NR568 Final Exam Study Guide week 5 -8 with Verified Answers |Latest 2023/ 2024| Chamberlain

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, longacting 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 1lOMoAR cPSD| - 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 2lOMoAR cPSD| 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 macrolideresistant 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 3lOMoAR cPSD| o Famciclovir 1 gm orally 2 times/day for 1 day OR o Famciclovir 500 mg once, followed by 250 mg 2 times/day for 2 days OR o Famciclovir 125 mg 2 times/day for 5 days OR o Valacyclovir 500 mg orally 2 times/day for 3 days OR o Valacyclovir 1 gm orally once daily for 5 days ▪ Trichomoniasis - Recommended Regimen for Trichomoniasis Among Women - Metronidazole 500 mg 2 times/day for 7 days - Recommended Regimen for Trichomoniasis Among Men - Metronidazole 2 g orally in a single dose - Alternative Regimen for Women and Men - Tinidazole 2 g orally in a single dose ▪ Syphilis - Recommended Regimen for Primary and Secondary Syphilis* Among Adults - Benzathine penicilli