Term
Ethinyl Estradiol
+
Norgestimate |
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Definition
Ortho-Tri-Cyclen
1 po QD x21
placebo x7
MOA = estrogen + progestin
-estrogen inhibits release of FSH and LH leading to inhibition of ovulation and ovum implantation
-progestin makes cervical mucous thick and alters endometrium, making implantation more difficult
DI
Phenytoin
Antibiotics= Tetracycline, Sulfonamides
Antifungals = Ketoconazole, Fluconazole
(↓ effectiveness)
ADR
GI related - constipation, gas, heartburn, Nausea, stomach pain
bleeding risk in some pts
Misc
abdominal discomfort
anorexia or appetite stimulation
n/v
weight gain
breast enlargement
risk of thromboembolic disorders
(smoking ↑ risk)
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Term
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Definition
Fosamax
MOA: inhibit osteoclast formation (responsible for bone breakdown)
Also inhibits bone reabsorbtion
70mg po qWeek
10mg po QD
-take on empty stomach
-must stay upright for 30 min after dose
-drink w/ full glass of H20
DI
-NSAIDs
-ASA
(↑ GI ADR)
-food will ↓ bioavailability
ADR
-Abd. pain
-esophageal irritation
-musculoskeletal complaints
osteonecrosis of jaw (rare)
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Term
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Definition
Premarin
0.45-1.25 mg po QD
Used for HRT during menopause
tx of vasomotor sx - hot flashes, vag. dryness
MOA = provides endogenous action of estrogen by binding to nuclear receptors, thereby reducing levels of LH and FSH through negative feedback
estrogens increase cervical secretions and cause proliferation of the endometrium
DI
-aromatase inhibitors - anatstrozole, letrozole
-cyclosporine (↑ conc)
ADR
-fluid retention
-breast tenderness
- n/v
-weight gain
-risk of breast cancer
-risk of thromboembolic disorders
MISC
-to use estrogen, must have had hysterectomy (uterus removed) - b/c of increased risk of endometrial hyperplasia
-if still have uterus - must combine estrogen with progesterone
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Term
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Definition
Climara
0.0375 - 0.1 mg/day patch applied to trunk or buttocks
replaced q 7days
Estrace
0.5-2 mg PO QD
Vivelle
0.0375 - 0.1 mg/day patch applied to trunk or buttocks
replaced 2x/week
MOA = provides endogenous action of estrogen by binding to nuclear receptors, thereby reducing levels of LH and FSH through negative feedback
estrogens increase cervical secretions and cause proliferation of the endometrium
DI
-aromatase inhibitors - anatstrozole, letrozole
-cyclosporine (↑ conc)
ADR
-fluid retention
-breast tenderness
- n/v
-weight gain
-risk of breast cancer
-risk of thromboembolic disorders
MISC
-to use estrogen, must have had hysterectomy (uterus removed) - b/c of increased risk of endometrial hyperplasia
-if still have uterus - must combine estrogen with progesterone
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Term
Ethinyl Estradiol
+
Drospirenone |
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Definition
Yasmin
1 tab PO QD x 21d
7 days w/o drug
MOA = estrogen + progestin
-estrogen inhibits release of FSH and LH leading to inhibition of ovulation and ovum implantation
-progestin makes cervical mucous thick and alters endometrium, making implantation more difficult
DI
Phenytoin
Antibiotics= Tetracycline, Sulfonamides
Antifungals = Ketoconazole, Fluconazole
(↓ effectiveness)
ADR
GI related - constipation, gas, heartburn, Nausea, stomach pain
bleeding risk in some pts
Misc
abdominal discomfort
anorexia or appetite stimulation
n/v
weight gain
breast enlargement
risk of thromboembolic disorders
(smoking ↑ risk)
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Term
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Definition
Actonel
35mg PO qWeek
or
5mg PO QD
MOA: inhibit osteoclast formation (responsible for bone breakdown)
