NR566 FINAL ADVANCED

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NR566 FINAL (ADVANCED

PHARMACOLOGY FOR CAR E OF

THE

FAMILY)

Question 1: What is the effect of hormone replacement

therapy (HT) on osteoporosis prevention and what happens when HT is stopped?

CORRECT ANSWER : HT reduces postmenopausal

bone loss and thereby decreases the risk for osteoporosis and related fractures. Unfortunately, when HT is stopped, bone mass rapidly decreases by approximately 12%.Hence to maintain bone health, HT must continue lifelong.

Question 2: What is the most common non-contraceptive

use of estrogens?

CORRECT ANSWER : Hormone therapy (-when HT is

stopped, bone mass rapidly decreases by approximately 12%. Hence to maintain bone health, HT must continue lifelong.

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Question 3: When should progestin be used for hormone

replacement therapy and why?

CORRECT ANSWER : To counterbalance estrogen-

mediated stimulation of the endometrium, which can lead to endometrial hyperplasia and cancer.

Question 4: When should progestin not be used for

hormone replacement therapy and why?

CORRECT ANSWER : Progestins should not be

prescribed as HRT for women who have undergone hysterectomy.

Question 5: What are the advantages of transdermal

estrogen formulations compared to oral formulations?

CORRECT ANSWER : Compared with oral

formulations of estrogen, 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.

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• There is a lower risk for DVT, pulmonary embolism,

and stroke.

Question 6: What is the function/mechanism of

combination oral contraceptives (OCs)?

CORRECT ANSWER: Reduce fertility primarily by

inhibiting ovulation.

Question 7: What is the role of progestin in combination

oral contraceptives?

CORRECT ANSWER : Acts in the hypothalamus and

pituitary to suppress the midcycle luteinizing hormone surge, which normally triggers ovulation.

Question 8: What is the role of estrogen in combination

oral contraceptives?

CORRECT ANSWER : Suppresses release of follicle-

stimulating hormone from the pituitary (and thereby inhibits follicular maturation).

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Question 9: What are the two main categories of oral

contraceptives?

CORRECT ANSWER : 1) those that contain an estrogen

plus a progestin, known as combination OCs, and 2) those that contain just a progestin, known as "minipills" or progestin-only OCs.

Question 10: What are the absolute contraindications for

oral contraceptive therapy?

CORRECT ANSWER : Thrombophlebitis,

thromboembolic disorders, cerebral vascular disease, coronary occlusion, or a past history of these conditions, or a condition that predisposes to these disorders, abnormal liver function, known or suspected breast cancer, undiagnosed abnormal vaginal bleeding, known or suspected pregnancy, smokers older than 35 years.

Question 11: What are the advantages and disadvantages

of progestin-only oral contraceptives ("minipills") compared to combination OCs?