Pharmacological Interventions for Dependence

Q1) 

Margaret appears to have no major issues. It is, nevertheless, important for her to note that the history of hypertension (HTN) and diabetes in her family puts her at a great risk especially since she is under stress. A surge of hormones during a stressful situation may cause her blood to spike leading her to become highly susceptible to HTN. So the first most important recommendation is to find ways of reducing stress such as exercising regularly. Secondly, her renewed smoking efforts are bound to be disastrous especially when she is taking pills. Smoking is bound to hasten atherothrombotic processes resulting in inflammation, thrombosis and lipids (Coleman, Chamberlain, Davey, Cooper & Leonardi ‐ Bee, 2015). Smoking cessation is thus highly recommendable for her to prevent cardiovascular ailments. Concurrently, if she smokes now that she is taking pills, there is a greater probability that she will end up experiencing a heart attack, blood clot or stroke (Coleman et al., 2015). A female individual with a height 5'5" and weight 172 lb ought to have a BMI of 28.8 which means that Margaret`s BMI of 28.6 is sustainable. It is fundamental, however, that she feeds well and in a healthy manner. 

Q2) 

If Margaret is still engaging in sexual relations despite her separation, it would be best for her to stick to the use of pills or other contraceptives. She can stick to using pills just like she is accustomed to since the estrogen levels present in contemporary birth control pills is lower than it was previously. It is, therefore, safe for someone aged 40 years to take pills. The pill is beneficial since it is bound to reduce incidences of irregular menstrual bleeding, hip fractures and also endometrial and colorectal cancer (Skovlund et al., 2016). Moreover, it manages to maintain bone mineral density. This method of contraception can, therefore, be used until she is 50 years old. Finally, her retroverted firm, mobile, nonenlarged, nontender uterus may not be a significant problem. It can, nevertheless, be important for her to consider whether she has endometriosis because then she would have to consider taking antibiotics. 

References 

Coleman, T., Chamberlain, C., Davey, M. A., Cooper, S. E., & Leonardi ‐ Bee, J. (2015). Pharmacological interventions for promoting smoking cessation during pregnancy.  Cochrane Database of Systematic Reviews , (12). 

Skovlund, C. W., Mørch, L. S., Kessing, L. V., & Lidegaard, Ø. (2016). Association of hormonal contraception with depression.  JAMA psychiatry ,  73 (11), 1154-1162.