Also inhibits bone reabsorbtion
-take on empty stomach
-must stay upright for 30 min after dose
-drink w/ full glass of H20
DI
-NSAIDs
-ASA
(↑ GI ADR)
-food will ↓ bioavailability
ADR
-Abd. pain
-esophageal irritation
-musculoskeletal complaints
osteonecrosis of jaw (rare)
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Term
Ethinyl Estradiol
+
Norethindrone |
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Definition
Necon
Ortho-Novum
1 PO QD x21d
placebo x7d
MOA = estrogen + progestin
-estrogen inhibits release of FSH and LH leading to inhibition of ovulation and ovum implantation
-progestin makes cervical mucous thick and alters endometrium, making implantation more difficult
DI
Phenytoin
Antibiotics= Tetracycline, Sulfonamides
Antifungals = Ketoconazole, Fluconazole
(↓ effectiveness)
ADR
GI related - constipation, gas, heartburn, Nausea, stomach pain
bleeding risk in some pts
Misc
abdominal discomfort
anorexia or appetite stimulation
n/v
weight gain
breast enlargement
risk of thromboembolic disorders
(smoking ↑ risk)
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Term
Ethinyl Estradiol
+
Levonorgestrel |
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Definition
Seasonale
1 tab PO QD x 84 days (3 months)
placebo x 7 days
MOA = estrogen + progestin
-estrogen inhibits release of FSH and LH leading to inhibition of ovulation and ovum implantation
-progestin makes cervical mucous thick and alters endometrium, making implantation more difficult
DI
Phenytoin
Antibiotics= Tetracycline, Sulfonamides
Antifungals = Ketoconazole, Fluconazole
(↓ effectiveness)
ADR
GI related - constipation, gas, heartburn, Nausea, stomach pain
bleeding risk in some pts
Misc
abdominal discomfort
anorexia or appetite stimulation
n/v
weight gain
breast enlargement
risk of thromboembolic disorders
(smoking ↑ risk)
decreases breakthrough bleeds compared to other BC |
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Term
Ethinyl Estradiol
+
Desogestrel |
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Definition
Ortho-Cept
Apri
1 tab PO QD x21 days
placebo x7 days
Kariva
1 tab PO QD x28 days (no drug free week)
MOA = estrogen + progestin
-estrogen inhibits release of FSH and LH leading to inhibition of ovulation and ovum implantation
-progestin makes cervical mucous thick and alters endometrium, making implantation more difficult
DI
Phenytoin
Antibiotics= Tetracycline, Sulfonamides
Antifungals = Ketoconazole, Fluconazole
(↓ effectiveness)
ADR
GI related - constipation, gas, heartburn, Nausea, stomach pain
bleeding risk in some pts
Misc
abdominal discomfort
anorexia or appetite stimulation
n/v
weight gain
breast enlargement
risk of thromboembolic disorders
(smoking ↑ risk)
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Term
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Definition
Detrol
2 mg PO BID
LA (long acting) - 4 mg PO QD
MOA = competitive antagonist on muscarinic receptors in the bladder
-leads to an ↑ in bladder capacity
-↓ in bladder contraction and urge to void
DI
-cyclobenzaprine
-TCA
(additive ADR)
-metoclopramide
(opposing effect)
ADR
-dry mouth
-blurred vision
-GI symptoms
-confusion |
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Term
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Definition
Evista
60 mg PO QD
-prevention and tx of osterperosis in women who cannot take biphosphonates
MOA = estrogen agonist/antagonist
-estrogen agonist in bone
-estrogen antagonist in mammary tissues
-thereby, reducing bone breakdown and increasing bone mineral density WITHOUT stimulating endometrium or breast tissue
DI
-estrogens
-levothyroxine
(decreased absorbtion)
ADR
-leg cramps
-hot flashes
-risk of thrombosis
BLACK BOX WARNING
-do not use in pts who have a hx of or an increased risk of stroke or thromboembolic diseases |
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