COCP FSRH Flashcards
With typical use how many pregnancies/100 within 1st year
9
What can make COCP less effective
Weight >90kg
Bariatric surgery
Enzyme inducing drugs = 28 days after stopping
Lamotrigene
5 days after UPA-EC
Diarrhoea and vomiting - missed pill within 3 hours or severe diarrhoea >24hrs
Risk VTE /10,000
No using hormones/not pregnancy
2
Risk VTE /10,000
Levenogestrel, norethisterone, norgestimate
5-7
Risk VTE /10,000
Etonogestrel, noreigestromin
6-12
Risk VTE /10,000
Drospirenone, gestodene, desogestrel
9-12
When to avoid COCP due to risk VTE
Fhx unprovoked VTE
Personal Hx VTE
Thombophilia
BMI > 35
Age >35 + smoker
When to avoid COCP due to risk of MI/stroke
Avoid BP >160/95
Migrane with aura
Multiple RF stroke (smoking, HTN, high BMI, dyslipiadiaemia, DM)
Stop if develop aura
How to start COCp
Start day 1-5 cycle, otherwise need 7 days barrier
When can give postpartum + BF
Avoid 6 weeks
Caution 6 months
When can give postpartum + no BF
Avoid 3 weeks
Additional VTE RF: 6 weeks
Chanaing COCP
Start day after last active COC
When to stop COCP before surgery?
4 weeks before surgery/major immobility
UK Mec for COCP base on BMI (including bariatric surgery)
· Less than 30 = UKMEC 1
· 30-34 = UKMEC 2
· 35 or more = UKMEC 3
UK MEC based on VTE risk
· History of VTE = UKMEC 4
· First degree relative with VTE aged < 45 years = UKMEC 3
· First degree relative with VTE aged 45 years or over = UKMEC 2
· Varicose veins = UKMEC 1
· Superficial vein thrombosis = UKMEC 2
Known thrombophilia = UKMEC 4. Factor V Leiden, prothrombin mutation, protein S, protein C and antithrombin deficiencies
