32 Emergency Contraceptives Besinque

Question 1

Which EC products are Progestin-Only?

Answer 1

Plan B OneStep and NextChoice. Approved for 72 hours after UPI, evidence indicates LNG is effective up to 120 hours after intercourse. Most effective when taken sooner

Question 2

Which EC product is a progesterone agonist-antagonist?

Answer 2

Ella. Single 30mg tablet. Effective and approved for use up to 120 hours after UPI

Question 3

What is the dose in Plan B OneStep and NextChoice One Dose?

Answer 3

1.5mg levonorgestrel tablet. OTC purchase. Prescription only for women under 17 (can’t have prescription for men < 17

Question 4

What is the dose for NextChoice and Levonorgestrel (generic)?

Answer 4

Two 0.75mg levonorgestrel tablets. Take 1 pill immediately and 2nd one 12 hours later. OTC. Prescription only for women under 17

Question 5

How is ella dosed?

Answer 5

One 30mg ulipristal acetate tablet. Appears to maintain efficacy throughout the 120 hour window. Prescription required for all users

Question 6

How is ParaGard (Copper-T IUD) used for EC?

Answer 6

Off label use. Placed within 5 days after intercourse. Effectiveness does not decline with delay

Question 7

Which ECs are the most effective?

Answer 7

ParaGard > ella (1 in 1000) > Plan B/NextChoice (1 in 100) > Yuzpe > nothing

Question 8

Which EC doesn’t seem to have an increased failure rate in obese women?

Answer 8

Ulipristal (ella)

Question 9

What are the three possible ways that ECs can work?

Answer 9

Inhibit or delay ovulation. Prevent sperm and egg from meeting. Prevent implantation by disrupting the uterine lining

Question 10

What is the most fertile time during menstrual cycle?

Answer 10

At the end of follicular stage before the LH surge and ovulation

Question 11

What is the clinical evidence of LNG ECPs?

Answer 11

Can inhibit ovulation, though not always (may be only MOA). Have no effect on the quality of cervical mucus or on the penetration of spermatozoa into the uterine cavity. Can shorten the luteal phase. Do not alter endometrium

Question 12

What is the clinical evidence of Ulipristal ECPs?

Answer 12

Can inhibit ovulation, though not always (may be only MOA). Do not alter endometrium

Question 13

What is the ECP Safety?

Answer 13

Breastfeeding women may use progestin-only ECPs and IUDs. Short duration of exposure and low total hormone content of ECPs. Safer than pregnancy. No increased risk of birth defects. No increased risk of ectopic pregnancy

Question 14

What are the possible side effects of ECPs?

Answer 14

N/V. Abdominal pain. Breast tenderness. HA. Dizziness. Fatigue. Short-term cycle changes

Question 15

In the new 2012 protocol, if intercourse was more than 72 hours ago, which EC may be more effective?

Answer 15

ella (Ulipristal) may be more effective than levonorgestrel

Question 16

Which EC can be taken with or without food?

Answer 16

Ulipristal

Question 17

How long should back-up contraception be used after ella and LNG?

Answer 17

ella: rest of cycle. LNG: for 7 days

Question 18

Which EC can be used while breast feeding?

Answer 18

LNG

Question 19

If vomiting occurs with EC, when should repeat dose be taken?

Answer 19

ella: repeat if within 3 hours. LNG: repeat dose less than 1-2 hours