Osteoporosis Treatment Alternatives and Prevention Strategies
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Questions and Answers

What are the three estrogens commonly found in oral contraceptive pills?

  • Estradiol, Estriol, Estrone
  • Estradiol, Ethinyl estradiol, Estropipate (correct)
  • Ethinyl estradiol, Mestranol, Estropipate
  • Estriol, Ethinyl estradiol, Estropipate

    • What are the unique properties of Beyaz and Safyral among combination oral contraceptives?

  • Higher progestin content
  • Include a folic acid supplement (correct)
  • Contain a diuretic component
  • Lower estrogen content

    • How is Nuvaring typically used as a contraceptive method?

  • Oral administration
  • Intravenous injection
  • Subcutaneous implantation
  • Vaginal insertion (correct)

    • What is the primary drawback of progestin-only contraceptives?

    <p>Must be taken at the exact same time daily</p> Signup and view all the answers

    What are the indications of prostaglandins in a medical context?

    <p>Induction of labor</p> Signup and view all the answers

    What are the rare side effects associated with phosphodiesterase type 5 (PDE-5) inhibitors?

    <p>Hearing loss and vision changes</p> Signup and view all the answers

    What is a potential risk associated with using Canagliflozin for diabetes?

    <p>Urinary Tract Infections (UTIs)</p> Signup and view all the answers

    Which medication is contraindicated in gestational diabetes?

    <p>Glucotrol</p> Signup and view all the answers

    What is the appropriate Levothyroxine dosage for Stacy, a 30-year-old with elevated TSH and low Free T4 weighing 100 lbs?

    <p>75 mcg</p> Signup and view all the answers

    Which medication is typically used to treat symptomatic hyperthyroidism in the first trimester of pregnancy?

    <p>Propylthiouracil</p> Signup and view all the answers

    What potential issue should Jane, a type 1 diabetic taking a beta blocker, be aware of?

    <p>Impaired glycogenolysis response to low blood glucose</p> Signup and view all the answers

    What interval is considered optimal for reassessing TSH after adjusting Levothyroxine dosage?

    <p>6-8 weeks</p> Signup and view all the answers

    What is the main purpose of combining levomefolate with estrogen and progestin in certain oral contraceptive pills?

    <p>To reduce the risk of fetal neural tube defects</p> Signup and view all the answers

    What unique components does Natazia contain?

    <p>Estradiol valerate and dienogest</p> Signup and view all the answers

    Which oral contraceptive pill component does not cause potassium retention?

    <p>Estradiol valerate</p> Signup and view all the answers

    What is the onset of success within 21 days after taking Next Choice emergency contraceptive pills?

    <p>Onset of menses</p> Signup and view all the answers

    Which component is common in all Selective Estrogen Receptor Modulators (SERMs)?

    <p>Variable estrogen receptor activity in different tissues</p> Signup and view all the answers

    What was the main reason for developing Selective Estrogen Receptor Modulators (SERMs)?

    <p>To selectively target estrogen receptors in different tissues</p> Signup and view all the answers

    'Duavee' is a combination drug used for what purpose?

    <p>'Menopause hormone therapy'</p> Signup and view all the answers

    'Premature epiphyseal closure' is a potential side effect associated with the therapeutic use of which hormone?

    <p>'Testosterone'</p> Signup and view all the answers

    'Edema caused from retention of salt and water' is a known side effect of which hormone therapy?

    <p>'Testosterone'</p> Signup and view all the answers

    'Reducing HDL and increasing LDL cholesterol levels' is an adverse effect known for which therapy?

    <p>'Testosterone' therapy</p> Signup and view all the answers

    What is the primary route of excretion for Methimazole?

    <p>Urine</p> Signup and view all the answers

    In a person with a Sulfa allergy, which medication should be used with caution?

    <p>Meglitinides</p> Signup and view all the answers

    What is the most common adverse effect associated with the use of alpha-glucosidase inhibitors?

    <p>GI upset</p> Signup and view all the answers

    For an elderly person compared to a young adult, what is the approximate difference in the Levothyroxine dose needed?

    <p>75% less</p> Signup and view all the answers

    Which medication should be monitored for ALT levels?

    <p>Thiazolidinediones</p> Signup and view all the answers

    What is the main reason women discontinue progestin-only pills?

    <p>Breakthrough bleeding</p> Signup and view all the answers

    What is the mechanism of action of alpha adrenergic agents?

    <p>Blockade of alpha 1 receptors and relaxation of smooth muscle</p> Signup and view all the answers

    What is not a possible side effect of Testosterone therapy?

    <p>Hair loss</p> Signup and view all the answers

    What should John, a type 1 diabetic having his wisdom teeth removed, do with his insulin regime?

    <p>Continue the glargine and take lispro only as a supplement</p> Signup and view all the answers

    What is the effect of iodine on the thyroid gland?

    <p>Stimulates thyroid hormone production</p> Signup and view all the answers

    Which drug is specifically mentioned to not activate estrogen receptors in the endometrium?

