NR 566 Final Exam Questions and Answers (Graded A)
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NR 566
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NR 566
NR 566 Final Exam Questions and Answers (Graded A)NR 566 Final Exam Questions and Answers (Graded A)NR 566 Final Exam Questions and Answers (Graded A)NR 566 Final Exam Questions and Answers (Graded A)
How to respond to missed doses or changing of contraceptive types from one to another? - ANSWER-F...
NR 566 Final Exam Questions and
Answers (Graded A)
How to respond to missed doses or changing of contraceptive types from one to
another? - ANSWER-For products that use a 28-day cycle, the following
recommendations from the Centers for Disease Control apply:
• If one or more pills are missed in the first week, take one pill as soon as possible and
then continue with the pack. Use an additional form of contraception for 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.
-If two pills are missed, the regimen should be restarted and backup contraception
should be used for at least 2 days.
-If two or more pills are missed and no menstrual bleeding occurs, a pregnancy test
should be done.
Role of androgens in treating anemia - ANSWER-Androgen therapy will increase bone
marrow stimulation to make more RBCs.
Types of contraceptives and which would be best for specific patient scenarios -
ANSWER-Combination OCs should be avoided by women with certain cardiovascular
disorders (see later) as well as by women older than 35 years who smoke. For women
in these categories, an alternative method (e.g., diaphragm, progestin-only pill, or IUD)
is preferable.
For women who engage in coitus frequently, OCs or a long-term method (e.g.,
Nexplanon, Depo-Provera, IUD) are reasonable choices.
- Transdermal estrogen therapy has fewer adverse effects. - ANSWER-Compared with
oral formulations, 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.
, How to change patient from one combination oral contraceptive to another. - ANSWER-
When one combination OC is being substituted for another, the change is best made at
the beginning of a new cycle.
Benefits and drawbacks of progestin-only contraception (Norethindrone) - ANSWER-
Beneifits:
Because they lack estrogen, minipills do not cause thromboembolic disorders,
headaches, nausea, or most of the other adverse effects associated with combination
OCs
when sexual activity is limited, and if individual has multiple partners use of a
spermicide, condom, or diaphragm may be more appropriate. Because barrier methods
combined with spermicides can offer some protection against STDs (as well as
providing contraception)
If adherence is a problem (as it can be with OCs, condoms, and diaphragms), usterm-
16e of a long-term method (e.g., vaginal contraceptive ring, IUD, Nexplanon, Depo-
Provera) can confer more reliable protection.
For combination OCs that use an extended or continuous cycle, up to 7 days can be
missed? - ANSWER-with little or no increased risk for pregnancy provided that the pills
had been taken continuously for the prior 3 weeks.
If one or more doses is missed or taken greater than 3 hours after the scheduled dose,
the following guidelines apply: - ANSWER--If one pill is missed, it should be taken as
soon as remembered and backup contraception should be used for at least 2 days. The
pills should be resumed as scheduled on the next day.
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? - ANSWER-Inhibitors: Inducers:
Acyclovir Carbamazepine
Ciprofloxacin Phenobarbital
Ethinyl estradiol Phenytoin
Fluvoxamine Primidone
Isoniazid Rifampin
Norfloxacin Ritonavir
Oral contraceptives Tobacco
Zafirlukast St. John's wort
Zileuton
As a rule, high-estrogen OCs are reserved for women taking drugs that induce P450.
drugs that interact with oral contraceptives? - ANSWER-Products that induce hepatic
cytochrome P3A4 can accelerate OC metabolism and thereby reduce OC effects.
indications are reduced OC blood levels, such as breakthrough bleeding or spotting. If
these signs appear, it may be necessary to either (1) increase the estrogen dosage of
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