A woman in the clinic complains of severe hot flashes associated with perimenopause. Her past medical history includes deep vein thrombosis (DVT) 10 years ago. The nurse can anticipate teaching the woman about what treatment?
A.
A trial of a selective serotonin reuptake inhibitor
B.
A trial of the anticonvulsant phenytoin (Dilantin)
C.
Hormone replacement with estrogen only
D.
Hormone replacement with estrogen-progestin
ANS: A
Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft), have been used to reduce vasomotor symptoms such as hot flashes. The anticonvulsant gabapentin (Neurontin) has also been used. This woman is not a candidate for estrogen-only hormone replacement therapy for two reasons: she has not had a hysterectomy and she has a history of DVT. She is not a candidate for estrogen-progestin therapy because of her previous history of DVT.
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