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Ama - Contraception > Combined oral contraceptives > Flashcards

Combined oral contraceptives Flashcards

1
Q

COC

A

Contains oestrogen + progesterone
Inhibits ovulation

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2
Q

Monophasic preparation

A

Fixed amount of oestrogen + progesterone

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3
Q

Phasic preparation

A

Varying amounts of oestrogen + progesterone
- For women who do not have withdrawal bleeding OR
- Have breakthrough bleeding with monophasic preparations

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4
Q

Every day preparation

A

Pill free interval replaced with inactive pills

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5
Q

Low strength-oestrogen preparation

A

Suitable for those with a risk factor for circulatory disease
Contains 20 mg Ethinylestradiol

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6
Q

Oestrogen - increases risk of?

A

VTE
ATE (arterial thromboembolism)

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7
Q
A
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8
Q

VTE risk factors

A

Avoid COC if 2 or more are present
- Obesity BM1 >30
- Smoking
- First degree relative under 45 with VTE
- Superficial thrombophlebitis
- Long-term immobilisation
- Age >35
- Type of progesterone (Desogestrel, gestodene, drosperinone)

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9
Q

ATE risk factors

A

Avoid COC if 2 or more present
- Diabetes
- Hypertension
- Migraine without aura

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10
Q

Surgery

A
  • Stop 4 weeks before (major surgery/surgery to legs/surgery that causes immobilisation)
  • POP is alternative
  • Restart usual contraception on 1st period at least 2 weeks after full mobilisation.
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11
Q

Emergency surgery/COC not stopped

A

Thormboprophylaxis

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12
Q

Travel

A

3+ hour journeys = compression stocking and leg exercises

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13
Q

Reasons to stop

A

VTE
Stroke
Hepatotoxicity
Prolonged immobility after surgery/leg injury
Risk factor that C/I treatment

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14
Q

VTE

A

PE = chest pain, breathlessness, cough with blood sputum
DVT = unexplained swelling or severe pain in calf of one leg

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15
Q

BP

A

> 160/95 mmHg

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16
Q

Stroke

A
  • Prolonged, severe headhace
  • Partial/complete loss of vision
  • Hearing disturbance
  • Perceptual disorders
  • Slurred speech
  • Seizure
  • Weakness
  • Numbness on one side of the body
17
Q

Risk factors that C/I treatment

A

Smoker (40+)
Personal history of VTE or ATE
Migraine with aura
Migraine 72 hours
Migraine treated with ergot derivatives
Diabetes with complications
Heart disease with pulmonary hypertension/risk of embolus
Valvular heart disease
BMI >35
50+
TIA
BP >160/95 mmHg
2 or more risk factors for VTE/ATE

18
Q

How to take

A

OD for 3 weeks
1 week pill free interval (withdrawal bleeding)
Start anytime in cycle
Started on day 6 or later = protection for 7 days

19
Q

What age cannot use?

A

50+

20
Q

Benefits of COC

A

Reduced risk of ovarian + endometrial cancer
Reduces:
- Dysmenorrhea
- Menorrhagia
- PMS
Less risk of PID
Less symptomatic fibroids or functional ovarian cysts

Ama - Contraception (11 decks)

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