NR 568 Midterm Exam newest version 2025:
Advanced Pharmacology for the Adult-
Gerontology Primary Care Nurse Practitioner
Questions and Verified Answers - Chamberlain
Save
Terms in this set (200)
combined estrogen-progestin therapy for women
When and when not to
with an intact uterus. Estrogen-only HRT can be given
use progestin for
to someone with a hysterectomy. Progestin is
hormone replacement
required to prevent estrogen-associated endometrial
therapy and why?
hyperplasia.
intravaginal preparations are most helpful in treating
symptoms associated with local estrogen deficiency,
such as vaginal and vulvar atrophy; these preparations
are associated with a lower risk of systemic effects
progesterone is contraindicated in women who have
undergone a hysterectomy but required in women
with an intact uterus who have undergone hormone
Local vs. systemic replacement therapy
estrogen options and why IV administration is generally limited to acute,
one would be chosen emergency control of heavy uterine bleeding.
over the other One of the two available vaginal rings (Estring) are
used only for local effects, primarily treatment of
vulval and vaginal atrophy associated with
menopause.
The other vaginal ring (Femring) is used for systemic
effects (e.g., control of hot flashes and night sweats)
as well as local effects (e.g., treatment of vulval and
vaginal atrophy).
, remains the most effective treatment option for
relieving perimenopausal and menopausal hot flashes
and night sweats.
taken to compensate for the loss of estrogen that
occurs during menopause.
Peri-menopausal
There are two basic regimens for HT: estrogen alone
estrogen therapy (ET)
(ET) and estrogen plus a progestin
(estrogen/progestin therapy [EPT]).
The purpose of estrogen in both regimens is to
control menopausal symptoms by replacing estrogen
that was lost owing to menopause.
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,
Transdermal estrogen
and stroke.
therapy has fewer
Types:
adverse effects
Emulsion (Estrasorb)
Spray (Evamist)
Gels (EstroGel, Elestrin, Divigel)
Patches (Alora, Climara, Estraderm, Menostar, Vivelle-
Dot, Oesclim )
Are drugs that activate ERs in some tissues and block
them in others.
These drugs were developed in an effort to provide
Selective estrogen
the benefits of estrogen (e.g., protection against
receptor modulator
osteoporosis, maintenance of the urogenital tract,
(SERM)
reduction of LDL cholesterol) while avoiding its
drawbacks (e.g., promotion of breast cancer, uterine
cancer, and thromboembolism)
, Duavee (conjugated estrogens/bazedoxifene) for
prevention of vasomotor symptoms and osteoporosis
in postmenopausal women with a uterus.
Duavee is the first drug to combine estrogen with an
estrogen agonist/antagonist (bazedoxifene).
Bazedoxifene
The bazedoxifene component of Duavee reduces the
risk for excessive growth of the lining of the uterus
that can occur with the estrogen component.
Contraindications to taking Duavee are the same as
for other estrogen-containing products.
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
Prevention of maintain bone health, HT must continue lifelong.***
osteoporosis with HT should be considered only for women with
hormone replacement significant risk for osteoporosis, and only when that
therapy risk outweighs the risks of HT.
A person on HT and pts, in general, should practice
primary prevention of bone loss by ensuring
adequate calcium and vitamin D intake, regular
weight-bearing exercise, and avoiding smoking and
excessive alcohol use.
start the new brand on active hormone tablets and
How to change a patient
skip the pill free interval or use non-hormonal forms
from one combination oral
of contraception until 7 active tablets of the new
contraceptive to another
brand have been taken
How to initiate treatment Use is initiated on day 1 of the menstrual cycle, and
(when in the cycle is it one pill is taken daily thereafter.
best to start- may vary A backup contraceptive method should be used for
based on the type of the first 7 days.
contraceptive)
, Take pill around the same time daily
Among women of higher weight, efficacy is somewhat
reduced.
Report leg tenderness/pain/redness, SOB,
headaches/migraines, sudden chest pains, visual
changes.
If a mini pill is missed by more than 3 hours, take it
immediately and use backup for at least 2 days
If one or more pills are missed in the first week, take
one pill as soon as possible and then continue with
What teaching needs to
the pack. Use an additional form of contraception for
be done for OCs
7 days.
If one or two pills are missed during the second or
third week, take one pill as soon as possible and then
continue with the active pills in the pack but skip the
placebo pills and go straight to a new pack once all
the active pills have been taken.
If three or more pills are missed during the second or
third week, follow the same instructions given for
missing one or two pills but use an additional form of
contraception for 7 days.
Baseline Data:
Assess for history of hypertension, diabetes,
thromboembolism, cerebrovascular or cardiovascular
Baseline data for OCs disease, breast cancer. Urine pregnancy test.
