NR566 -Week 5 Study Guide-
A doctor tells his patient that there are two scary progestin-only
drugs that have HIGH risk for blood clots. What are these? - -
Drospirenone & Desogestrel A doctor tells the patient she can't have
OC's. What are the contraindications for OCs? - -Pregnancy -Blood
clots -Strokes -Acute coronary syndrome -Liver problems -Breast
cancer -Unknown vaginal bleeding -Smoking (35yrs >) A patient
asks her doctor if progestin is okay while breast feeding. What does
he say? - -Progestins while breastfeeding may cause neonatal
jaundice. A patient has undiagnosed vaginal bleeding, should she be
prescribed HT? - -No, don't give HT with undiagnosed vaginal
bleeding A patient wants to know if progestin-only "mini pills" are
effective too? How should the doctor reply? - -They are not as
productive, but they are considered more safe. Adverse effects from
Tamsulosin/dutasteride (Jalyn) - Decreased libido and abnormal
ejaculation (ejaculation failure, reduced ejaculate volume,
retrograde ejaculation) Adverse effects of NON-SELECTIVE A1
Blockers - Hypotension, fainting, dizziness, somnolence, and nasal
congestion (from blocking α1 receptors on blood vessels) Adverse
effects of phosphodiesterase 5 inhibitors - Hypotension and priapism
Adverse effects of SELECTIVE A1 blockers - Abnormal ejaculation
(ejaculation failure, reduced ejaculate volume, retrograde
ejaculation). Risk of floppy-iris syndrome during cataract surgery. All
intravaginal estrogens are used to treat what? - -urogenital atrophy
Although HT therapy is great for bone loss prevention, what will
happen when HT is stopped? - -bone mass rapidly decreases by
approximately 12% ---Therapy must be life long-- Amy has active
liver disease, would HT be okay? - No, better not use HT with active
liver problems Androgen can promote what kind of cancer? -
prostate cx after it occurs. Accordingly, androgens are
contraindicated for men with diagnosed prostate cancer. Men
without diagnosed prostate cancer should be monitored for the
emergence of covert cancer. Androgen replacement therapy is
indicated for when testicle failure occurs. What are the benefits? -
Restores libido Increases ejaculatory volume Secondary sex
characteristics WILL NOT RESTORE FERTILITY Androgen therapy
helps with anemia by doing what? - Promote synth of erythropoetin
With the emergence of other therapies such as erythropoietin-
stimulating agents, however, androgens have fallen out of favor for
off-label treatment of anemia. androgens are frequently misused to
enhance athletic performance. Because of their abuse potential,
nearly all androgens are regulated as - schedule III controlled
substances. Androgens can cause cholestatic hepatitis and other
disorders of the liver. Clinical jaundice may occur but is rare.
Patients receiving androgens should undergo - periodic tests of liver
function. If jaundice develops, it will reverse after discontinuation of
, androgen use. Androgens can lower plasma levels of - HDL
cholesterol and elevate plasma levels of LDL cholesterol. These
actions may increase the risk for atherosclerosis and related
cardiovascular events. Androgens do not cause prostate cancer,
but....... - they can promote the growth of this cancer after it occurs.
Accordingly, androgens are contraindicated for men with diagnosed
prostate cancer. Men without diagnosed prostate cancer should be
monitored for the emergence of covert cancer. Androgens may also
be carcinogenic. Expound further. - hepatocellular carcinoma has
developed in some patients after prolonged use of these drugs.
Because systemic estrogen carries significant risks, the FDA
recommends... - -If HT is being used solely to manage vulvar and
vaginal symptoms, a topical estrogen formulation should be
considered. Billy bob took some nasal testosterone, he wants to
know possible side effects. What should you tell him? - Sir, you may
experience: -runny nose -nose bleeds -or nasopharyngitis Billy Joel
wants to know if his Finesteride will act quickly. What does his NP
tell him? - prostate shrinkage occurs slowly—over a period of 6 to 12
months C. trachomatis from an oropharyngeal sample warrants the..
- same treatment as with urogenital chlamydial infection:
doxycycline 100 mg orally twice daily for 7 days as the preferred
regimen for nonpregnant adults and azithromycin 1 gram single
dose orally preferred for pregnant persons Cindy wants to know
whether topical or oral estrogen is safer. How does her doctor
answer this? - -Although long-term data are lacking, it seems likely
that topical estrogen is safer than oral estrogen because, with
nearly all topical formulations, blood levels of estrogen remain low. -
The notable exception is the Femring, which releases enough
estrogen to cause significant systemic effects. Common oral drugs
in the treatment of hypogonadism - fluoxymesterone
Methyltestosterone Does Dutasteride work quickly? - Well, probably
not since it has a half life of about 5 months. Does IM testosterone
have varying blood levels? - Yep, sure does. Does urogenital atrophy
and osteoporosis prevention sustain after withdrawal of HT? - --No,
benefits will decline after HT withdrawal Drug therapy for
transgender men - although not approved by the FDA for this
purpose, testosterone is prescribed off label as part of gender-
affirmation drug therapy. Dutasteride (AKA Avodart) is a 5a
Reductase Inhibitor. What is its action in BPH? - Reduce
dihydrotestosterone production, which causes the prostate to
shrink, which reduces mechanical obstruction of the urethra. May
also delay BPH progression. Benefits take months to develop.
Dutasteride (AKA Avodart) is a 5a Reductase Inhibitor. What is its
adverse reactions in BPH? - Decreased ejaculate volume and libido.
