Question

Case 2: Gwendolyn, a 64-year-old female Subjective: • She presents today to follow-up on a recent DEXA scan It showed worsening osteoporosis • She is post-menopausal and has been for the past 2 years • She has a history of a wrist fracture after falling due to vertigo last year, vertigo, vaginal atrophy, iron deficiency anemia, and chickenpox Medications: Antivert (meclizine) 25mg tabs, Fosamax (alendronate) 70mg, Calcium carbonate 1.000mg, Vitamin D3 2,000 IU, Lopressor (metoprolol) 25mg. Premarin (conjugated estrogens) vaginal Objective: • HR 70, BP 120/70, RR 10. Temp 98.2 F • A&Ox3, the patient is sweet and pleasant 11. Which of the patient's medications is a beta-blocker (beta-adrenergic blocking agent)? a Antivert b. Fosamax c. Lopressor d Premarin 12. Which of the following are possible side effects of an estrogen prescription? a. Breast tenderness, spotting, and nausea b. Spotting, insomnia, and loss of consciousness C. Breast tenderness, galactorrhea, and erectile dysfunction d. Spotting, hirsutism, and breast tenderness 13. Which of the following is not a risk of hormone replacement therapy? a. Increased risk of blood clots b. Increased risk of endometrial cancer C. Increased risk of colorectal cancer d. Increased risk of deep vein thrombosis 14. At the end of her office visit, Gwendolyn has had her Fosamax refilled by her doctor. She asks for a reminder on how to take it and you say: a. Take it first thing in the morning. 30 minutes before eating or drinking anything and with a glass of water and lay down for 60 minutes afterward b. Take it first thing in the morning, before eating or drinking anything, with a full glass of water, and sit upright for at least 30-60 minutes c. Take it first thing in the morning, with food, and a full glass of water d. Bite the pill in half and chew completely before swallowing with a glass of milk 15. Which of the following medications would not be prescribed for patients used to prevent and/or treat osteoporosis? a. Boniva (ibandronate) b. Septra (trimethoprim and sulfamethoxazole c. Fortical (calcitonin) d. Evista (Raloxifene)

Answer 1

11. Answer is: c. Lopressor

Antivert (meclizine) is an antihistamine that reduces the effects of histamine in the body. Antivert is used to treat or prevent nausea, vomiting, and dizziness caused by motion sickness.

Fosamax (alendronate) is used to prevent and treat certain types of bone loss (osteoporosis) in adults.

Lopressor (metoprolol) is a beta blocker which acts on beta receptor and affect the heart and circulation. It is used to treat hypertensiokn and angina pectoris.

Premarin tablets contain conjugated estrogens.

12. Answer is: a. Breast tenderness, spotting and nausea

Estrogens referred to as female sex hormones. It induces various side effects in female. This includes Breast tenderness, spotting and nausea, Abdominal cramping, Changes in menstrual periods, Missed menstrual periods, Loss of scalp hair, Itching, Stomach upset etc.

13. Answer is: c. increased risks of colorectal cancer.

High-dose estrogen therapy is associated with a greater increased risk of venous thrombosis. An increased risk of endometrial cancer (only if a woman still has her uterus and is not taking a progestin along with estrogen). Increased risk of blood clots and stroke.

15. Answer is: b. Septra (trimethoprim and sulfamethoxazole).

Ibandronate (Boniva) is Bisphosphonate commonly prescribed in treatment of osteoporosis. Fortical contains calcitonin which also used for treatment of osteoporosis. Raloxifene (Evista) is hormone like medication for the treatment of osteoporosis.

Septra (Trimethoprim and sulfamethoxazole) is an antibiotic medication and is not prescribed for the osteoporosis treatment.