Week 9 Discussion Post (response)

Read a selection of your colleagues’ responses from Week 9 and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.
Colleague Post:
Main Post:

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.

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Menopause occurs when a woman hasn’t menstruated in 12 consecutive months and can no longer become pregnant naturally. It usually begins between the ages of 45 and 55, but can develop before or after this age range. (Huizen 2020) Menopause can cause uncomfortable symptoms, such as hot flashes and weight gain. For most women, medical treatment isn’t needed for menopause. (Huizen 2020) An estimated 75 percent of women experience hot flashes with menopause. (Huizen 2020) Some genitourinary symptoms are vaginal dryness, vaginal burning, vaginal discharge, genital itching, burning with urination, and frequent urination. Vaginal dryness is also a common symptom of menopause. Vasomotor symptoms (hot flashes and night sweats) develop in about 70% of postmenopausal women. Episodes are characterized by sudden skin flushing, sweating, and a sensation of uncomfortable warmth. These episodes can occur at night, resulting in drenching sweats. (Rosenthal & Burchum, 2018)

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To help alleviate the patient’s symptoms of menopause we would do hormone therapy. Hormone therapy in postmenopausal women is the most common noncontraceptive use of estrogens. When estrogen is used for this purpose, it is usually accompanied by the use of progestins. Hundreds of clinical studies have provided evidence that systemic HT (estrogen with or without progestogen) effectively helps such conditions as hot flashes, vaginal dryness, night sweats, and bone loss. These benefits can lead to improved sleep, and sexual relations, and quality of life. (NAMS 2021) There are some risks associated with doing HT, with people who have a history of breast cancer, and heart disease etc. Although the patient herself has not had breast cancer but she has a family history of breast cancer. She also had a history of ASCUS about 5 years ago. Doing HT can increase the risk of her getting breast cancer although her recent pap smears have been cleared. I would recommend an alternative treatment.

I would recommend an estrogen topical.To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms. (Mayo Clinic 2021) To relieve vasomotor symptoms the patient can take low dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can\’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder. (Mayo Clinic 2021)

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References

Hormone therapy: Benefits & risks. Menopause Hormone Therapy (HT) Benefits & Risks, Menopause Relief | The North American Menopause Society, NAMS. (n.d.). https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-therapy-benefits-risks.

Mayo Foundation for Medical Education and Research. (2020, June 9). Hormone therapy: Is it right for you? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372.

Mayo Foundation for Medical Education and Research. (2020, October 14). Menopause. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401.

Person. (2020, January 13). What you need to know about menopause. Healthline. https://www.healthline.com/health/menopause#treatments.

Rosenthal, L., & Burchum, J. (2017). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-EBook. Elsevier Health Sciences.

SAMPLE SOLUTION

At old age, it’s essential to keep one’s weight checked. Overweight may result in hypertension. Blood pressure should be maintained between 90/60mmHg and 120/80mmHg.Breast cancer may be genetically transferred. Screening is essential for awareness. Treating hypertension includes the use of diuretics and| PLACE YOUR ORDER NOW AT writtask.com | months of not experiencing menstrual periods, signs and symptoms can be enough to indicate a menopausal transition. In the menopause phase, the women’s body produces less progesterone and | PLACE YOUR ORDER NOW AT writtask.com | levels are causes of virginal dryness, hot flashes, night sweats, vasomotor symptoms, and mood disorders (Nudyet al.,2020). Hormone therapy is essential for treating the symptoms of menopause; however, it does not apply to everyone. Women who have had…