NR568 Final Exam Study Guide Weeks 5-8
NR568 Final Exam Study Guide
Week 5
- Prevention of osteoporosis with hormone replacement therapy
- When and when not to use progestin for hormone replacement therapy and why
- Local vs. systemic estrogen options and why one would be chosen over the other
o Peri-menopausal estrogen therapy (ET)
- Transdermal estrogen therapy has fewer adverse effects.
- Osteoporosis, osteopenia, and hormone replacement therapy (HRT)
o Selective estrogen receptor modulator (SERM)
▪ Bazedoxifene
- Management of oral contraceptives (OCs)
o How to change patient from one combination oral contraceptive to another.
o How to initiate treatment (when in the cycle is it best to start- may vary based on
the type of contraceptive)
o What teaching needs to be done
o What baseline data is needed?
o Contraindications for OCs
- How to achieve an extended cycle with oral contraceptives
- What behaviors would make one birth control method more effective over another?
o Be able to evaluate a patient scenario and suggest an appropriate birth control
method (type of prescribed contraception: OC, long-term methods, IUD, long-
acting reversible contraceptives (LARCs), etc.
- What effect does CYP450 inhibitors or inducers have on OCs?
o Recall examples of CYP450 inhibitors and inducers from NR565 (Chapter 4 in
textbook)
o How does this impact prescribing of OCs?
- Benefits and drawbacks of progestin-only contraception
- What are the most effective forms of contraception?
- Testosterone replacement
o Administration
o Benefits
o Patient Teaching
- Treatment of delayed puberty
o When is it appropriate to initiate androgen therapy (short course and long-term)
- Androgen therapy
o Effects
▪ Therapeutic
▪ Adverse
o Monitoring Needs
o Role of androgens in treating anemia
- Preferred administration route of alprostadil and why
1
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, NR568 Final Exam Study Guide Weeks 5-8
NR568 Final Exam Study Guide
- Treatment of hypogonadism
o Benefits
o Administration methods for transdermal preparations
▪ Testosterone gels
- Erectile Dysfunction (ED)
o Patient Teaching
o Medication Classes used to treat ED
▪ Vasodilators
▪ PGE1
- Treatment of BPH
o Know examples of drugs in each major drug class
o Adverse effects of common therapies
▪ 5-α-Reductase Inhibitors:
▪ α1 Blockers principal adverse effects are hypotension,
fainting, dizziness, somnolence, and nasal congestion. However,
silodosin and tamsulosin can cause abnormal ejaculation (ejaculation
failure,
reduced volume, retrograde ejaculation), whereas the nonselective
agents do
not. In contrast to dutasteride and finasteride, the alpha blockers do not
reduce
levels of PSA.
For men undergoing cataract surgery, alpha blockade increases the risk
for
intraoperative floppy-iris syndrome, a complication that can increase
postoperative pain, delay recovery, and reduce the hoped-for
improvement in
vision acuity. In severe cases, the syndrome can cause defects to the iris
that
2
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, NR568 Final Exam Study Guide Weeks 5-8
NR568 Final Exam Study Guide
may lead to blindness. Men anticipating cataract surgery should postpone
alpha blocker therapy until after the procedure.
▪ Phosphodiesterase-5 Inhibitor
▪ α1a Blocker/5-α-Reductase Inhibitor
o Therapeutic Effects
▪ Time to achieve
▪ Patient education/Provider response
▪ Assessment for therapeutic effect
- National STI/STD Curriculum
o Treatment of STIs/STDs
▪ Chlamydia: Doxycycline 100 mg orally 2 times/day for 7 days,
Azithromycin 1 g orally in a single dose
OR
Levofloxacin 500 mg orally once daily for 7 days
▪ Uncomplicated gonococcal urethritis: Uncomplicated M.
genitalium infection without macrolide resistance mutations or resistance
testing: Azithromycin 500 mg on day one, then 250 mg on days 2–5
▪ Second-line treatment and treatment for uncomplicated macrolide-
resistant M. genitalium infection: Moxifloxacin 400 mg for 7 days
▪ Third-line treatment for persistent M. genitalium infection after
azithromycin and moxifloxacin: Doxycycline or minocycline 100 mg bid
for 14 days or Pristinamycin 1 g qid for 10 days
▪ Complicated M. genitalium infection (PID, epididymitis): Moxifloxacin
400 mg for 14 days
▪ Bacterial Vaginosis: flagyl
▪ Herpes Simplex Virus
▪ First of genitlal herpes
▪ Acyclovir† 400 mg orally 3 times/day for 7–10 days
OR
Famciclovir 250 mg orally 3 times/day for 7–10 days
OR
Valacyclovir 1 gm orally 2 times/day for 7–10 days
▪ Maintain
▪ Acyclovir 400 mg orally 2 times/day
OR
Valacyclovir 500 mg orally once a day*
OR
Valacyclovir 1 gm orally once a day
OR
Famciclovir 250 mg orally 2 times/day
▪ Reoccuring episodic
o Acyclovir 800 mg orally 2 times/day for 5 days OR
o Acyclovir 800 mg orally 3 times/day for 2 days
OR
3
about:blank 3/15
NR568 Final Exam Study Guide
Week 5
- Prevention of osteoporosis with hormone replacement therapy
- When and when not to use progestin for hormone replacement therapy and why
- Local vs. systemic estrogen options and why one would be chosen over the other
o Peri-menopausal estrogen therapy (ET)
- Transdermal estrogen therapy has fewer adverse effects.