    <p>Raloxifene</p> Signup and view all the answers

    What is the principal difference between tamoxifen and raloxifene?

    <p>Raloxifene activates estrogen</p> Signup and view all the answers

    Which drug combines estrogen with an estrogen agonist/antagonist?

    <p>Duavee</p> Signup and view all the answers

    What is the primary noncontraceptive use of progestins?

    <p>Counteracting adverse effects of estrogen on the endometrium</p> Signup and view all the answers

    What are the adverse effects associated with progesterone use?

    <p>Gynecologic effects and breast cancer</p> Signup and view all the answers

    Which drug produces hot flashes due to blocking estrogen receptors?

    <p>[Nolvadex] Tamoxifen</p> Signup and view all the answers

    What is the purpose of cyclic therapy in the treatment of dysfunctional uterine bleeding?

    <p>To establish a regular monthly cycle</p> Signup and view all the answers

    Which progestin can induce menstrual flow in selected women experiencing amenorrhea?

    <p>[Provera] Medroxyprogesterone acetate</p> Signup and view all the answers

    Which hormone helps maintain the uterus throughout pregnancy?

    <p>Progesterone</p> Signup and view all the answers

    What is a significant risk associated with receptor activation by tamoxifen?

    <p>Endometrial cancer risk</p> Signup and view all the answers

    Which progestin is specifically approved for preventing preterm birth in women with a singleton pregnancy and a history of preterm delivery?

    <p>Makena</p> Signup and view all the answers

    What is the purpose of a progestin in hormone therapy when used in combination with estrogen?

    <p>Counterbalance estrogen-mediated endometrial stimulation</p> Signup and view all the answers

    Which medication was specifically highlighted for the treatment of vasomotor symptoms in menopause?

    <p>Brisdelle</p> Signup and view all the answers

    What condition can endometrial hyperplasia potentially lead to?

    <p>Endometrial carcinoma</p> Signup and view all the answers

    For which condition should nonestrogen treatments be considered carefully before prescribing hormone therapy?

    <p>Preventing osteoporosis</p> Signup and view all the answers

    What is the main reason for including a progestin in estrogen/progestin therapy (EPT)?

    <p>Addressing endometrial hyperplasia risk</p> Signup and view all the answers

    Which hormone therapy indication requires reassessment of continued therapy due to symptom subsiding over time?

    <p>Treatment of vasomotor symptoms</p> Signup and view all the answers

    Which antidepressant was specifically mentioned for reducing the frequency and severity of hot flashes?

    <p>Lexapro</p> Signup and view all the answers

    What is the key reason for using physiologic doses of estrogen in hormone therapy?

    <p>To counteract proliferative effects of estrogen</p> Signup and view all the answers

    What should be avoided in hormone therapy according to the text?

    <p>Long-term therapy</p> Signup and view all the answers

    What is the ratio of levothyroxine to liothyronine in Armour?

    <p>5:1</p> Signup and view all the answers

    What is the therapeutic use of Methimazole and Propylthiouracil?

    <p>Treatment of hyperthyroidism</p> Signup and view all the answers

    What is the main effect of Radioactive Iodine on the thyroid?

    <p>Destruction of thyroid tissue</p> Signup and view all the answers

    What is the diagnostic use of Radioactive Iodine?

    <p>Diagnosis of hyperthyroidism</p> Signup and view all the answers

    What are the metabolic actions of Estrogen mentioned in the text?

    <p>Enhancement of insulin sensitivity</p> Signup and view all the answers

    What adverse effect is associated with Estrogen therapy?

    <p>Growth promotion of existing breast cancer cells</p> Signup and view all the answers

    In what noncontraceptive use is estrogen most commonly used postmenopause?

    <p>Menopausal hormone therapy</p> Signup and view all the answers

    What route of administration is NOT mentioned for Estrogen in the text?

    <p>Sublingual</p> Signup and view all the answers

    What is the peak duration of Glulisine (Apidra) insulin?

    <p>0.75-1 hour</p> Signup and view all the answers

    Which insulin medication comes in 10 ml vials with 1000 units per 28 days after opening?

    <p>NPH</p> Signup and view all the answers

    What technology do insulin pumps use to account for basal insulin needs throughout the day?

    <p>Basal insulin infusion</p> Signup and view all the answers

    Why is it advised to counsel patients on the specific needles required for U-500 insulin?

    <p>To prevent overdosing on insulin</p> Signup and view all the answers

    What is the main reason for refrigerating insulin medications until opening?

    <p>To prevent the breakdown of proteins</p> Signup and view all the answers

    In giving insulin shots, why is it important to hold for 5-10 seconds after injecting?

    <p>To ensure all medication is given</p> Signup and view all the answers

    What is the primary mechanism of action of Metformin?

    <p>Reducing hepatic glucose output</p> Signup and view all the answers

    What is the most common adverse effect of Metformin?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    Which diabetic medication is associated with Lipoatrophy?

