Podcast
Questions and Answers
A premenopausal client is prescribed raloxifene for breast cancer prevention. What potential side effect should the nurse include in the client's education?
A premenopausal client is prescribed raloxifene for breast cancer prevention. What potential side effect should the nurse include in the client's education?
- Weight gain
- Increased appetite
- Hot flashes (correct)
- Decreased libido
A client taking raloxifene reports sudden onset chest pain and difficulty breathing. What is the priority nursing action?
A client taking raloxifene reports sudden onset chest pain and difficulty breathing. What is the priority nursing action?
- Notify the primary care provider immediately. (correct)
- Administer oxygen and monitor vital signs.
- Reassure the client and assess pain level.
- Instruct the client to perform deep breathing exercises.
Which condition would be a contraindication for a client considering raloxifene therapy?
Which condition would be a contraindication for a client considering raloxifene therapy?
- Osteoporosis
- Elevated serum lipid levels
- History of deep vein thrombosis (correct)
- Family history of breast cancer
A client who is on raloxifene develops a deep vein thrombosis. What is the most appropriate action?
A client who is on raloxifene develops a deep vein thrombosis. What is the most appropriate action?
Why is concurrent administration of raloxifene and estrogen not recommended?
Why is concurrent administration of raloxifene and estrogen not recommended?
Why is raloxifene generally preferred over tamoxifen by primary care providers for postmenopausal women?
Why is raloxifene generally preferred over tamoxifen by primary care providers for postmenopausal women?
A postmenopausal woman is prescribed raloxifene. Which instruction should the nurse emphasize regarding lifestyle modifications?
A postmenopausal woman is prescribed raloxifene. Which instruction should the nurse emphasize regarding lifestyle modifications?
A client taking raloxifene reports sudden onset of shortness of breath and chest pain. What is the priority nursing intervention?
A client taking raloxifene reports sudden onset of shortness of breath and chest pain. What is the priority nursing intervention?
Raloxifene's mechanism of action involves:
Raloxifene's mechanism of action involves:
Which of the following findings would warrant immediate discontinuation of raloxifene?
Which of the following findings would warrant immediate discontinuation of raloxifene?
A patient with a history of deep vein thrombosis (DVT) is asking about options for managing her osteoporosis. What information is most important to consider?
A patient with a history of deep vein thrombosis (DVT) is asking about options for managing her osteoporosis. What information is most important to consider?
A client of childbearing age is prescribed raloxifene. What is the most important instruction to provide regarding pregnancy?
A client of childbearing age is prescribed raloxifene. What is the most important instruction to provide regarding pregnancy?
Which laboratory value is most important to monitor in a client receiving raloxifene therapy?
Which laboratory value is most important to monitor in a client receiving raloxifene therapy?
Flashcards
Raloxifene Side Effect
Raloxifene Side Effect
Hot flashes can be a side effect of raloxifene in premenopausal women.
SERM Blood Clot Risk
SERM Blood Clot Risk
Report leg or chest pain with breathing difficulty immediately; could indicate a blood clot.
SERMs and Pregnancy
SERMs and Pregnancy
SERMs are unsafe during pregnancy and breastfeeding due to teratogenic effects.
SERMs and DVT History
SERMs and DVT History
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SERMs and Estrogen
SERMs and Estrogen
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SERMs
SERMs
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Primary therapeutic uses of SERMs
Primary therapeutic uses of SERMs
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Prototype SERM
Prototype SERM
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Pharmacologic Action of SERMs
Pharmacologic Action of SERMs
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Serious Adverse Effects of Raloxifene
Serious Adverse Effects of Raloxifene
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SERMs and Pregnancy/Breastfeeding
SERMs and Pregnancy/Breastfeeding
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Nursing Interventions for SERMs
Nursing Interventions for SERMs
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Client Instructions for SERMs
Client Instructions for SERMs
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Study Notes
- Selective Estrogen Receptor Modulators (SERMs) are mainly used for preventing and treating postmenopausal osteoporosis.
- SERMs are suitable for clients at risk of or previously treated for estrogen-dependent or receptor-positive cancer.
Prototype and Other Medications
- Raloxifene serves as the prototype medication for SERMs.
- Raloxifene is more commonly prescribed than tamoxifen due to its lower risk of uterine cancer.
- Medication classification: Bone Resorption Inhibitor.
Pharmacologic Action
- SERMs activate estrogen receptors in some tissues while blocking them in others.
- This action reduces bone resorption and bone loss, maintaining bone mineral density (BMD).
- Raloxifene blocks estrogen receptors in breast tissue, beneficial for clients with estrogen-dependent or positive cancer.
- Unlike most SERMs, raloxifene does not activate receptors in the endometrium.
Adverse Drug Reactions
- Adverse reactions primarily relate to the activation of estrogen receptors.
- Serious adverse effects of raloxifene include increased risk of stroke, pulmonary embolism, and deep vein thrombosis.
- Hot flashes may occur due to the blockage of estrogen receptors in other tissues.
Safety Information
- SERMs are teratogenic and should not be taken during pregnancy or breastfeeding.
- SERMs can pass through breast milk, potentially harming the infant.
Interventions
- Monitor bone density to assess the effectiveness of SERM therapy.
- Watch for signs of blood clots in the lower legs or lungs, such as leg cramps and difficulty breathing.
- Routine lab work is important to monitor blood components like cholesterol, hormones, and fibrinogen.
Administration
- SERMs are administered orally on a daily basis.
- Can be taken with or without food.
Client Instructions
- Consume enough calcium and vitamin D.
- Engage in daily weight-bearing exercises like walking or running.
- Use contraception to prevent pregnancy during therapy.
- Premenopausal clients using raloxifene for breast cancer prevention may experience hot flashes.
Safety Alert
- Clients should immediately report pain in the lower extremities or chest pain with difficulty breathing.
- These symptoms may indicate a blood clot in the leg or lungs.
Contraindications and Precautions
- Raloxifene and tamoxifen are contraindicated in pregnant and breastfeeding clients due to teratogenic effects.
- Clients with deep vein thrombosis or a history of it should not take SERMs.
- Discontinue SERMs if deep vein thrombosis develops during treatment.
- Use SERMs with caution in clients with elevated serum lipid levels.
Interactions
- Concurrent administration with estrogen is not recommended due to the increased risk of estrogen-supported cancers.
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Description
Selective Estrogen Receptor Modulators (SERMs) like Raloxifene, prevent osteoporosis by modulating estrogen receptors. Raloxifene, a bone resorption inhibitor, is favored over tamoxifen because it doesn't activate receptors in the endometrium, reducing the risk of uterine cancer. It blocks estrogen receptors in breast tissue, which benefits clients with estrogen-dependent or positive cancer.
