NR 567 Final – Hormone Replacement Therapy for Osteoporosis Prevention, Estrogen and Progestin Clinical Decision-Making, Oral and Progestin-Only Contraceptive Management, Androgen and Testosterone Replacement Therapy, Erectile Dysfunction and Benign Prost

NR 567 Final – Hormone Replacement Therapy for Osteoporosis Prevention, Estrogen and Progestin Clinical Decision-Making, Oral and Progestin-Only Contraceptive Management, Androgen and Testosterone Replacement Therapy, Erectile Dysfunction and Benign Prostatic Hyperplasia Pharmacotherapy, Sexually Transmitted Infection Treatment Guidelines, Parkinson’s Disease Medication Management, and Antiepileptic Drug Selection with Contraceptive Considerations Comprehensive Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Prevention of Osteoporosis with Hormone Replacement Therapy Estrogen therapy helps maintain bone density and prevent osteoporosis in postmenopausal women. HRT is only recommended when the benefits outweigh risks When/when not to use progestin for HRT Should be added to estrogen therapy in women with an intact uterus to prevent endometrial hyperplasia and reduce risk of endometrial cancer. UNNECESSARY IN WOMEN WITHOUT A UTERUS What are local estrogen options and what are they used for ex: vaginal rings and creams, used for GU symptoms like vaginal dryness without significant systemic effects What are system estrogen options and what are they used for ex: transdermal patches and oral formulations, used for generalized menopausal symptoms such as hot flashes and prevention of osteoporosis What are transdermal estrogen options and what are they used for has fewer adverse effects compared to oral estrogen and has a reduced risk of venous thromboembolism and stroke What Selective Estrogen Receptor Modulator (SERM) is used to treat osteoporosis Bazedoxifene, benefits bones and protects against breast cancer How do you change a patient from one combo oral contraceptive (OC) to another Switch after the last active pill of the previous pack without a break How to start OC treatment best to start on the first day of menstruations or the first Sunday after menstruations. If started mid-cycle, backup contraption should be used for a week What to educate patients on when taking OCs Importance of adherence, what to do if dose is missed, and potential side effects ex: nausea, breakthrough bleeding What baseline data is need to start OCs blood pressure and thorough medical history to assess for contraindications ex: hx of thromboembolic disease How to suggest the appropriate birth control method Consider the patients health status, risk of thromboembolism, preference for daily vs long term contraception What effect do CYP450 inhibitors have on OCs ex: grapefruit juice and erythromycin. Increase the level of estrogen which increases the risk of adverse effects What effect do CYP450 inducers have on OCs ex: rifampin and phenytoin. Reduces the effectiveness of OCs which increase the risk for pregnancy. Use a backup benefits of progestin only contraceptives safe for women who are breastfeeding or at risk for estrogen related complications (thromboembolism) Drawbacks of Progestin-only contraception must be taken at the same time each day with strict adherence, higher incidence of breakthrough bleeding Whats the most effective forms of contraception long acting reversible contraceptives ex: IUDs and implants. 99% effective How can testosterone be administered? Gels, patches, or IM injections benefits of testosterone replacement Increased energy, improved libido, and muscle mass in men with hypogonadism Patient teaching for testosterone replacement Proper application of transdermal preparations, and potential side effects like acne and changes in mood What's the treatment of delayed puberty? Androgen therapy is initiated when there's a confirmed delayed puberty typically starting at 12-14 years old short courses are used to jumpstart puberty Therapeutic effects of androgen therapy Increased muscle mass, bone density, and red blood cell production Adverse effects of androgen therapy Acne increased cholesterol levels and liver toxicity with oral forms What monitoring is done for Androgen therapy Hematocrit liver enzymes and cholesterol levels