    <p>Sulfonylureas</p> Signup and view all the answers

    What is the primary adverse effect that can result from metformin accumulation in patients with severe renal or liver disease?

    <p>Lactic acidosis</p> Signup and view all the answers

    Which oral antidiabetic class of drugs is associated with weight loss rather than weight gain?

    <p>SGLT-2 inhibitors</p> Signup and view all the answers

    How does Sulfonylureas induce insulin release in the body?

    <p>By depolarizing cells and promoting insulin release</p> Signup and view all the answers

    What is the main difference between Lipoatrophy and Lipohypertrophy?

    <p>Lipoatrophy involves fat loss around injection sites, while Lipohypertrophy involves fat accumulation.</p> Signup and view all the answers

    Which diabetic medication is considered a first-line therapy?

    <p>Metformin</p> Signup and view all the answers

    What should be counseled to a patient experiencing severe gastrointestinal disturbances with Metformin?

    <p>To titrate up to the required dose gradually.</p> Signup and view all the answers

    What is the action patients should take 48 hours prior to undergoing a contrast dye procedure while on Metformin?

    <p>Discontinue the use of Metformin.</p> Signup and view all the answers

    What is the key reason behind the inclusion of levomefolate in Beyaz and Safyral oral contraceptive pills?

    <p>To reduce the risk of fetal neural tube defects if pregnancy occurs</p> Signup and view all the answers

    What distinguishes Natazia from other combination oral contraceptives in terms of its components?

    <p>It has a unique progestin component called dienogest</p> Signup and view all the answers

    What is the primary advantage of Natazia over other combination oral contraceptives?

    <p>Does not induce potassium retention</p> Signup and view all the answers

    When administering Estrogen-progestin contraceptives, what should be done 1 to 2 hours before each dose?

    <p>Administer an antiemetic</p> Signup and view all the answers

    Which component in Natazia is responsible for undergoing rapid conversion to the predominant endogenous estrogen?

    <p>Estradiol valerate</p> Signup and view all the answers

    What distinguishes Estradiol/levonorgestrel from other combination oral contraceptives?

    <p>Requires a Yuzpe regimen with 2 tablets q12h</p> Signup and view all the answers

    What is the recommended action if a patient misses 1 or 2 oral contraceptive pills during the second or third week of the pack?

    <p>Take one pill as soon as possible and then continue with the active pills but skip the placebo pills.</p> Signup and view all the answers

    Which antibiotic is NOT listed as decreasing the effectiveness of oral contraceptives?

    <p>Ciprofloxacin</p> Signup and view all the answers

    What is the follow-up recommendation for patients who initiate all methods of contraception?

    <p>Pelvic exam, Pap smear, and STI testing 2 to 3 months post-initiation.</p> Signup and view all the answers

    What is essential for a patient using a diaphragm to do prior to each use?

    <p>Inspecting the device</p> Signup and view all the answers

    Which contraceptive method has a potential complication related to site reactions including pain, bleeding, and infection?

    <p>Injectables</p> Signup and view all the answers

    What is the recommended monitoring action for patients on estrogen-containing methods of contraception?

    <p>Monthly blood pressure checks</p> Signup and view all the answers

    What should be done if a diaphragm is placed more than 6 hours before intercourse?

    <p>Apply new spermicide before intercourse</p> Signup and view all the answers

    'St.John’s wort may alter estrogen levels, reducing efficacy or causing breakthrough bleeding.' What type of contraception is most likely affected by this interaction?

    <p>&quot;The pill&quot;</p> Signup and view all the answers

    What could be an outcome if a patient with an IUD becomes pregnant?

    <p>Higher likelihood of ectopic pregnancy</p> Signup and view all the answers

    What is the recommended procedure for a patient who misses several contraceptive pills during the second or third week of the pack?

    <p>Follow instructions for one or two missed pills and use additional contraception for 7 days</p> Signup and view all the answers

    What is the initial recommended treatment approach for type 2 diabetes according to the position statement?

    <p>Start lifestyle changes and metformin</p> Signup and view all the answers

    In the treatment of type 2 diabetes, when should a three-drug combination regimen be considered?

    <p>If the patient does not achieve goals with two drugs</p> Signup and view all the answers

    Which of the following drugs is NOT mentioned as a potential second drug to add in step 2 of the treatment approach?

    <p>Metformin</p> Signup and view all the answers

    According to the recommendations, what should be added if a three-drug combination inclusive of basal insulin fails to achieve treatment goals?

    <p>GLP-1 receptor agonist</p> Signup and view all the answers

    When should SGLT-2 inhibitors be avoided in patients according to the text?

    <p>When GFR is low</p> Signup and view all the answers

    If a patient with type 2 diabetes has been on a three-drug combination regimen for 4 months without achieving treatment goals, what is the next recommended step?

    <p>Initiate a combination injectable regimen inclusive of insulin and possibly a GLP-1 receptor agonist</p> Signup and view all the answers

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