NR 566 FINAL EXAM

NR 566 FINAL EXAM Raloxifene (Evista) and bisphosphonates (alendronate, calcitonin) - CORRECT ANSWER-alternatives for hormone replacement therapy Selective Estrogen Receptor Modulators (SERMs) - CORRECT ANSWER-Tamoxifen, toremifene, raloxifene -- provide estrogen benefits while avoiding its drawbacks Dysfunctional uterine bleeding - CORRECT ANSWER-10-14 day course of progestin Amenorrhea treatment - CORRECT ANSWER-progestin helps induce menstrual flow Amenorrhea estrogen levels are low - CORRECT ANSWER-give progestin for 5-10 days Long term progestin therapy - CORRECT ANSWER-protection against endometrial cancer Estradiol - CORRECT ANSWER-most active estrogenic compound. oral estrogen option Advantages of estrogen transdermal patch - CORRECT ANSWER-lower total estrogen dose. less n/v. less fluctuation of estrogen blood levels. lower r/f DVT, PE and stroke Femring - CORRECT ANSWER-intravaginal ring controls hot flashes and night sweats. Treats vulval and vaginal atrophy No gap method of changing from one OC to another - CORRECT ANSWER-go straight from one type of OC to the other without taking a gap. initiating OC treatment - CORRECT ANSWER-first day of menstrual cycle (no backup BC needed) OR first sunday after onset of menses (backup BC needed for 7 days) Initiating androgen therapy short term - CORRECT ANSWER-delayed sexual maturation causing a boy significant distress. Limited course of Fluoxymesterone and methyltestosterone are approved. androgen therapy long term - CORRECT ANSWER-if delayed puberty is the result of true hypogonadism role of androgens in anemia - CORRECT ANSWER-promote synthesis of erythropoietin the renal hormone that stimulates production of RBCs Alprostadil preferred administration - CORRECT ANSWER-direct injection into the corpus cavernosum. Rapid response Finasteride - CORRECT ANSWER-BPH tx 5a reductase inhibitor. Causes prostate to shrink. benefits take months Tamsulosin - CORRECT ANSWER-BPH tx alpha adrenergic antagonist. relaxes smooth muscle. benefits are rapid Adverse effects of silodosin and tamsulosin - CORRECT ANSWER-r/f floppy iris syndrome during cataract surgery. Chlamydia tx - CORRECT ANSWER-azithromycin 1g PO x single dose. doxycycline 100mg PO BID 7 days Gonococcal urethritis tx - CORRECT ANSWER-ceftriaxone IM single dose 250mg-1g based on weight Bacterial vaginosis tx - CORRECT ANSWER-metronidazole 500mg PO 2x day for 7 days. Herpes (HSV) tx - CORRECT ANSWER-acyclovir 400mg TID 7-10 days, valacyclovir or famciclovir Trichomoniasis tx - CORRECT ANSWER-metronidazole 2g PO x1 dose or tinidazole Syphilis - CORRECT ANSWER-benzathine penicillin 2.4mil units IM Mild symptoms PD tx - CORRECT ANSWER-MAO-B inhibitor like rasagiline or selegiline Severe symptoms PD tx - CORRECT ANSWER-levodopa + carbodopa or dopamine agonist PD tx for improving motor function - CORRECT ANSWER-levodopa PD tx for drug induced dyskinesias - CORRECT ANSWER-dopamine agonist COMT inhibitor - CORRECT ANSWER-Entacapone (Comtan). added to levo/carbidopa to increase levo concentrations & extend half life & decrease wearing off time Pramipexole side effects - CORRECT ANSWER-impulse control disorders, combined with levodopa causes orthostatic hypotension and dyskinesias Pregabalin - CORRECT ANSWER-Safest medication for seizure patients on OC Phenytoin - CORRECT ANSWER-can decrease effects of OCs, warfarin and glucocorticoids Migraine tx 1st line - CORRECT ANSWER-serotonin 1b/1d receptor agonists (triptans) First line migraine prevention - CORRECT ANSWER-propanolol Divalproex - CORRECT ANSWER-antiepileptic med reduce migraine attacks. Contraindicated in pregnancy Amitriptyline - CORRECT ANSWER-tricyclic antidepressant. Can prevent migraine/tension type headache. Orthostatic hypotension Preventative migraine meds - CORRECT ANSWER-propanolol, divalproex and amitriptyline Abortive migraine meds - CORRECT ANSWER-non specific NSAIDs, migraine specific analgesics, ergot alkaloids, dihydroergotamine Non-specific NSAIDS - CORRECT ANSWER-aspirin, naproxen, diclofenac and metoclopramide. Combos of acetaminophen +aspirin + caffeine Butorphanol nasal spray - CORRECT ANSWER-opioid analgesic for migraine Migraine specific analgesics - CORRECT ANSWER-SS 1b/1d receptor angonists (triptans) Triptans MOA - CORRECT ANSWER-constrict intracranial blood vessels and suppress release of inflammatory neuropeptides Sumatriptan contraindications - CORRECT ANSWER-contraindicated in pts with hx of ischemic HD, MI, uncontrolled HTN or other heart dz. Avoid in pregnancy Ergot Alkaloids and dihydroergotamine - CORRECT ANSWER-2nd line therapy after 1st doesnt work Pramipexole can cause - CORRECT ANSWER-sleep attacks (overwhelming and irresistible sleepiness) screening before pramipexol prescribing - CORRECT ANSWER-compulsive behaviors Parkinsons disease - CORRECT ANSWER-underlying cause of motor symptoms is loss of dopaminergic neurons in the substantia nigra