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ADVANCED PHARMACOLOGY NSG 533
2025 BRAND NEW ACTUAL EXAM WITH
ANSWERS.
Progestin Only oral contraceptives - correct answer -- indicated in
Breastfeeding (post-partum phase), older women, women who
cannot take estrogen
The failure rate is higher than other progestin-only methods or
COCs
Effectiveness is lowered when taken as little as a few hours late
DM I/II/GDM in pregnancy: - correct answer -DM I / II / GDM
TreatmentADA diet
Insulin - drug of choice
Regular insulin or NPH
Insulin lispro (Humalog)
Insulin aspart (Novolog)◦Insulin requirements will increase
beginning around 28 weeks gestation and continue to increase
due to placental hormones
Increasing data on safety of insulin glargine in pregnancy
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Oral agents (metformin / glyburide) 2nd line. Reasonable
alternative for women who decline to take, or are unable to
comply with, insulin therapy.
HTN in pregnancy: - correct answer -HTN
when SBP reaches 160 or DBP reaches 110
Continue treatment when multiple hypertensive's were required
before pregnancy or when end organ damage is present
methyldopa / labatolol / nifedipine ER 1st line
Hypothyroidism in pregnancy: - correct answer -hypothyroidism
◦Levothyroxine - DOC
◦Attain normal thyrotropin concentrations
◦Women who received thyroid replacement prior to pregnancy
can expect an increased dosage requirement of 25-50% during
pregnancy
Depression in pregnancy: - correct answer -depression
Pregnant patients with severe unipolar major depression who
were successfully treated with antidepressants prior to pregnancy
should generally receive the same drug during pregnancy. For
patients who have not been treated with antidepressants in the
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past, we suggest selective serotonin reuptake inhibitors (SSRIs)
as initial treatment, rather than other antidepressants
No psychotropic drugs with labeling approved by the FDA for use
during pregnancy and lactation
1st line - psychotherapy, but not always an option
SSRI's
◦Avoid paroxetine (D) during first trimester
CV malformations
◦Fluoxetine (C) citalopram (C) sertraline (C) -->Literature is
reassuring, best data for use during pregnancy
◦Risk of PPHTN after 20 weeks gestation with SSRI's
◦Risk of neonatal withdrawal or adaptation syndrome1
d/c 2 weeks before term
TCA's
◦Literature is reassuring
◦Possible withdrawal symptoms
Atypical antidepressants
◦Limited data
Dyslipidemia in pregnancy: - correct answer -Dyslipidemia
Women who are on statin therapy and anticipate becoming
pregnant should stop statins three months prior to attempting to
conceive.
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Maternal consumption of fish and marine omega-3 fatty acid
supplement is an active area of investigation because of potential
favorable effects on pregnancy and offspring outcome.
Menopause nonpharmacological interventions: - correct answer -
Goals - Alleviate or reduce symptoms, Improve QOL, Minimize
ADRs
Non-pharmacological interventions - avoid vasomotor triggers (hot
beverage, spicy food, EToh, etc), exercise, water based lubricants
Pharmacotherapy menopause - correct answer -
Pharmacotherapy - hormone therapy remains the most effective
treatment for vasomotor symptoms and vulvovaginal atrophy,
especially in women with moderate to severe symptoms, provided
there is not CHD, significant CHD risk factors or history of breast
cancer
Oral Estrogens - correct answer -FDA approved for moderate to
severe vasomotor symptoms, vulvovaginal atrophy and
prevention of post-menopausal osteoporosis.
Note, oral estrogens should NOT be used for osteoporosis
prevention in the absence of vasomotor symptoms of menopause
or for patients with local symptoms ONLY
ADVANCED PHARMACOLOGY NSG 533
2025 BRAND NEW ACTUAL EXAM WITH
ANSWERS.
Progestin Only oral contraceptives - correct answer -- indicated in
Breastfeeding (post-partum phase), older women, women who
cannot take estrogen
The failure rate is higher than other progestin-only methods or
COCs
Effectiveness is lowered when taken as little as a few hours late
DM I/II/GDM in pregnancy: - correct answer -DM I / II / GDM
TreatmentADA diet
Insulin - drug of choice
Regular insulin or NPH
Insulin lispro (Humalog)
Insulin aspart (Novolog)◦Insulin requirements will increase
beginning around 28 weeks gestation and continue to increase
due to placental hormones
Increasing data on safety of insulin glargine in pregnancy
, Page | 2
Oral agents (metformin / glyburide) 2nd line. Reasonable
alternative for women who decline to take, or are unable to
comply with, insulin therapy.
HTN in pregnancy: - correct answer -HTN
when SBP reaches 160 or DBP reaches 110
Continue treatment when multiple hypertensive's were required
before pregnancy or when end organ damage is present
methyldopa / labatolol / nifedipine ER 1st line
Hypothyroidism in pregnancy: - correct answer -hypothyroidism
◦Levothyroxine - DOC
◦Attain normal thyrotropin concentrations
◦Women who received thyroid replacement prior to pregnancy
can expect an increased dosage requirement of 25-50% during
pregnancy
Depression in pregnancy: - correct answer -depression
Pregnant patients with severe unipolar major depression who
were successfully treated with antidepressants prior to pregnancy
should generally receive the same drug during pregnancy. For
patients who have not been treated with antidepressants in the
, Page | 3
past, we suggest selective serotonin reuptake inhibitors (SSRIs)
as initial treatment, rather than other antidepressants
No psychotropic drugs with labeling approved by the FDA for use
during pregnancy and lactation
1st line - psychotherapy, but not always an option
SSRI's
◦Avoid paroxetine (D) during first trimester
CV malformations
◦Fluoxetine (C) citalopram (C) sertraline (C) -->Literature is
reassuring, best data for use during pregnancy
◦Risk of PPHTN after 20 weeks gestation with SSRI's
◦Risk of neonatal withdrawal or adaptation syndrome1
d/c 2 weeks before term
TCA's
◦Literature is reassuring
◦Possible withdrawal symptoms
Atypical antidepressants
◦Limited data
Dyslipidemia in pregnancy: - correct answer -Dyslipidemia
Women who are on statin therapy and anticipate becoming
pregnant should stop statins three months prior to attempting to
conceive.
, Page | 4
Maternal consumption of fish and marine omega-3 fatty acid
supplement is an active area of investigation because of potential
favorable effects on pregnancy and offspring outcome.
Menopause nonpharmacological interventions: - correct answer -
Goals - Alleviate or reduce symptoms, Improve QOL, Minimize
ADRs
Non-pharmacological interventions - avoid vasomotor triggers (hot
beverage, spicy food, EToh, etc), exercise, water based lubricants
Pharmacotherapy menopause - correct answer -
Pharmacotherapy - hormone therapy remains the most effective
treatment for vasomotor symptoms and vulvovaginal atrophy,
especially in women with moderate to severe symptoms, provided
there is not CHD, significant CHD risk factors or history of breast
cancer
Oral Estrogens - correct answer -FDA approved for moderate to
severe vasomotor symptoms, vulvovaginal atrophy and
prevention of post-menopausal osteoporosis.
Note, oral estrogens should NOT be used for osteoporosis
prevention in the absence of vasomotor symptoms of menopause
or for patients with local symptoms ONLY
