Birth Control

Question 1

When does birth control interfere with the reproductive process?

Answer 1

Any step from gametogenesis to nidation?

Question 2

How do combination OCs work?

Answer 2

Inhibit ovulation

Question 3

What hormones do combo OCs work on?

Answer 3

Estrogen and progestin

Question 4

Combination OCs
Adverse effects

Answer 4

-Thromboembolic disorders
-Cancer (breast cancer - debated - might be growth of pre-existing cancer)
-Hypertension
-Stroke (in patients with migraine w. aura)

Question 5

What are the absolute and relative contraindications of hormonal contraception?

Answer 5

See Table 62-3

Absolute -
Smoker over 35

Question 6

Noncontraceptive benefits of combined OCs

Answer 6

-Decrease risks of ovarian cancer, endometrial cancer
-Acne
-Diminished cramps, lighter, shorter, more predictable flow

Question 7

What drugs and herbs reduce the effects of OCs?

Answer 7

-P450 inducers
-Rifampin
-Ritonavir
-Antiepileptic drugs
-St. John’s Wort

Question 8

What drug effects decreased by OCs?

Answer 8

-Warfarin
-Insulin
-Oral hypoglycemics

Question 9

What unique properties do drugs containing drospirenone have? (like Yaz)

Answer 9

Form of progestin
Raise potassium level

Question 10

What are dosing schedules for birth control pills?

Answer 10

28 day cycle schedules
OR extended cycle (84 days OR indefinite continuous use)

Question 11

Progestin-only contraceptives vs. combined OCs

Answer 11

-Lower risk of clotting
-Higher risk of irregular bleeding
-Less effective

Question 12

What is the schedule for the patch and ring?

Answer 12

3 weeks on
1 week off

Question 13

What hormones are in the patch?

Answer 13

Combined - estrogen and progestin

Question 14

What are the long-active contraceptives?

Answer 14

-Etonogestrel implant (Nexplanon) and Depot medoxyprogesterone acetate (Depo-Provera)

Question 15

How long does Etonogestrel implant (Nexplanon) work?

Answer 15

-Lasts 3 years

Question 16

Depot medoxyprogesterone acetate (Depo-Provera)
Adverse effects

Answer 16

-Irregular bleeding
-Bone Loss
(both reversible)
-Like progestin, less clotting risk

Question 17

What is the brand name for levonorgestrel-releasing intrauterine system?

Answer 17

Mirena

Question 18

What is in Plan B One-Step and what is the dose?

Answer 18

One high-dose (1.5 mg) tab of levonorgestrel within 72 hours

Question 19

What is mifepristone (RU 486 misoprostol) ? How does it work?

Answer 19

-Medical abortion pill
-Prostaglandin
-Blocks uterine progesterone receptors
-Causes shedding of endometrium

Question 20

When do you take Mifepristone / misoprostol?

Answer 20

Effective if taken within 7 weeks of conception or 9 weeks after LMP

Question 21

Prostaglandins
Therapeutic uses

Answer 21

-Induction of abortion
-Cervical ripening before induction of labor
-Control of postpartum hemorrhage

Question 22

Progestin-only pills
Mechanism

Answer 22

Thicken uterine lining