Sarah is a 50-year-old woman who stopped having her menstrualperiod 2 months ago. She presents today with complaints of hotflashes and changes to her complexion and her hair.
She says that she understands menopause is a natural part oflife, but that the hot flashes are reducing her quality of life,and that now she is having zits on her face—that come and go, andher hair has decreased in thickness and texture in just 2 months.She requests something for her signs and symptoms.
Sarah has no known allergies. She is healthy. No previoussurgeries. She had a mammogram 5 months ago that was normal.
There is no family history of strokes, breast or gynecologicalcancer.
On exam, she is a well-groomed female in no acute distress. Sheis 5 feet 7 inches tall and she weighs 135 pounds. Breast checkdone by you is normal; pelvic reveals a multi-parous os, nocervical motion tenderness, no bulkiness of the uterus or adnexalregions. There is a fishy aroma that you note on exam, with aclear-whitish vaginal discharge. Under the microscope you seetrichomonads.
You tell her that today, you will need to prescribe hersomething for her vaginal infection, and that you will prescribe asecond—on going prescription for her menopausal s/sx.
1. What drug and drug class would be the best choice in thisscenario? State name of drug and its mechanism of action. If thereis information from the patient’s history that was important inchoosing the agent [patient specific factors], cite those.
2, Cite any lab/diagnostic testing needed for before prescribingthat are required and any needed for monitoring. State patienteducation/counseling or side effect education that should beincluded. Note pertinent any drug-drug interactions, Black Boxwarnings and life span considerations?
