NR 566 PHARM FINAL QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
Doxazosin side effects - ANSWER orthostatic hypotension, falls, reflex tachycardia, headache, and nasal
congestion
Dutasteride patient teaching and response to delayed onset of therapeutic effect - ANSWER o benefits
take months to develop
o decreased ejaculate volume and libido.
o FDA Pregnancy Risk Category X. It can be absorbed through the skin, so pregnant women should not
handle the drug.
o men should not donate blood while using it or for at least 6 months after stopping it to avoid
transmission to women through an infusion
How to know Terazosin is working - ANSWER improved symptoms of dysuria, urgency, urinary tract
infections, hesitancy
Various routes of administration of estrogen therapy and when each would be used - ANSWER o PO—
used more than any other
o 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
o Intravaginal administration—available as tablets, creams, and vaginal rings. They are used only for local
effects, primarily treatment of vulval and vaginal atrophy associated with menopause. The other vaginal
ring [Femring] can also help with systemic effects (i.e. control of hot flashes and night sweats)
o IV and IM—limited to acute, emergency control of heavy uterine bleeding
When is it safe and not safe to prescribe progesterone (AKA: progestin) - ANSWER o Safe—menopausal
hormone therapy, dysfunctional uterine bleeding, amenorrhea, endometrial cacer and hyperplasia
o Not safe—arterial disease, breast cancer, depression
Side effects of progestin-only oral contraceptives - ANSWER o more likely to cause irregular/inconsistent
bleeding
o must be taken at same time every day to be effective
Benefits of prescribing medroxyprogesterone acetate - ANSWER protects against pregnancy for 3 months
or longer
Patient teaching in general and consider teaching specific to different routes of testosterone therapy -
ANSWER § GELS
· good hand washing is required after application
· cover application site with clothing after medication has dried
· females and children may experience negative effects from exposure to testosterone
§ PILLS
· Pose a risk for hepatotoxicity, so do not take long term
, § PATCH
· Principal adverse effect is rash at the site of application
§ IM
· Cause variations in libido, energy, mood
When is androgen therapy appropriate vs. not needed related to puberty? - ANSWER Appropriate when
the psychological pressures of delayed sexual maturation are causing a boy significant distress or if
delayed puberty is related to true hypogonadism
Common side effects of androgen therapy - ANSWER Hot flashes, bone fractures, decreased libido,
insulin resistance, erectile dysfunction, gynecomastia, acne, HTN, sterility, hepatotoxicity, mood swings/
aggression
alprostadil benefits of various routes - ANSWER o injection: can be done by patient or in ER setting;
rapidly leads to erection, painless
o intraurethral pellet insertion: can be done by patient, erection occurs within 5-10 mins, minimal side
effects
papaverine plus phentolamine patient education - ANSWER do not inject more than once in a 24 hr
period, notify provider of erection duration and efficacy, do not take other ED meds with this
medication, needle/injection teaching, do not change the dose yourself, seek medical attention if
erection is >3 hrs
How does carbamazepine (Tegretol) impact oral contraceptives and what symptoms may be associated
with that? - ANSWER o accelerates OC metabolism, reducing OC effect
o can lead to abnormal bleeding, return of menstrual symptoms, and of course pregnancy!
How do the affects of carbamazepine (Tegretol) which OCP is prescribed? - ANSWER o increase the
estrogen dosage of the OC
o combine the OC with a second form of birth control
o switch to an alternative form of birth control
Benefits of etonogestrel subdermal implant [Nexplanon] - ANSWER it is one of the most effective forms
of contraception, long-term option (contraception up to 5 years), reversible by removing rod
What is abortive therapy and when is it used? - ANSWER The objective of abortive therapy is to
eliminate headache pain and suppress associated nausea and vomiting. Treatment should commence at
the earliest sign of an attack
First-line treatment for migraine prevention - ANSWER Beta Blockers: Propranolol #1, Metoprolol #2
First-line treatment for acute, mild to moderate migraine without nausea or vomiting - ANSWER aspirin,
acetaminophen, naproxen, diclofenac, and other aspirin-like analgesics
How to know someone would be appropriate for preventative therapy - ANSWER Indicated for patients
who have frequent attacks (3+ a month), severe attacks, or attacks that do not respond adequately to
abortive therapy