Osteoporosis
The essential component of all treatment of prevention strategies
What is calcium?
This medication reduces hepatic glucogenesis, reduces intestinal absorption of glucose and improves insulin sensitivity.
What is metformin?
After a careful interview, examination and laboratory studies you want to start thyroid replacement therapy in an otherwise healthy woman who is 51 years old. What is the drug and dose. And when do you want to evaluate her for follow up?
Levothyroxine 125 mcg per day. Reevaluate in 6 weeks.
This quinolone should not be used for infections of the urinary tract
What is moxifloxacin?
This SERM is not useful in men.
What is Raloxifene?
Facilitates the action of endogenous insulin
What are Incretin enhancers?
How should your patient take the thyroid dose prescribed in thyroid for 100?
Take 60 minutes prior to or 4 hours after any food, or Take at Bedtime.
How does Kayexalate work? What else needs to happen.
Exchanges Na for K in the gut. Need functional GI tract, & without constipation. Not an option for when a prompt response is needed.
A go to antibiotic for gram positive infections
What is vancomycin? Bonus- How do you dose and administer?
Useful option for post-menopausal women who do not tolerate bisphosphonates like alendronate.
What is Raloxifene?
Stimulates insulin secretion via blockade of K channels on the pancreatic beta cell
What are sulfonylurea agents (glyburide)
Your patient is concerned about osteoporosis as her mother was disabled by this problem. She wants to continue to take calcium supplements. How should she do this while taking thyroid replacement?
Calcium supplements, as well as iron, or antacids that contain aluminum, should be taken about 4 hours before or after the dose.
Intravenous glucose + insulin/ and IV calcium Gluconate/ and Albuterol
What are pharmacologic agents used to reverse Hyperkalemia.
A go to antibiotic for enteric gram negative infections.
What is ceftriaxone?
A BPH Question Prompt: How would you manage Mr. Howard. and why?
Discussion
Blocks renal glucose reabsorption
What are SGLT-2 Inhibitors? (Empagliflozin - Jardiance)
This treatment for hyperthyroidism blocks conversion of iodide to iodine AND is preferentially iodinated by the thyroid over thyroglobulin.
What is Methimazole or propylthiouracil (PTU)?
Pharmacologic agent Used in patients with hyperkalemia and related ECG changes.
What is IV calcium gluconate?
What is the MOA for glucocorticoid induced osteopenia?
Action on osteoblasts.
Mr Bourne is having a good response to metformin but he needs a second agent. Choose an option (eg insulin, sufonylurea, SGLT2 inhibitor, incretin enhancer, starch blocker) and state the benefits and risks and problems this medication poses for Mr Bourne
Graded in class
8 weeks after starting 125 mcg per day of levothyroxine your patients symptoms have only marginally improved. Her labs are closer to normal but not nearly at target. The med student wants to reflexively up the dose of levothyroxine and move on to the next patient. Remembering your favorite pharmacology professor- What do you suggest we do first.
Check for compliance, and verify proper administration of levothyroxine. In this real case she was taking her thyroid with breakfast and along with 3 tablets of calcium carbonate.
Your patient has urosepsis, and significantly reduced renal function. Choose antibiotics that are active against likely organisms and discuss their +/-
Discuss
Discuss the antibiotics that you would use for Mr Hoffman's urosepsis and infected artificial knee. What are the likely organisms? Identify the advantages and disadvantages of your choice.
Discussion