Monitoring:
No routine monitoring required.
Advanced Pharmacology for the Adult-
Gerontology Primary Care Nurse Practitioner
Questions and Verified Answers - Chamberlain
Save
Terms in this set (200)
combined estrogen-progestin therapy for women
When and when not to
with an intact uterus. Estrogen-only HRT can be given
use progestin for
to someone with a hysterectomy. Progestin is
hormone replacement
required to prevent estrogen-associated endometrial
therapy and why?
hyperplasia.
intravaginal preparations are most helpful in treating
symptoms associated with local estrogen deficiency,
such as vaginal and vulvar atrophy; these preparations
are associated with a lower risk of systemic effects
progesterone is contraindicated in women who have
undergone a hysterectomy but required in women
with an intact uterus who have undergone hormone
Local vs. systemic replacement therapy
estrogen options and why IV administration is generally limited to acute,
one would be chosen emergency control of heavy uterine bleeding.
over the other One of the two available vaginal rings (Estring) are
used only for local effects, primarily treatment of
vulval and vaginal atrophy associated with
menopause.
The other vaginal ring (Femring) is used for systemic
effects (e.g., control of hot flashes and night sweats)
as well as local effects (e.g., treatment of vulval and
vaginal atrophy).
, remains the most effective treatment option for
relieving perimenopausal and menopausal hot flashes
and night sweats.
taken to compensate for the loss of estrogen that
occurs during menopause.
Peri-menopausal
There are two basic regimens for HT: estrogen alone
estrogen therapy (ET)
(ET) and estrogen plus a progestin
(estrogen/progestin therapy [EPT]).
The purpose of estrogen in both regimens is to
control menopausal symptoms by replacing estrogen
that was lost owing to menopause.
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,
Transdermal estrogen
and stroke.
therapy has fewer
Types:
adverse effects
Emulsion (Estrasorb)
Spray (Evamist)
Gels (EstroGel, Elestrin, Divigel)
Patches (Alora, Climara, Estraderm, Menostar, Vivelle-
Dot, Oesclim )
Are drugs that activate ERs in some tissues and block
them in others.
These drugs were developed in an effort to provide
Selective estrogen
the benefits of estrogen (e.g., protection against
receptor modulator
osteoporosis, maintenance of the urogenital tract,
(SERM)
reduction of LDL cholesterol) while avoiding its
drawbacks (e.g., promotion of breast cancer, uterine
cancer, and thromboembolism)
, Duavee (conjugated estrogens/bazedoxifene) for
prevention of vasomotor symptoms and osteoporosis
in postmenopausal women with a uterus.
Duavee is the first drug to combine estrogen with an
estrogen agonist/antagonist (bazedoxifene).
Bazedoxifene
The bazedoxifene component of Duavee reduces the
risk for excessive growth of the lining of the uterus
that can occur with the estrogen component.
Contraindications to taking Duavee are the same as
for other estrogen-containing products.
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
Prevention of maintain bone health, HT must continue lifelong.***
osteoporosis with HT should be considered only for women with
hormone replacement significant risk for osteoporosis, and only when that
therapy risk outweighs the risks of HT.
A person on HT and pts, in general, should practice
primary prevention of bone loss by ensuring
adequate calcium and vitamin D intake, regular
weight-bearing exercise, and avoiding smoking and
excessive alcohol use.
start the new brand on active hormone tablets and
How to change a patient
skip the pill free interval or use non-hormonal forms
from one combination oral
of contraception until 7 active tablets of the new
contraceptive to another
brand have been taken
How to initiate treatment Use is initiated on day 1 of the menstrual cycle, and
(when in the cycle is it one pill is taken daily thereafter.
best to start- may vary A backup contraceptive method should be used for
based on the type of the first 7 days.
contraceptive)
, Take pill around the same time daily
Among women of higher weight, efficacy is somewhat
reduced.
Report leg tenderness/pain/redness, SOB,
headaches/migraines, sudden chest pains, visual
changes.
If a mini pill is missed by more than 3 hours, take it
immediately and use backup for at least 2 days
If one or more pills are missed in the first week, take
one pill as soon as possible and then continue with
What teaching needs to
the pack. Use an additional form of contraception for
be done for OCs
7 days.
If one or two pills are missed during the second or
third week, take one pill as soon as possible and then
continue with the active pills in the pack but skip the
placebo pills and go straight to a new pack once all
the active pills have been taken.
If three or more pills are missed during the second or
third week, follow the same instructions given for
missing one or two pills but use an additional form of
contraception for 7 days.
Baseline Data:
Assess for history of hypertension, diabetes,
thromboembolism, cerebrovascular or cardiovascular
Baseline data for OCs disease, breast cancer. Urine pregnancy test.
Monitoring:
No routine monitoring required.
