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RxPrep
Menopause (CH 49)
| Question | Answer |
|---|---|
| What is most effective for vasomotor symptoms? | Systemic estrogen |
| When must progesterone be added to estrogen? | If uterus intact |
| Why add progestin with estrogen? | Prevent endometrial cancer |
| Preferred for vaginal symptoms only? | Local vaginal estrogen |
| Lower VTE risk formulation? | Transdermal or topical estrogen |
| Estrogen boxed warnings? | VTE, stroke, dementia, breast cancer |
| Unopposed estrogen risk? | Endometrial cancer |
| Estrogen major ADRs? | Edema, headache, weight gain |
| Estrogen contraindications? | Breast cancer, VTE, pregnancy |
| What is Estrace? | Vaginal estradiol cream |
| What is Estring? | Vaginal ring |
| What is Vagifem? | Vaginal tablet |
| What is Imvexxy? | Vaginal insert |
| What is premarin? | Conjugated estrogen (tabs and injection) |
| What is Provera? | medroxyprogesterone tabs, depo-Provera is SC injections |
| What is prometrium? | Micronized progesterone oral tab |
| What is Ospemifene used for? | Dyspareunia |
| Ospemifene boxed warnings? | Same as estrogen (VTE, stroke) |
| Ospemifene contraindication? | Severe hepatic impairment |
| Ospemifene common side effects? | Hot flashes, discharge |
| What is Brisdelle (paroxetine) used for? | Vasomotor symptoms (hot flashes, night sweats) |
| Paroxetine major DDI? | Decreases tamoxifen effectiveness, 2D6 inhibition |
| What is Veozah? | Fezolinetant, Neurokinin-B antagonist |
| Fezolinetant boxed warning? | Hepatotoxicity |
| Fezolinetant contraindications? | Cirrhosis, severe renal impairment |
| Fezolinetant common ADRs? | Hot flashes, ↑ LFTs |
| Evamist spray counseling? | Apply to inside of forearm, avoid skin contact with others |
| Estrogen patch placement? | Lower abdomen below waistline |
| Topical gel absorption? | Allow it to dry |
| Best for hot flashes? | Systemic estrogen |
| Best for vaginal dryness? | local estrogen |
| Use nonhormonal when? | Contraindication to estrogen |
| Progestin warnings? | Mood changes, spotting |
| Advantage of micronized progestin (medroxyprogesterone)? | Lower CV risk |
| Which population has a higher risk for cancer on estrogens? | Elderly |
| Which drugs contain a combo of estrogen and progrestin products? | Prempro, Premphase, Combipatch, Activella, Angeliq, Femhrt, Bijuva. |
| What is actevella | Estradiol/norethindrone |
| What is Climara pro? | Estradiol/levonorgestrel |
| Which products are estrogen only? | Premarin (pills), Estrace (pills, now often generic), Climara (patch), Vivelle-Dot (patch). |