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Pharmacology > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the effect of estrogen on fertility?

A

They suppressh FSH meaning a dominant follicle isn’t formed.
It also stimulates endometrial proliferation (uterus wall thickening)

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2
Q

Name 3 side effects of estrogens

A

Nausea and vomiting
breast tenderness
fluid retention
change in libido
chloasma

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3
Q

What happens to HDLs and LDLs with estogens? Is this good or bad?

A

HDLs increase and LDLs decrease. This is good because HDLs are a good cholesterol and LDLs are bad

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4
Q

Does a patient with estrogens have blood which has lower or higher coagulability?

A

higher

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5
Q

What happens to bone resorption with estrogens?

A

it decreases

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5
Q

What are triglycerides? Do they increase or decrease with estrogens?

A

A type of fat, also known as lipids. They increase

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6
Q

Are progestogens synthetic or natural?

A

Synthetic

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7
Q

What is the difference in VTE risk between 2nd generation progestogens and a third generation progestogen such as gestodene?

A

higher generations have a higher risk of VTE

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8
Q

What does progestogen do? (4)

A

Suppresses the LH surge and blocks ovulation
suppresses endometrial proliferation and thickens the uterus wall
thickens cervical mucus making it impermeable
produces secretory endometrium which prevents endometrium cancer

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9
Q

When does a withdrawal bleed occur when a patient is on COCs?

A

during the 7 pill free days or placebo days

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10
Q

What are 3 side effects of progestogen?

A

menstrual irregularity
nausea
bloating/weight gain
breast tenderness
acne
change in libido
mood changes

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11
Q

What happens to HDLs and LDLs with progestogens? Is this good or bad?

A

decrease HDL and increase LDL This is bad because HDLs are a good cholesterol and LDLs are bad

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12
Q

What is a monophasic COC?

A

same amount of estogen and progestogen for 21 days

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13
Q

Who should you give progestogen only tablets to?

A

women who can’t take estrogens and people who are breast feeding

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14
Q

Name an example of an emergency contraceptive?

A

Levonorgestrel and ulipristal

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15
Q

How many days after unprotected sex is ulipristal effective for?

A

5

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16
Q

What are two side effects of emergency contraception?

A

Nausea and vomiting

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17
Q

If a patient had Levonorgestrel and then vomited 30 mins after, do they need to repeat the dose?

A

yes

18
Q

How does a vaginal ring work? (3)

A

insert in vagina for 21 days
releases estrogen and progestogen slowly
take ring out for 7 days

19
Q

How does COCs werk? (2)

A

inhibit ovulation
inhibits endometrium development and therefore corpus luteum

20
Q

How do progestogen only tablets work?

A

thickens cervical mucus so sperm penetration is unlikely

21
Q

What are three dose forms of progestogen?

A

tablet, subdermal implant, IUD and IM depot injection.

22
Q

What are 5 adverse effects for COCs?

A

breakthrough bleeding, nausea, breast enlargement, tenderness, headache, fluid retention, chloasma, VTE, allergy, hypertemsion, jaundice, pancreatitis, liver, cervical and breast cancer and stroke.

23
Q

What are 3 adverse effects for progestogen only tablets?

A

menstrual irregularities, depression and weight gain

24
Q

What are three things which COCs can prevent?

A
  • ovarian and endometrial cancers
  • ovarian cysts
  • pelvic inflammatory disease
25
Q

Name 3 examples of drugs which interact with estrogen?

A

CYP3A4 inducers e.g. rifampicin, phenytoin, carbamazepine
Orlistat
St John’s Wort

26
Q

What should I do if i give a patient on carbamezapine a COC?

A

Increase the dose

27
Q

Name an example of a progestogen only tablet?

A

levonogestrel and norethisterone

28
Q

When do you start a progestogen only tablet?

A

first day of menstruation or 21 days postpartum

29
Q

How long do you need to use extra contraception if you have a progestogen only tablet on the 5th day of menstruation?

A

48 hours

30
Q

If I wanted to change from one COC to another, what do I do?

A

Start day after old ones

31
Q

If I wanted to change from progestogen only tablets to a COC, what do I do?

A

Start day after old ones and use extra contraception

32
Q

Do you start with a low or high dose of a COC?

A

Low

33
Q

What is trycycling and what type of COCs can you do this with?

A

taking three packets of monophasic pills without taking an inactive tablet

34
Q

If you are taking COCs, what class of drugs do you need a high dose with?

A

antiepileptics

35
Q

If you start you first active COC pill on day 4 of the menstrual cycle, do you need extra protection?

A

yes, for 7 days after

36
Q

What is the most dangerous dose of a COC to miss?

A

those at the beginning or end of the active pill cycle

37
Q

Is contraception affected if you forget a COC dose after 6 hours?

A

no

38
Q

What do you do if you missed a COC pill in the first 7 days of active pills and sexual
intercourse occurred?

A

Get emergency contraception

39
Q

What do you do if you missed a COC dose for 30 hours?

A

take a pill when you remember and then take the next when it is due
continue pill and use another form of contraception for the next 7 active pill doses

40
Q

If you vomit 3 hours after taking a COC, what do you do?

A

Take another ASAP and use extra contraception

41
Q

My patient took their progestogen tablet yesterday at 1400hrs, when should they have it today?

A

1400 hrs- 1700hrs at the absolute max

42
Q

How long is the maximum contraceptive effect after administration?

A

3-20 hours after

43
Q

What are 4 issues to consider when choosing contraception?

A

effectiveness, best protection against STIs, life stages, medical hx, personal/ethical/religious
beliefs, risk vs benefit.

Pharmacology (23 decks)

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