provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples
Week 9 Initial Post- Mel Mal,
Top of Form
This case study presents a particularly hard case to untangle. The 46-year-old women is exhibiting the night sweats, hot-flushing, and genitourinary symptoms common in menopause. The patient is still getting a regular period, so these symptoms are most likely pre-menopausal, as periods stop in true menopause. In a patient with no familial history increasing the patient’s risk for breast cancer, an estrogen or combination estrogen/progestin therapy would most likely be initiated (Rosenthal et al. 2021). This therapy would likely reduce the uncomfortable symptoms, however in a patient with a family history of breast cancer, the therapy can increase the likelihood of breast cancer occurrence.
Luciano et al., found that both estrogen therapies and combined estrogen/progestin therapies increased the risk for breast cancer (2020). It is important to notice that this study notes that the risks for patients who take the therapy on a short-term basis are at a slightly lower risk, however this patient is young at 46 years old and would possibly need a long-term medication solution.
On the opposite side, Carr summarizes the North American Menopause society’s 2022 updated guidelines on hormonal replacement therapy and explains that a patient with menopausal symptoms can take combined hormone therapy until at least the mean age of menopause (53) without any significant increase in breast cancer (2022). With the newest recommendations, I would recommend that the patient start a combined estrogen and progestin hormone therapy for reduction in symptoms. With this recommendation is the caveat that the patient will need regular visits to re-evaluate the need for the therapy with hopeful cessation of treatment within three to five years to keep any increase in breast cancer risk to a minimum.
The lowest dose medication should be used for the shortest time period in order to reduce comorbidity risk so this patient recommendation will be to start Prempro 0.3mg/1.5mg daily and then reevaluate for effectiveness and need to increase dosage (Rosenthal et al., 2021).
The patient also needs adjustments in her hypertension medication. The patient is currently on Norvasc 10mg daily, and HCTZ 25mg daily. This therapy is within guidelines because she is on Norvasc, a calcium-channel blocker, and Hydrochlorothiazide, a thiazide diuretic, are being used to potentiate each other’s effects. In cases where a thiazide diuretic is ineffective in controlling HTN, a loop diuretic may be added. In this patient, we will recommend adding Furosemide to hopefully control the hypertension. This dosage will start low, at 20mg daily, (taken in the morning to decrease nocturia), with regular home blood pressure checks as well as in office re-evaluation to determine how effective the medication and dosage are (Rosenthal et al., 2021).
This patient would benefit from educational strategies that address medication adherence, as well as lifestyle and nutrition choices. The patient is 230 pounds, which most likely indicates an unhealthy weight. Education on cardio exercises, as well as eating a healthy and balanced diet to help control her weight would be a good starting point. The patient also needs specific education on the importance of taking her medications every day, with explanations that she will not have level and even control of her symptoms and blood pressure if she does not adhere correctly.
References:
-Carr, L. (2022). NAMS: New hormone therapy guidelines.  Contemporary OB/GYN,  67(9), 27.
-Hill, D. A., Crider, M., & Hill, S. R. (2016). Hormone Therapy and Other Treatments for Symptoms of Menopause.  American Family Physician,  94(11), 884–889.
-Luciano de Melo Pompei, & César Eduardo Fernandes. (2020). Hormone Therapy, Breast Cancer Risk and the Collaborative Group on Hormonal Factors in Breast Cancer Article.  Revista Brasileira de Ginecologia e ObstetrÃcia,  42(5), 233–234. https://doi.org/10.1055/s-0040-1712941
-Rosenthal, L. D., & Burchum, J. R. (2021).  Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Bottom of Form
MI JON KIM
A 46-year-old woman presents typical symptoms and physical changes of menopause; hot flushing, night sweats, and genitourinary symptoms. Menopause, simply menstruation cease, means decreasing the body’s production of estrogen. Lack of estrogen in the body causes discomfort to women who never experience it before. Roberts and Hickey (2016) described the physiological changes during women’s menopause transition; “Vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction and mood disturbance†(p. 53). Menopause in women begins at the approximate age of 51 to 52 years, with 95% of women entering menopause between the ages of 45 and 55 years (Rosenthal & Burchum, 2021). And they suggest the moderate dose estrogen-containing hormone replacement therapy (HRT) as the most effective treatment. The patient, however, has a family history of breast cancer and hypertension and is overweight (230 lbs.). Considering the hormonal replacement therapy for the patient needs the evaluation for the patient’s comorbidity and the interaction with the patient’s current hypertension medication adjustment with the blood pressure monitoring.
Types of treatment regimen you would recommend for treating the patient
There are three recommended treatment therapies for managing menopause; hormone replacement therapy (HRT), symptomatic medication management, and alternative therapy, including improving a healthy lifestyle, such as sleep hygiene, exercise, smoking cessation, and diet changes. First, “Estrogen used alone (estrogen replacement therapy [ERT]) or with the addition of progesterone (hormone replacement therapy [HRT]) is known to be effective in reducing menopausal symptoms including hot flashes, vaginal dryness, and urinary symptoms†(Pritchard, 2001, para 1). However, hormonal therapy increases the risk of cancer, hypertension, heart disease, and stroke. Low-dose HR of estrogen only or mixed with progesterone in a short period is recommended for healthy women between the ages of 50 to 59 (Roberts & Hickey, 2016). So, it should be informed for patients to decide the balance between benefits and risks. Second, there is a symptomatic medication to relieve the vasomotor symptoms (VMS) of hot flush & night sweats. Other than estrogen, some antidepressants- selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI)-can decrease the VSM (Rosenthal & Burchum, 2021). Lastly, the natural way of alternative therapy for handling menopause is more desirable because menopause is a normal process of aging. The goal for the menopause transition is to increase the quality of life by adjusting lifestyle through diet, exercise, and patterns of life.
Patient education strategy recommend for assisting the patient
Education is the most critical part of managing the menopause transition for women. One education strategy is to give patients the correct information, possible options, related benefits, and risks related to treatment. Suppose the patient fully understands the relationship between menopause and other health issues, such as hypertension, obesity, increased cholesterol level, risk of cardiovascular disease, and stroke (“Menopause and hypertension,” 2008). In that case, the patient is willing to change unhealthy patterns of daily life. If they learn that estrogen binds to the receptor in the cell membrane, stimulates cell overgrowth & proliferation, and finally might develop cancer cells, they would choose natural ways of improving rather than hormonal replacement. The role of health providers is to advocate for people’s quality of life and safety. Informed health decision-making is the essential strategy and priority in interactions between health providers and patients.
Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?
Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.
Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.
Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.
Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!
While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.
Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.
In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.
Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.
We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!
We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.
Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.
We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.
Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.
There is a very low likelihood that you won’t like the paper.
Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.
We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.
You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.
We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.
You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.
Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.
You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.
The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.
GET A PERFECT SCORE!!! 
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.
Read moreEach paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.
Read moreThanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.
Read moreYour email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.
Read moreBy sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.
Read more