Contraception
POP pills contain only this hormone
Progestin
Vitamin B9 (folic acid)
Definition of menopause
no menstrual period for 12 consecutive months
This medication indicated for BPH is first-line, does not decrease prostate size, and has more risk of hypotension.
(provide both brand/generic names of both agents)
Doxazosin (Cardura)
Terazosin (Hytrin)
Insulin conversions
Regular to Rapid Acting
NPH to Insulin Glargine
Toujeo to Insulin Glargine U-100
1:1
NPH dosed BID to Insulin glargine dosed daily
•Use 80% of the NPH dose
Toujeo other insulin glargine (Lantus, Basaglar) dosed daily
•Use 80% of the Toujeo dose
This contraceptive is a CHC applied weekly for 3 weeks followed by a patch free week. Back up is needed for the first 7 days of starting. Not recommended for patients that are over198lbs or with a BMI above 30.
Transdermal contraceptive Patch
Xulane, Zafemy, Evra – must weigh less than 198lbs/ 90kg
Twirla – reduced efficacy with BMI of 25 or more, contraindicated with BMI of 30 or more due to increased risk of VTE
Which dose of aspirin is used in pregnancy for preventing pre-eclampsia
81mg (low dose)
Hormone formulations used for vasomotor symptoms best recommended for a woman with a uterus
both estrogen and progestin
Only 2 oral progestins (Provera and Prometrium)
Estrogen and Progestogen combinations: Oral: Premphase, Prempo, Activella, FemHRT, Prefest, Bijuva
Transdermal Patch: Combipatch, ClimaraPro
Transdermal patch
If a patient is using a non-selective alpha 1 blocker what is a key counseling point
take the first dose at bedtime to reduce risk of dizziness or fainting
Formula to calculate anion gap
AG= Na -Cl- HCO3
This CHC has less estrogen related side effects and must be stored in refrigerator prior to dispensing
Nuvaring, EluRyng - ring inserted for 3 weeks, then 1 week without ring
Annovera-reusable up to 1 year
Which antibiotics are not recommended in pregnancy?
Fluoroquinolone
Bactrim
Tetracylcine
(Cephalexin and Nitrofurantoin could be used)
Which of the following medications contain medroxyprogesterone?
Which of the following medications contain Micronized oral progesterone ?
Medroxyprogesterone acetate (Provera)
Micronized oral progesterone (Prometrium)
What are key counseling points for patients to know about alprostadil?
first administration in MD office
effects typically only last 30-90 minutes
It is available as injection
Not to be used with 5 alpha reductase inhibitor
What formula would be used to determine a patient's insulin to carbohydrate ratio if they used regular insulin?
They use the following insulin regimens. Insulin Glargine 32 units daily and Humulin R 5 units with breakfast, 6 units with lunch and 6 units with dinner.
Insulin to carbohydrate ratio with interpretation Rule of 450 used due to patient using insulin regular and total daily dose of insulin is 49 (32+17) = 450 divided by 49= 9.1and correctly interpretated as 9 grams of carbohydrates are covered by 1 unit of insulin
This generic is medroxyprogesterone and is a progestin only agent that is an oral contraceptive agent associated with more weight gain, decreases bone mineral density, and may take longer to get pregnant after stopping
What is Depo-Provera
Which therapy is preferred for hypertension in pregnancy
Labetolol, nifedipine, methyldopa
Which menopause therapy is preferred for a patient with migraines with aura, high cardiac risk, gallbladder disease history?
Transdermal estrogen
Name the medication that shrinks the prostate and decreases PSA levels and takes up to 6 months or longer for maximal efficacy for BPH
What is Avodart (dutasteride) or Proscar (Finasteride)
What is the Correction Dose formula for Rapid Acting Insulin?
If a patient is using Lantus 36 units daily and Novolog 5 units TID and their current pre dinner blood glucose is 210mg/dL and her goal is 85mg/dL. What is her correction dose
calculate new Humalog dinner dose use current BG minus target premeal BG and divide by correction factor or insulin sensitivity factor with rule of 1800 for rapid acting insulin requires TDD (total daily dose of insulin) add the total amount of basal insulin and meal time insulin 1800 divided by TDD for correction factor
1800/51=35
210-85=125/35=3.6~4 units is the correction dose
Name at least 4 diagnoses that recommends avoiding COC and prefers progestin-only contraceptives
Breastfeeding
DVT or PE
Age >35 and currently smoking
Migraine headache, especially with aura
What is a treatment dose of enoxaparin for a pregnant female with DVT weighing 120kg.
120mg BID
Lovenox (enoxaparin) 120mg SQ every 12 hours
Which agent would be recommended for a patient with a history of breast cancer and having hot flashes.
All estrogen containing products are contraindicated with cancers of the breast.
Use nonhormonal options, Fezolinetant is a NK3 receptor antagonist, Elinzanetant is a NK1 and NK3 receptor antagonist, Paroxetine, Venlafaxine, Desvenlafaxine
Cognitive behavioral therapy and clinical hypnosis
List medications and behaviors that worsen BPH symptoms (name at least 4)
testosterone
caffeine
diphenhydramine
pseudoephedrine
All agents used for Kidney Risk reduction for T2DM
ACEI or ARB, SGLT2I +/- GLP-1RA, ns MRA (Finerone)