Week 7 Study Outline
Chapter 48: Women as Patients
Non-pharmaceutical treatment of symptoms associated with menopause
• Exercise, relaxation techniques, massage therapy, acupuncture, herbs
• Ginseng, black cohosh, licorice, carrots, yams, calcium, vitamin e and d, SOY
Pharmacokinetic gender differences between men and women
• Absorption and bioavailability
o Gastric emptying is slower r/t effects of estrogen
o Gastric levels of alcohol dehydrogenase are lower in females
• Distribution
o Females have lower body wts and BMI
o Females have higher proportion of body fat, lipophilic drugs more readily
absorbed
o Plasma volume is lower in females
o Organ blood flow is lower in females
• Metabolism
o Females have lower levels of p-glycoprotein and higher rates of drug clearance
for drugs that are substrates of p-glycoprotein
Rationale drug selection for PMDD
• 1st- SSRIs- Fluoxetine, paroxetine, sertraline,
• 2nd- Xanax, spironolactone
• Calcium, mag, tryptophan, vit b6, vit E
Treatment for primary dysmenorrhea
• NSAIDs 2-3 days before period
Recommended calcium and vitamin D intake for adolescents and adults
• 1,000 50 and younger of, 1200 older than 50
LGBTQ population
• Increased rates in smoking, ETOH, depression, HIV/AIDS, violence and suicide rates
Chapter 49: Men as Patients
Testosterone therapy and monitoring
• Erythrocytosis- H/H need to be monitored
• If Hct > 54% tx is stopped
• Should also be evaluated for hypoxia and sleep apnea
• Risk or prostate CA
• Evaluate pt 3-6 months after tx is started
Contraindications for testosterone replacement therapy
• Abnormal digital rectal exam
• Breast CA
• Elevated PSA levels
• Hypercoagulable states
Chapter 48: Women as Patients
Non-pharmaceutical treatment of symptoms associated with menopause
• Exercise, relaxation techniques, massage therapy, acupuncture, herbs
• Ginseng, black cohosh, licorice, carrots, yams, calcium, vitamin e and d, SOY
Pharmacokinetic gender differences between men and women
• Absorption and bioavailability
o Gastric emptying is slower r/t effects of estrogen
o Gastric levels of alcohol dehydrogenase are lower in females
• Distribution
o Females have lower body wts and BMI
o Females have higher proportion of body fat, lipophilic drugs more readily
absorbed
o Plasma volume is lower in females
o Organ blood flow is lower in females
• Metabolism
o Females have lower levels of p-glycoprotein and higher rates of drug clearance
for drugs that are substrates of p-glycoprotein
Rationale drug selection for PMDD
• 1st- SSRIs- Fluoxetine, paroxetine, sertraline,
• 2nd- Xanax, spironolactone
• Calcium, mag, tryptophan, vit b6, vit E
Treatment for primary dysmenorrhea
• NSAIDs 2-3 days before period
Recommended calcium and vitamin D intake for adolescents and adults
• 1,000 50 and younger of, 1200 older than 50
LGBTQ population
• Increased rates in smoking, ETOH, depression, HIV/AIDS, violence and suicide rates
Chapter 49: Men as Patients
Testosterone therapy and monitoring
• Erythrocytosis- H/H need to be monitored
• If Hct > 54% tx is stopped
• Should also be evaluated for hypoxia and sleep apnea
• Risk or prostate CA
• Evaluate pt 3-6 months after tx is started
Contraindications for testosterone replacement therapy
• Abnormal digital rectal exam
• Breast CA
• Elevated PSA levels
• Hypercoagulable states