Teratogenic to the male fetus. Edema can result from androgen-
induced retention of salt and water. This complication is a concern
for patients with - heart failure and those with a predisposition to
developing edema from other causes. Treatment consists of
discontinuing the androgen and giving a diuretic if needed. Effective
A doctor tells his patient that there are two scary progestin-only
drugs that have HIGH risk for blood clots. What are these? - -
Drospirenone & Desogestrel A doctor tells the patient she can't have
OC's. What are the contraindications for OCs? - -Pregnancy -Blood
clots -Strokes -Acute coronary syndrome -Liver problems -Breast
cancer -Unknown vaginal bleeding -Smoking (35yrs >) A patient
asks her doctor if progestin is okay while breast feeding. What does
he say? - -Progestins while breastfeeding may cause neonatal
jaundice. A patient has undiagnosed vaginal bleeding, should she be
prescribed HT? - -No, don't give HT with undiagnosed vaginal
bleeding A patient wants to know if progestin-only "mini pills" are
effective too? How should the doctor reply? - -They are not as
productive, but they are considered more safe. Adverse effects from
Tamsulosin/dutasteride (Jalyn) - Decreased libido and abnormal
ejaculation (ejaculation failure, reduced ejaculate volume,
retrograde ejaculation) Adverse effects of NON-SELECTIVE A1
Blockers - Hypotension, fainting, dizziness, somnolence, and nasal
congestion (from blocking α1 receptors on blood vessels) Adverse
effects of phosphodiesterase 5 inhibitors - Hypotension and priapism
Adverse effects of SELECTIVE A1 blockers - Abnormal ejaculation
(ejaculation failure, reduced ejaculate volume, retrograde
ejaculation). Risk of floppy-iris syndrome during cataract surgery. All
intravaginal estrogens are used to treat what? - -urogenital atrophy
Although HT therapy is great for bone loss prevention, what will
happen when HT is stopped? - -bone mass rapidly decreases by
approximately 12% ---Therapy must be life long-- Amy has active
liver disease, would HT be okay? - No, better not use HT with active
liver problems Androgen can promote what kind of cancer? -
prostate cx after it occurs. Accordingly, androgens are
contraindicated for men with diagnosed prostate cancer. Men
without diagnosed prostate cancer should be monitored for the
emergence of covert cancer. Androgen replacement therapy is
indicated for when testicle failure occurs. What are the benefits? -
Restores libido Increases ejaculatory volume Secondary sex
characteristics WILL NOT RESTORE FERTILITY Androgen therapy
helps with anemia by doing what? - Promote synth of erythropoetin
With the emergence of other therapies such as erythropoietin-
stimulating agents, however, androgens have fallen out of favor for
off-label treatment of anemia. androgens are frequently misused to
enhance athletic performance. Because of their abuse potential,
nearly all androgens are regulated as - schedule III controlled
substances. Androgens can cause cholestatic hepatitis and other
disorders of the liver. Clinical jaundice may occur but is rare.
Patients receiving androgens should undergo - periodic tests of liver
function. If jaundice develops, it will reverse after discontinuation of
, androgen use. Androgens can lower plasma levels of - HDL
cholesterol and elevate plasma levels of LDL cholesterol. These
actions may increase the risk for atherosclerosis and related
cardiovascular events. Androgens do not cause prostate cancer,
but....... - they can promote the growth of this cancer after it occurs.
Accordingly, androgens are contraindicated for men with diagnosed
prostate cancer. Men without diagnosed prostate cancer should be
monitored for the emergence of covert cancer. Androgens may also
be carcinogenic. Expound further. - hepatocellular carcinoma has
developed in some patients after prolonged use of these drugs.
Because systemic estrogen carries significant risks, the FDA
recommends... - -If HT is being used solely to manage vulvar and
vaginal symptoms, a topical estrogen formulation should be
considered. Billy bob took some nasal testosterone, he wants to
know possible side effects. What should you tell him? - Sir, you may
experience: -runny nose -nose bleeds -or nasopharyngitis Billy Joel
wants to know if his Finesteride will act quickly. What does his NP
tell him? - prostate shrinkage occurs slowly—over a period of 6 to 12
months C. trachomatis from an oropharyngeal sample warrants the..
- same treatment as with urogenital chlamydial infection:
doxycycline 100 mg orally twice daily for 7 days as the preferred
regimen for nonpregnant adults and azithromycin 1 gram single
dose orally preferred for pregnant persons Cindy wants to know
whether topical or oral estrogen is safer. How does her doctor
answer this? - -Although long-term data are lacking, it seems likely
that topical estrogen is safer than oral estrogen because, with
nearly all topical formulations, blood levels of estrogen remain low. -
The notable exception is the Femring, which releases enough
estrogen to cause significant systemic effects. Common oral drugs
in the treatment of hypogonadism - fluoxymesterone
Methyltestosterone Does Dutasteride work quickly? - Well, probably
not since it has a half life of about 5 months. Does IM testosterone
have varying blood levels? - Yep, sure does. Does urogenital atrophy
and osteoporosis prevention sustain after withdrawal of HT? - --No,
benefits will decline after HT withdrawal Drug therapy for
transgender men - although not approved by the FDA for this
purpose, testosterone is prescribed off label as part of gender-
affirmation drug therapy. Dutasteride (AKA Avodart) is a 5a
Reductase Inhibitor. What is its action in BPH? - Reduce
dihydrotestosterone production, which causes the prostate to
shrink, which reduces mechanical obstruction of the urethra. May
also delay BPH progression. Benefits take months to develop.
Dutasteride (AKA Avodart) is a 5a Reductase Inhibitor. What is its
adverse reactions in BPH? - Decreased ejaculate volume and libido.
Teratogenic to the male fetus. Edema can result from androgen-
induced retention of salt and water. This complication is a concern
for patients with - heart failure and those with a predisposition to
developing edema from other causes. Treatment consists of
discontinuing the androgen and giving a diuretic if needed. Effective
