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Pharmacology Week 11
Pharmacology Urogenital Drug Therapy
| Question | Answer |
|---|---|
| Which phrase accurately describes the mechanism of action and roles of conjugated equine estrogens (CEEs) in hormone replacement therapy? | Binds to nuclear receptors in estrogen-sensitive tissues to replenish low hormone levels in menopause |
| Which statements accurately describe the pharmacokinetic parameters of oral conjugated equine estrogens (CEEs)? | - The drug is well absorbed with oral administration. - CEE undergoes hepatic metabolism. - The drug is subject to enterohepatic recirculation when given orally |
| Which statement is accurate regarding the absorption of testosterone? | Oral absorption of testosterone may be reduced when it is taken with food. |
| Which statement is accurate regarding the pharmacokinetic profile of sildenafil? | The drug is metabolized by CYP3A4 and CYP2C9 |
| Which conditions may lead to organic erectile dysfunction (ED)? | Arteriosclerosis Diabetes Hormonal imbalance Penile disorders Vascular insufficiency |
| Which time frame describes how long sildenafil’s effects last? | 4 to 6 hours |
| Which type of urinary incontinence is treated with a β3-adrenergic agonist? | Urge |
| Which statements accurately describe the pharmacokinetic parameters of conjugated equine estrogens (CEE) vaginal cream? | - Topical CEE cream is well-absorbed through mucosal membranes in the vagina. - Topical CEE is highly protein bound. - The drug undergoes hepatic metabolism. |
| In which time frame can a patient expect to experience duloxetine’s onset of action? | 2 to 6 weeks |
| Which urogenital drug works through inhibition of the enzyme 5-alpha-reductase? | Finasteride |
| Which statements accurately describe the pharmacokinetic parameters of tamsulosin? | -Following oral administration, absorption is almost complete - The drug is highly protein bound (94% to 99%) and is widely distrib - Tamsulosin is extensively metabolized through the CYP450 system. - The drug is predominantly excreted in the urine. |
| Which patient parameters would a nurse ensure are assessed before a male patient begins therapy with intramuscular testosterone for testosterone deficiency? | - Lipid panel - Liver function - Complete blood counts - Total testosterone levels |
| Which patients would a nurse determine can safely receive treatment with oral conjugated equine estrogens (CEE)? | - A patient with type 2 diabetes mellitus - A patient with osteoporosis |
| Match the testosterone formulation with its appropriate administration technique 1. Inserted by health care provider 2. Take by mouth with or without food 3. Inject deeply into gluteal muscle 4. Apply to underarms | 1. Fortesta® 2. Buccal testosterone 3. Testosterone pellets 4. Methyltestosterone |
| A patient who was newly prescribed oral conjugated equine estrogens (CEE) is also taking levothyroxine and carbamazepine. Which drug interaction would a nurse determine may occur when the patient begins taking CEE? | Concomitant administration of carbamazepine and CEE may lead to decreased levels of CEE, necessitating a dosage increase in CEE. |
| A nurse is caring for a patient who has been prescribed sildenafil 50 mg orally 1 hour before sexual activities. The patient also takes simvastatin (for dyslipidemia), isosorbide dinitrate (for angina), aspirin (for heart disease prevention), and nicotine | Isosorbide dinitrate |
| Which patient parameters would a nurse ensure are assessed before a patient receives therapy with sildenafil? | - Sexual history - Cardiovascular history - Blood pressure and heart rate |
| Which patient parameters would a nurse identify as potentially requiring a lower dosage of sildenafil? | - A 72-year-old patient with dyslipidemia - A 67-year-old patient with alcoholic cirrhosis - A 64-year-old patient receiving ketoconazole - A 61-year-old patient with a creatinine clearance of 20 mL/min |
| Which interventions are important for a nurse to make in a patient with benign prostatic hyperplasia (BPH) who has been prescribed both tamsulosin and finasteride? | - Blood pressure assessment - Prostate-specific antigen (PSA) level assessment |
| A nurse is providing care to a patient who has been prescribed the oxybutynin transdermal patch. Which administration steps should be shared with the patient to ensure the drug is used correctly? | - The patch should be applied to clean, dry skin on the abdomen, hips, or buttocks. - To discard the patch, fold the sticky sides of the patch together and throw it away. - The patch should not be placed on skin where lotions, oils, or powders have been |
| Which patients would a nurse determine can safely receive therapy with topical conjugated equine estrogen (CEE) for stress urinary incontinence? | - A patient with osteoporosis - A patient with hyperkalemia - A patient who had back surgery 6 months ago |
| A patient who has been prescribed mirabegron also takes aspirin and digoxin. Which potential drug interaction would a nurse suspect may occur with the administration of mirabegron? | Digoxin and mirabegron is associated with an increase in digoxin levels, potentially requiring a dosage reduction. |
| Place the steps in the order a patient would follow to appropriately administer topical CEE therapy. | Remove the cap from the tube of cream. Screw the nozzle end of the application to the tube. Gently squeeze the cream from the bottom of the tube into the applicator to the indicated line. After unscrewing the applicator from the tube, lie on your ba |
| Which statements regarding the pharmacokinetic parameters of medroxyprogesterone acetate is accurate? | - Food increases the drug’s bioavailability. - Medroxyprogesterone acetate is 90% protein bound. - The drug undergoes hepatic metabolism involving hydroxylation and conjugation. |