- Osteoporosis, osteopenia, and hormone replacement therapy (HRT)
o Selective estrogen receptor modulator (SERM)
▪ Bazedoxifene
- Management of oral contraceptives (OCs)
o How to change patient from one combination oral contraceptive to another.
o How to initiate treatment (when in the cycle is it best to start- may vary based on
the type of contraceptive)
o What teaching needs to be done
o What baseline data is needed?
o Contraindications for OCs
- How to achieve an extended cycle with oral contraceptives
- What behaviors would make one birth control method more effective over another?
o Be able to evaluate a patient scenario and suggest an appropriate birth control
method (type of prescribed contraception: OC, long-term methods, IUD, long-
acting reversible contraceptives (LARCs), etc.
- What effect does CYP450 inhibitors or inducers have on OCs?
o Recall examples of CYP450 inhibitors and inducers from NR565 (Chapter 4 in
textbook)
o How does this impact prescribing of OCs?
- Benefits and drawbacks of progestin-only contraception
- What are the most effective forms of contraception?
- Testosterone replacement
o Administration
o Benefits
o Patient Teaching
- Treatment of delayed puberty
o When is it appropriate to initiate androgen therapy (short course and long-term)
- Androgen therapy
o Effects
▪ Therapeutic
▪ Adverse
o Monitoring Needs
o Role of androgens in treating anemia
- Preferred administration route of alprostadil and why
1
about:blank 1/15
, NR568 Final Exam Study Guide Weeks 5-8
NR568 Final Exam Study Guide
- Treatment of hypogonadism
o Benefits
o Administration methods for transdermal preparations
▪ Testosterone gels
- Erectile Dysfunction (ED)
o Patient Teaching
o Medication Classes used to treat ED
▪ Vasodilators
▪ PGE1
- Treatment of BPH
o Know examples of drugs in each major drug class
o Adverse effects of common therapies
▪ 5-α-Reductase Inhibitors:
▪ α1 Blockers principal adverse effects are hypotension,
fainting, dizziness, somnolence, and nasal congestion. However,
silodosin and tamsulosin can cause abnormal ejaculation (ejaculation
failure,
reduced volume, retrograde ejaculation), whereas the nonselective
agents do
not. In contrast to dutasteride and finasteride, the alpha blockers do not
reduce
levels of PSA.
For men undergoing cataract surgery, alpha blockade increases the risk
for
intraoperative floppy-iris syndrome, a complication that can increase
postoperative pain, delay recovery, and reduce the hoped-for
improvement in
vision acuity. In severe cases, the syndrome can cause defects to the iris
that
2
about:blank 2/15
, NR568 Final Exam Study Guide Weeks 5-8
NR568 Final Exam Study Guide
may lead to blindness. Men anticipating cataract surgery should postpone
alpha blocker therapy until after the procedure.
▪ Phosphodiesterase-5 Inhibitor
▪ α1a Blocker/5-α-Reductase Inhibitor
o Therapeutic Effects
▪ Time to achieve
▪ Patient education/Provider response
▪ Assessment for therapeutic effect
- National STI/STD Curriculum
o Treatment of STIs/STDs
▪ Chlamydia: Doxycycline 100 mg orally 2 times/day for 7 days,
Azithromycin 1 g orally in a single dose
OR
Levofloxacin 500 mg orally once daily for 7 days
▪ Uncomplicated gonococcal urethritis: Uncomplicated M.
genitalium infection without macrolide resistance mutations or resistance
testing: Azithromycin 500 mg on day one, then 250 mg on days 2–5
▪ Second-line treatment and treatment for uncomplicated macrolide-
resistant M. genitalium infection: Moxifloxacin 400 mg for 7 days
▪ Third-line treatment for persistent M. genitalium infection after
azithromycin and moxifloxacin: Doxycycline or minocycline 100 mg bid
for 14 days or Pristinamycin 1 g qid for 10 days
▪ Complicated M. genitalium infection (PID, epididymitis): Moxifloxacin
400 mg for 14 days
▪ Bacterial Vaginosis: flagyl
▪ Herpes Simplex Virus
▪ First of genitlal herpes
▪ Acyclovir† 400 mg orally 3 times/day for 7–10 days
OR
Famciclovir 250 mg orally 3 times/day for 7–10 days
OR
Valacyclovir 1 gm orally 2 times/day for 7–10 days
▪ Maintain
▪ Acyclovir 400 mg orally 2 times/day
OR
Valacyclovir 500 mg orally once a day*
OR
Valacyclovir 1 gm orally once a day
OR
Famciclovir 250 mg orally 2 times/day
▪ Reoccuring episodic
o Acyclovir 800 mg orally 2 times/day for 5 days OR
o Acyclovir 800 mg orally 3 times/day for 2 days
OR
3
about:blank 3/15
