

Asthma, HTN, Anemia, Jaundice, Epilepsy

Answer 22

Synth PGs:

Dinoprostone/Carboprost/Misoprostol

Question 23

DOC for hypothyroidism, must be carefully titrated to individual…

Answer 23

Levothyroxine

Question 24

Used in hypothyroidism as initial therapy due to faster steady state…

Answer 24

liothyronine

Question 25

What are adverse effects of levothyhroxine, liothyronine and dessicated thyroid?

Answer 25

thyrotoxicosis (hyperthyroid)

Question 26

What are four approaches to treating hyperthyroidism?

Answer 26

surgery, radioablation, pharm. decrease T3/T4, beta blockers (sxs)

Question 27

What is the 1st line tx for medical management of Graves?

Answer 27

Thioamides: | PTU/Methimazole

Question 28

There is a black box warning for PTU for what...

Answer 28

severe liver injury, acute liver failure

Question 29

In cases of severe liver injury/liver failure and Graves, what can you give instead of PTU?

Answer 29

methimazole

Question 30

Between PTU and methimazole, which is DOC in most cases?

Answer 30

methimazole

Question 31

When would you give PTU instead of methimazole for tx of hyperthyroidism?

Answer 31

Pregnancy, allergy

Question 32

Which drugs have the following adverse effects? - itching/skin rash - granulocytopenia/agranulocytosis - goiter

Answer 32

Thioamides: PTU and methimazole

Question 33

Which drug has the following indications for hyperthyroidism? - used 7-10 days before surgery to decrease risk of thyroid storm - used in radioactive emergency

Answer 33

Iodide

Question 34

What offers definitive tx for Graves, but is secondary to thioamides?

Answer 34

radioactive iodide

Question 35

This tx for hyperthyroidism is used in elderly patients or those with heart disease...

Answer 35

radioactive iodine

Question 36

What is the preferred tx for toxic nodular goiter?

Answer 36

radioative iodine

Question 37

Which drug will cause hypothyroidism and increases risk for thyroid storm?

Answer 37

radioactive iodine

Question 38

what can be given to decrease risk of thyroid storm when giving radioactive iodine?

Answer 38

thioamides

Question 39

What are the 3 contraindications for radioactive iodine?

Answer 39

pregnancy, nursing, mothers w/o childcare

Question 40

Which drug is used to decrease sxs of hyperthyroidism and to prepare for surgery before thioamides or radioactive iodine take effect?

Answer 40

beta blockers: | propranolol, metoprolol

Question 41

What is the contraindication for beta blocker use? What can be used instead?

Answer 41

C/I: Asthma Use CCBs instead

Question 42

What is 1st line method of tx for hyperthyroidism/Graves?

Answer 42

pharmacologic tx

Question 43

What tx method of hyperthyroidism carries a high risk of thyroid storm?

Answer 43

radioactive iodine

Question 44

Caliconin has what two indications?

Answer 44

osteoporosis, pagets disease

Question 45

Which drug has the following adverse effects? - allergic rxn - rhinitis/sinusitis (IN) - N/V (IM)

Answer 45

calcitonin

Question 46

What are two adverse effects of teriparatide and abaloparatide?

Answer 46

hypercalcemia, hypercalciuria

Question 47

Teriparatide or Abaloparatide can cause hyperuricemia, and therefore shouldn't be administered to gout patients?

Answer 47

abaloparatide

Question 48

What is the contraindication to teriparatide and abaloparatide?

Answer 48

osteosarcoma

Question 49

Denosumab has what two indications?

Answer 49

osteoporosis w. high fx risk increase bone mass/strength in cortical and trabecular bone

Question 50

What are two contraindications for denosumab?

Answer 50

hypocalcemia | pregnancy

Question 51

What is the 1st line Tx for post-menopausal osteoporosis?

Answer 51

Bisphosphonates

Question 52

PO administration of bisphosphonates has what adverse effects?

Answer 52

GI sxs: pain, irritation, ulcer

Question 53

IV administration of bisphosphonates has what adverse effect if given quickly?

Answer 53

renal toxicity

Question 54

Bisphosphonates increase incidence of...

Answer 54

osteonecrosis of the jaw, atypical bone fx

Question 55

What are C/Is for oral and IV bisphosphonates?

Answer 55

PO: inability to stand/sit upright and esophageal disease IV: renal disease