| Which formulation of testosterone has the longest elimination half-life? | Intramuscular testosterone cypionate |
| Which phrases accurately describe the mechanism of action and roles of medroxyprogesterone acetate in hormone replacement therapy? | - Protects against endometrial proliferation, which can cause cancer - Causes a transition in the endometrium from the proliferative to the secretory phase - |
| Which time frame describes when oral conjugated equine estrogens (CEE) should reach the peak plasma concentration? | 6 to 10 hours |
| Which drugs are type 5 phosphodiesterase (PDE5) inhibitors used to treat erectile dysfunction (ED)? | - Avanafil - Sildenafil - Tadaladil - Vardenafil |
| Which statements accurately describe what occurs normally within the body during an erection? | - During the nonerect state, arterial blood flow into the penis is equal to venous outflow into the body. - Acetylcholine increases the production of nitric oxide from endothelial cells. - Nitric oxide activates guanine cyclase, which produces cyclic gu |
| In which time frame can a patient expect sildenafil to begin working? | 30 to 60 minutes |
| Which statement by the nursing student about benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) therapy requires further intervention? | Sildenafil is a 5-alpha-reductase inhibitor that causes smooth muscle constriction, allowing increased blood flow into the penis. |
| Which statement about the pharmacokinetic parameters of finasteride is accurate? | Finasteride is excreted in both the urine and the feces. |
| Which mechanism of action describes how pseudoephedrine works to treat stress urinary incontinence? | Alpha1-adrenergic agonism |
| Which statements regarding the pharmacokinetic parameters of oxybutynin are accurate? | - Gels and patches allow for passive diffusion of oxybutynin across the skin. - Oxybutynin is widely distributed in tissues. - The drug is hepatically metabolized, with most metabolism occurring through CYP3A4. - A small amount of the administered oxyb |
| Which statement regarding the pharmacodynamics and pharmacokinetics of mirabegron is accurate? | Mirabegron undergoes extensive metabolism that involves CYP2D6 and CYP3A4. |
| Which patient parameters would a nurse ensure are assessed before a female patient begins therapy with oral conjugated equine estrogens and medroxyprogesterone acetate for menopausal symptoms? | - Smoking status - Complete gynecologic history, including if she has an intact uterus. - History of or current thromboembolism - Patient and family history of hormone-sensitive cancers |
| Which patient education points are important for a nurse to share with a patient who has been prescribed buccal testosterone 30 mg twice daily? | - The old tablet should be removed before applying a new one. - It may take the drug about 30 seconds for the drug to be applied. - The tablet should be placed above the incisor tooth, adhering to the gum. |
| Which teaching points would the nurse share with a patient who had a hysterectomy and is newly prescribed conjugated equine estrogen (CEE)? | - The patient may experience depressive symptoms or mood changes with CEE therapy. - CEE increases the risk for deep vein thrombosis and stroke and should be used for the shortest amount of time. |
| CEE increases the risk for deep vein thrombosis and stroke and should be used for the shortest amount of time. | - The drug will not work without adequate sexual stimulation. - The drug should be administered about an hour before sexual activities. - The patient should report any dizziness, chest pain, or blood pressure changes to the health care provider. |
| A nurse is providing care to a patient with benign prostatic hyperplasia and erectile dysfunction who is receiving both sildenafil and tamsulosin. Which potential outcome may result from the two drugs being taken together? | hypotension |
| A patient with hyperthyroidism, prostate cancer, type 2 diabetes mellitus, and status post myocardial infarction 9 months ago is in clinic to see if he is able to receive sildenafil for erectile dysfunction. Which of the patient’s medical conditions would | Status post myocardial infarction |
| Which patients would a nurse determine cannot safely receive therapy with duloxetine for stress urinary incontinence? | - A patient with alcoholism - A patient with hepatitis B - |
| A patient with stress urinary incontinence is prescribed duloxetine 40 mg PO BID. The patient also takes paroxetine (for depression), ibuprofen (for osteoarthritis), lisinopril (for hypertension), atorvastatin (for dyslipidemia), and famotidine (for gastr | - Ibuprofen due to an increased risk for bleeding - Paroxetine due to an increased risk for serotonin syndrome |
| Which patient teaching points would a nurse to share with a female patient prescribed pseudoephedrine for stress urinary incontinence? | - Advise the patient to check her blood pressure at home. - The drug should be taken as prescribed, not taking more or less than what was prescribed - The patient should avoid taking the drug late in the day or early evening because it may cause jitteri |
| Which counseling point would a nurse share with a patient who has been newly prescribed oxybutynin 10% gel 1 sachet once daily? | Smoking should not occur when applying topical oxybutynin. |
| Which patient parameter would a nurse closely monitor in a patient who is taking mirabegron? | Blood pressure |
| Which patient education point would a nurse share with a patient who has been newly prescribed tamsulosin for benign prostatic hyperplasia? | Do not crush, chew, or cut open the capsules. |
Created by:
Brandi Sizemore
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