Summary NR 566 / NR566 Final Exam Study Guide 2023/2024 | Latest Update

NR 566 / NR566 Final Exam Study Guide 2023/2024 | Latest Update. Side effects of progestin-only oral contraceptives: o Excess –  Increased appetite  Weight gain  Depression  Tiredness  Fatigue  Hypomenorrhea  Breast regression  Monilial vaginitis  Acne, oily scalp  Hair loss  Hirsutism (excessive growth or dark or coarse hair in male-like pattern) o Deficiency –  Late breakthrough bleeding NR566 Final Study Guide  Amenorrhea  Hypermenorrhea  Benefits of prescribing medroxyprogesterone acetate  Testosterone therapy o Patient teaching in general and consider teaching specific to different routes  May take 1 month to take effect  LOOK AT NOTES o When is androgen therapy appropriate vs. not needed related to puberty?  Delayed puberty -  Providers will prescribe limited therapy if causing boy significant psychological distress  If due to true hypogonadism -> long-term therapy indicated  Not approved for testosterone therapy in the US  When prescribed off-label, must be prescribed at doses lower than those used for men  Goal = 300 mcg/day o Common side effects –  LOOK AT NOTES  Alprostadil (Papaverine/phentolamine) - o Benefits of various routes  Transurethral -> fewer side effects  Higher dose  Erection develops 5-10 minutes after drug administration and lasts 30-60 minutes  Intracavernous  ^ both lead to increased arterial blood flow to penis  Contraception o How does carbamazepine impact oral contraceptives and what symptoms may be associated with that?  How might this affect which OCP is prescribed?  Carbamazepine is an inducer, so it may make the OCP not as effective.  It would be recommended to prescribe a longer-lasting contraceptive o Benefits of Etonogestrel subdermal implant [Nexplanon]  MOST EFFECTIVE method of contraception (:  Alprostadil (Papaverine plus phentolamine) - o Patient education:  Adverse effects -  Orthostatic hypotension  Fibrotic nodules in the corpus cavernosum NR566 Final Study Guide Week 6  Migraines o What is abortive therapy and when is it used?  Used to eliminate headache pain and suppress associated nausea and vomiting  Start therapy at the earliest sign of attack o First-line treatment for migraine prevention:  Beta blockers =  Propranolol  Metoprolol o First-line treatment for acute, mild to moderate migraine without nausea or vomiting  NSAID and NSAID combinations:  ASA, naproxen, diclofenac  Opioid analgesics:  Butorphanol nasal spray o How to know someone would be appropriate for preventative therapy:  Indicated for patients with frequent attacks 3-4x a month  OR attacks that don’t respond adequately to abortive agents o Examples of opioid analgesics reserved for severe migraines that don’t respond to first-line medications  Acetaminophen, Butorphanol nasal spray opioid analgesics (Butorphanol nasal spray) o Triptans  Know mechanism of action for sumatriptan  Increases the release of inflammatory neuropeptides thereby diminishing perivascular inflammation  Causes vasoconstriction and decreased perivascular inflammation  Know contraindications for triptans