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contraception Flashcards

1
Q

latex condoms should not be used w/ ___

A

oil lubricants

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2
Q

do diaphragms and cervical caps req spermicide use?

A

yes

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3
Q

most effective barrier method if used perfectly

A

condom 2% (13% typical use)

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4
Q

estrogens suppress ___

A

FSH

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5
Q

progestins suppress ___

A

LH mid cycle surge

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6
Q

which estrogen is pharmacologically active?

A

ethinyl estradiol

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7
Q

estrogen in OCP should be below ___ to minimise SEs

A

<35mcg

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8
Q

AEs: HA, nausea, breast tenderness

A

estrogens

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9
Q

AEs: Acne, hirsutism, weight gain, fatigue, depression

A

progestin

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10
Q

low androgenic progestins

A

Ethynodiol, norgestimate, desogestrel, drospirenone, dienogest

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11
Q

progestin w/ antiandrogenic and antimineralcorticoid activity

A

drospirenone

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12
Q

progestin that can cause hyperkalemia

A

drospirenone

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13
Q

progestin w/ highest risk of clots

A

drospirenone

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14
Q

OCPs decrease risk for which cancers?

A

endometrial, ovarian

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15
Q

progestin indicated for PMDD

A

drospirenone

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16
Q

OCPs helpful for which conditions?

A

benign breast dz, ovarian cysts, endometriosis, acne

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17
Q

change to make if OCP pt complains of decreased libido

A

increase estrogen or consider vaginal ring

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18
Q

change to make if pt OCP pt complains of weight gain

A

decrease estrogen, or switch to progestin w/ lower androgenicity

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19
Q

change to make if pt OCP pt complains of high triglycerides

A

switch to progestin w/ lower androgenicity

20
Q

change to make if pt OCP pt complains of spotting

A

can increase estrogen, wait a few months, counsel to take pill at same time QD

21
Q

main risks of OCPs

A

CV events, HTN, VTEs, STIs, gallbladder dz, hepatic tumors, cervical CA

22
Q

combined OCP contras

A

Primarily d/t estrogen component
* Hx of DVT/PE
* CVA/CAD/Ischemic heart dz
* DM w/ vascular dz
* Breast cancer
* Liver adenoma, hepatitis, cirrhosis
* Migraine HA w/ aura - CVA risk is increased and would be difficult to differentiate
* Surgery w/ prolonged immobilization
* >35 years old AND smoking >1-5 cigarettes/day
* BP >160/100

23
Q

warning sign counseling for OCPs

A

stop med and seek care immediately if: Abdominal pain (severe)
* Chest pain (severe), cough, SOB
* Headache (severe), dizziness, weakness, or numbness
* Eye problems (vision loss or blurriness), speech problems
* Severe leg pain (calf or thigh)

24
Q

stay on OCP for __ months before changing

25
Q

missed dose interval for progestin only pills

26
Q

Advantages = decreased menstrual blood loss, decreased cramps, decreased risk of VTE, preferable in lactation

A

progestin only pills

27
Q

higher failure rates: combined or progestin only pills?

A

progestin only pills

28
Q

only abx w/ a true documented pharmacokinetic interaction

29
Q

DI for OCPs

A

abx
Phenobarbital, phenytoin, carbamazepine (induce metabolism)
Ritonavir-boosted protease inhibitors (HIV drug)
warfarin (increases clotting)
st johns wort (induces metabolism)
thyroid products

30
Q

is the patch good for obese women?

31
Q

if patch comes off for >24 hrs…

A

use back up method until on skin X 7d

32
Q

vaginal ring decreases which SEs?

A

less irritability, depression, acne, nausea, and emotional lability

33
Q

Medroxyprogesterone acetate (Depo-Provera) type of BC

A

IM or SQ injection Q 12-14 wks

34
Q

indications for Medroxyprogesterone acetate (Depo-Provera)

A

lactating, can’t take estrogen, seizures

35
Q

return to fertility after Medroxyprogesterone acetate (Depo-Provera)

36
Q

BBW: Medroxyprogesterone acetate (Depo-Provera)

A

significant decrease in BMD, possibly irreversible, increases w/ duration of use
* Long term use (>2 years) only recommended if other methods are inadequate or
symptoms of endometriosis return after discontinuation
* Recommend calcium, vitamin D, and weight bearing exercise

37
Q

which BC can cause decidual cast?

A

Medroxyprogesterone acetate (Depo-Provera)

38
Q

most effective BC

A

IUDs, implants

39
Q

CI for hormonal IUD Levonorgestrel (Mirena, Skyla, Liletta)

A

Undiagnosed uterine bleeding, current or hx of breast carcinoma, acute PID or STI, pregnancy

40
Q

plan B should be taken w/in ___ hrs

A

72, but can be up to 5 days

41
Q

plan B ASW fental malformations?

42
Q

emergency contraceptive ASW fetal malformations

A

Ulipristal (Ella)

43
Q

Ulipristal (Ella) should be taken w/in ___ days

44
Q

most effective form of emergency contraception

A

copper IUD inserted w/in 5 days

45
Q

best emergency contraception for obese women

A

copper IUD

Pharm 2 (29 decks)

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