Advanced Pharmacology Nsg 533 Already Passed

Managing hormone concerns {Ans: Estrogen Excess - N/V, cervical mucorrhea, hypertension, headache, breast tenderness, edema, melasma, bloating Deficiency - Early or mid-cycle breakthrough bleeding, increased spotting, hypomenorrhea, vasomotor symptoms Progestin Excess - breast tenderness, headache, fatigue, changes in mood Deficiency - Late break through bleeding, hypermenorrhea, dysmenorrhea Androgen Excess - increased appetite, weight gain, acne, oily skin, hirsutism, decreased libido, increased breast size, breast tenderness, increased LDL, decreased HDL Amenorrhea - rule out other causes. Can increase to more estrogenic formulation or to triphasic formulation to decrease amenorrhea.Not a concern if patient is happy. Acne/ oily skin/ hirsutism - Rule out other causes. Switch to less androgenic formulation of progestin (or decrease progestin content)3rd generation Desogestrel, norgestimate4th generation drospirenone Dienogest}Red Flag medications in pregnancy - Commonly used / teratogenic {Ans: Warfarin, Phenytoin, Valproic Acid, Carbamazepine, Lithium, ACE inhibitors/ARBs, Thalidomide, Ethanol, statins .. etc Considerations must be given to not only those who ARE pregnant, but all women of child bearing years where pregnancy is possible (planned or un-planned) Note: this is NOT a comprehensive list, but a good representation for exam purposes}There is a "compelling" indication in patients with hypertension and DM. These should be the 1st class