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30 Cards in this Set
- Front
- Back
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what are the desired outcomes in treating menopause? |
alleviate menopausal symptoms improve quality of life minimize adverse effects of therapy |
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what things should you screen for before you recommend a therapy? |
CHD risk breast cancer hysterectomy |
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what type of nonpharmacological therapies can you offer for menopause? |
smoking cesation, limit alchohol and caffeine, limit hot beverages and spicy foods |
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how can you treat dyspareunia? |
painful sex- use water based lubricants |
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when would you use topical estrogen? would you ever need a progestin? |
if no vasomotor symptoms andvulvovaginal atrophy use progestin if its a high dose of estrogen, the progestin would be oral |
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when should you consider nonhormonal therapy for vasomtor symtoms? how often do you asses HRT or ERT therapy? |
if patient is not interested in hrt or if they hit a contraindication, chd, or breast cancer 6-12 months |
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what are the benefits of HRT in menopause? what is an alternative to using HRT for osteoporosis? |
effective for treatment of vasomotor symptoms, treats vulvovaginal atrophy, prevents osteoporosis, may lower colon cancer bisphosphonates |
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what are the risks of HRT? |
cardiovascular disease, breast cancer, venous thromboembolism |
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what should a women with an intact utureus get if considering HRT? why? |
progestin and estrogen to decrease risk of endometrial hyperplasia or cancer |
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what are the benefits of transdermal products |
good if high LDL, LFT abnormalities, adherence, possibly less vte compared to oral |
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what are the contraindications to HRT? |
CVD like MI or stroke, breast cancer, DVT or history of, genital bleeding, liver disease, estrogen dependent cancer, pregnancy |
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what are some common side effects of estrogens? serious side effects? |
nausea, headache, bloating stroke, VTE, breast cancer |
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what are some common side effects of progestins? serious side effects? |
nausea, headache, weight gain VTE decreased BMD |
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describe the administration in cyclic hrt is their withdrawal bleeding? |
estrogen daily and progestin for days 15-28 with estrogen yes, period returns |
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describe the adminsitration in a continuous hrt is there withdrawal bleeding? how long until spotting resolves? |
estrogen and progestin daily for 28 days not with this one, but there is spotting 6-12 months |
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if a patient is taking a COC and experineces bleeding, what can you do? |
reduce estrogen dose and/or increase progestin dose |
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how often should you asses a patient on birth control? what are the non hormonal therapies for hot flushes? what treatments really arent used? |
every 6-12 months paroxetine 7.5 mg, clonidine, gabapentin isoflavones, black cohosh, vitamin E |
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when would you use osphena? is it oral or topical? what are some of the risks? |
after patient fails lubircant or topical estrogen or who doest want touse vaginal estrogen oral endometrial cancer w/ estrogens alone, cva and dvt |
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what should you monitor in a patient taking COC? |
symptoms, breakthrough bleeding, could check BP, lipids, TSH, breast exam |
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what are the goals of coc? |
prevent pregnancy, regulate menstrual cycle, reduce premenstrual symptoms, treat acne |
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are monophasic or biphasic/triphasic regimens better? is there a difference between drospirenone and levo? |
no evidence more vte in drospirenone |
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what are some of the non contraceptive benefits of COCs? |
reduction in endometrial cancer, ovarian cancer, improved regulation of menstruation, prevention of breast and ovarian cysts, reduce risk of pelvic inflammatory disease, improve ancne |
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what are some of the risks of COC |
STD, hypertension, vte, glucose intolerance, breast cancer, cervical cancer, gallbladder disease |
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what are the 3 ways you can initiate a COC? which ones should you use a back up method? |
first day of period, no back up quick start aka the day you pick up rx, back up start 1st sunday following period, back up for 7 days |
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contraindications for cocs? |
heavy smoker, liver disease, vte, stroke, breask cancer, uterine bleeding |
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what are the side effects of estrogen excess? how do you fix this |
nausesa, weight gain, headache, dysmenorrhea, edema decrease estrogen, use nsaid for dysmenorrhea |
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what are side effects of estrogen deficiency? how do you fix it? |
wasomotor, early cycle days 1-9 break through bleeding and spotting, amenorrhea increase estrogen |
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what are the symptoms of progestin excess? decrease progestin |
increased appetite, weight gain, bloating, ance, depression decrease progestin content |
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what are the symptoms of progestin defieincy? |
dymenorrhea or late cycle day 10-21 breakthrough bleeding and spotting increase progestin, nsaid for dsymenorrhea |
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what are some early warning signs of COCs? |
abdominal pain, chest pain, headaches, eye problems, leg pain |
