NR566-Advanced Pharmacology for Care of the Family_FINAL Exam

NR566-Advanced Pharmacology for Care of the Family_FINAL Exam Prevention of osteoporosis with hormone replacement therapy - answer HT reduces postmenopausal bone loss and thereby decreases the risk for osteoporosis and related fractures. Unfortunately, when HT is stopped, bone mass rapidly decreases by approximately 12%. Hence to maintain bone health, HT must continue lifelong. Most common non-contraceptive use of estrogens. - answer Hormone therapy (HT) in postmenopausal women When to use progestin for hormone replacement therapy and why - answer to counterbalance estrogen-mediated stimulation of the endometrium, which can lead to endometrial hyperplasia and cancer. When not to use progestin for hormone replacement therapy and why - answer Progestins should not be prescribed as HRT for women who have undergone hysterectomy. Local vs. systemic estrogen options and why one would be chosen over the other - answer Compared with oral formulations of estrogen, the transdermal formulations have four advantages: • The total dose of estrogen is greatly reduced (because the liver is bypassed). • There is less nausea and vomiting. • Blood levels of estrogen fluctuate less. • There is a lower risk for DVT, pulmonary embolism, and stroke Function/mechanism of combination OC - answer reduce fertility primarily by inhibiting ovulation. Role of Progestin in combination OC - answer acts in the hypothalamus and pituitary to suppress the midcycle luteinizing hormone surge, which normally triggers ovulation. Role of Estrogen in combination OC - answer suppresses release of follicle-stimulating hormone from the pituitary (and thereby inhibits follicular maturation), (2) main categories of OCs: - answer (1) those that contain an estrogen plus a progestin, known as combination OCs, and (2) those that contain just a progestin, known as "minipills" or progestin-only OCs Absolute Contraindication w/ OC Therapy - answer Thrombophlebitis, thromboembolic disorders, cerebral vascular disease, coronary occlusion, or a past history of these conditions, or a condition that predisposes to these disorders Abnormal liver function Known or suspected breast cancer Undiagnosed abnormal vaginal bleeding Known or suspected pregnancy Smokers older than 35 years Progestin-only OCs, also known as "minipills" - answer do not cause thromboembolic disorders, headaches, nausea, or most of the other adverse effects associated with combination OCs. Unfortunately, although slightly safer than combination OCs, less effective and are more likely to cause irregular bleeding Most Effective Contraception - answer Etonogestrel subdermal implants (Nexplanon)Intramuscular medroxyprogesterone acetate (Depo-Provera)SterilizationIntrauterine device (IUD) The method of contraception chosen most frequently by birth control users - answer Sterilization: female sterilization (tubal ligation) plus male sterilization (vasectomy) are selected by 19% of birth control users Factors considered when a method of birth control is being chosen. - answer effectiveness, safety, and personal preference The most effective birth control methods - answer etonogestrel subdermal implants (Nexplanon), intramuscular medroxyprogesterone acetate (Depo-Provera), sterilization