Breast cancer is not just a disease that strikes at women. It strikes at the very heart of who we are as women: how others perceive us, how we perceive ourselves, how we live, work, and raise our families—or whether we do these things at all.
–Debbie Wasserman Schultz
This sentiment that Schultz expressed is true for many disorders associated with women’s and men’s health such as hormone deficiencies, cancers, and other functional and structural abnormalities. Disorders such as these not only result in physiological consequences but also psychological consequences such as embarrassment, guilt, or profound disappointment for patients. For these reasons, the provider-patient relationship must be carefully managed. During evaluations, patients must feel comfortable answering questions so that you, as a key health-care provider, will be able to diagnose and recommend appropriate treatment options. Advanced practice nurses must be able to educate patients on these disorders and help relieve associated stigmas and concerns. Pharmacology Discussion And Hormone Replacement Therapy Essay Paper
This week, as you examine women’s and men’s health issues, you focus on treatments for hormone deficiencies and cancer. You also explore preventive services for women’s and men’s health.
Learning Objectives
By the end of this week, students will:
Evaluate the strengths and limitations of hormone replacement therapy
Evaluate treatments for hormone deficiencies
Analyze preventive services for women’s and men’s health
Analyze drug treatments for cancer patients
Evaluate implications of cancer drug treatments on patients
Understand and apply key terms, concepts, and principles related to prescribing drugs to treat disorders associated with women’s and men’s health
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Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week\’s assigned Learning Resources. To access select media resources, please use the media player below.
Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 33, “Prostatic Disorders and Erectile Dysfunction” (pp. 527-544)
This chapter examines the causes, pathophysiology, and drug treatment of four disorders: prostatitis, benign prostatic hyperplasia, prostate cancer, and erectile dysfunction. It also explores the importance of monitoring patient response and patient education.
Chapter 34, “Overactive Bladder” (pp. 545-564)
This chapter describes the causes, pathophysiology, diagnostic criteria, and evaluation of overactive bladder. It also outlines the process of initiating, administering, and managing drug treatment for this disorder.
Chapter 55, “Contraception” (pp. 959-970)
This chapter examines various methods of contraception and covers drug interactions, selecting the most appropriate agent, and monitoring patient response to contraceptions.
Chapter 56, “Menopause” (pp. 971-994)
This chapter presents various options for menopausal hormone therapy and examines the strengths and limitations of each form of therapy.
Chapter 57, “Osteoporosis” (pp. 985-994)
This chapter covers various options for treating osteoporosis. It also describes proper dosages, potential adverse reactions, and special considerations of each drug. Pharmacology Discussion And Hormone Replacement Therapy Essay Paper
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Chapter 58, “Vaginitis” (pp. 995-1006)
This chapter examines various causes of vaginitis and explores the diagnostic criteria and methods of treatment for the disorder.
Roberts, H. & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53-58. https://doi.org/10.1016/j.maturitas.2016.01.007
Note: Retrieved from the Walden Library databases.
This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction and mood disturbance are common during the menopause transition.
Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., &
Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5-15. doi: 10.3109/13685538.2015.1004049
Note: Retrieved from the Walden Library databases.
Mäkinen, J. I., & Huhtaniemi, I. (2011). Androgen replacement therapy in late-onset hypogonadism: Current concepts and controversies—A mini-review. Gerontology, 57(3), 193–202.
Note: Retrieved from the Walden Library databases.
This article examines the role of testosterone levels in the development of hypogonadism. It also explores health issues that are impacted by testosterone levels and the role of testosterone replacement therapy.
Drugs.com. (2012). Retrieved from http://www.drugs.com/
This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
U.S. Preventive Services Task Force. (2014). The Guide to Clinical Preventive Services: Section 2. Recommendations for Adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html
This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.
Optional Resources
Refer to the Optional Resources listed in Week 1.
Discussion: Hormone Replacement Therapy
In recent years, hormone replacement therapy has become a controversial issue. When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.
Consider the following scenario:
As an advanced practice nurse at a community health clinic, you often treat female (and sometimes male patients) with hormone deficiencies. One of your patients requests that you prescribe supplemental hormones. This poses the questions: How will you determine what kind of treatment to suggest? What patient factors should you consider? Are supplemental hormones the best option for the patient, or would they benefit from alternative treatments?
To prepare:
Review Chapter 56 of the Arcangelo and Peterson text, as well as the Roberts and Hickey (2016), Lunenfeld et al (2015), and Makinen and Huhtaniemi (2011) articles in the Learning Resources.
Review the provided scenario and reflect on whether or not you would support hormone replacement therapy.
Locate and review additional articles about research on hormone replacement therapy for women and/or men. Consider the strengths and limitations of hormone replacement therapy.
Based on your research of the strengths and limitations, again reflect on whether or not you would support hormone replacement therapy.
Consider whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies.
With these thoughts in mind:
By Day 3
Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why. Pharmacology Discussion And Hormone Replacement Therapy Essay Paper
Pharmacology Discussion: Hormone Replacement Therapy
Introduction
Hormone replacement therapy (HRT) has been used for a relatively long time. However, prescription of HRT has become controversial due to the benefits and risks associated with the therapy. This discussion will discuss the risk and benefits of HRT and make a stand regarding hormone replacement therapy.
Benefits
HRT has been shown to prevent hot flushes and night sweats among menopausal women. In addition, evidence shows that HRT prevents bone loss for individuals at a higher risk of cardiovascular disorders and osteoporosis (Sood et al, 2014). Bone loss can start 4 years prior to the menopause and therefore estrogen administration has been shown to prevent osteoporosis in this population. Similarly, evidence has shown that estrogen protects against heart disease; for example, a study conducted by Newson (2016) showed that estrogen therapy reduced the prevalence of stroke and coronary heart disease by 50-70 percent. HRT has also been shown to delay and decrease the risk of Alzheimer’s disease.
Risks
HRT has been shown to increase the risk of gallbladder disease, ovarian cancer, breast cancer, among other risks. HRT increases the risk for gallbladder disease by elevating the cholesterol permeation of the bile. HRT increases the risk of ovarian cancer and breast cancer particularly due to estrogen administration (Wise, 2016). Other risks associated with HRT include increasing high blood pressure, precipitating myocardial infarction, porphyria, vaginal bleeding, thromboembolic disease, as well as changes in liver function (Newson, 2016.
Position
The risks associated with hormonal replacement therapy outweigh the benefits associated with the therapy. Therefore, I would not prescribe HRT but would recommend alternative treatments to patients with hormone deficiencies.
Conclusion
The benefits of hormonal replacement therapy include preventing hot flushes and night sweats, osteoporosis, and also preventing stroke and coronary heart disease. On the other hand, the risks associated with HRT include ovarian cancer, gallbladder disease, hypertension, myocardial infarction, porphyria, vaginal bleeding, thromboembolic disease, and changes in liver function.
References
Newson L. (2016). Best practice for HRT: unpicking the evidence. Br J Gen Pract. 66(653), 597–598.
Sood R, Faubion S, Kuhle C, Thielen J & Shuster L. (2014). Prescribing menopausal hormone therapy: an evidence-based approach. Int J Womens Health. 1(6), 47–57.
Wise J. (2016). Combined HRT may raise breast cancer risk, study finds. BMJ. 354(2). Pharmacology Discussion And Hormone Replacement Therapy Essay Paper