KINE 2475 Lecture Notes - Lecture 47: Night Sweats, Urinary Tract Infection, Social History

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Therapeutic alternative appendix: list the pharmacologic and non-pharmacologic options for the treatment of menopause. Pharmacologic options: cooling techniques (dressing in layers, using fans, lowering ambient temperatures, cognitive behavioural therapy to reduce vasomotor problems, weight loss. 10lb weight loss in those obese can reduce/eliminate vasomotor symptoms: exercise, yoga, acupuncture and paced breathing to reduce severity or frequency of menopausal symptoms, continuous combined therapy (estrogen/progesterone) if intact uterus, estrogen only hysterectomy. Estrogen for relief of vasomotor symptoms to decrease frequency & severity of hot flashes. Beginning w/dose of 0. 3mg of conjugated estrogens. A low initiating dose (<0. 625mg) requires longer duration of therapy to reach max efficacy. Combined hormonal contraceptives are options during perimenopause requiring contraception or control of irregular/heavy bleeding. Mpa dose for cyclic regimen is 5mg or 2. 5mgs daily for continuous regimen. Non-oral routes (transdermal gel, patch), passes first-pass metabolism by liver. Less increase of triglycerides level, reduced risk of vte, possibly stroke but not myocardial infarction.

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