Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RESPIRATORY DISEASE AND GENITOURINARY DISEASE TOPIC - PRE REG > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the different methods of non-hormonal contraception

A

Barrier methods: condoms, diaphragms, cervical caps
- petroleum jell (Vaseline), baby oil and oil based products can damage condoms, contraceptive diaphragms and caps are made from latex rubber

Spermicidal contraceptive: used in ADDITION only (not alone)

Intra-uterine devices (IUD- copper coil)
-contraindicated in pelvic inflammatory disease or unexplained vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

POP - progesterone only contraceptive
What are the name of POP drugs

A

Levonorgestrel
Norethisterone
Desogestrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How often do you take POP

A

No pill free period- take every day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What precautions are needed for pop drugs

A

No additional precautions needed if started in the first 5 days of cycle
Eg if period starts on the 1st march and ends on the 7the march the first five days from the last day so the 11th don’t need precaution
- need 2 days precaution if taken after that
Eg anytime from the 12th of march need 2 days precaution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should POP be taken

A

Taken at the same time everyday for maximum efficacy
-desogestrel- needs to be taken within 12 hours otherwise considered missed pill
-other POPs needs to be taken 3 hours otherwise considered missed pill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When does your cycle start

A

The first day of a cycle is considered the first day of the patients bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two types of parental POP contraceptives

A

Medroxyprogesterone
Etongesterel (nexplanon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What POP contraceptive is administered via an injection

A

Injections are 99.8& effective in correct usage
Depot medroxyprogesterone acetate- every 13 weeks
- loss of bone density may occur
- delayed return of fertility of up to one year after treatment cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What POP contraceptive is administered via implants

A

Implants are 99.5% effective in correct usage
Etonogesterel (Nextplanon) placed in the upper arm
-lasts up to 3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What MHRA warning is said about POP contraceptive via implants

A

Neurovascular injury and migration of the implant- remove ASAP

Injected in the upper arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 3 forms that combined hormonal contraceptive exists in

A

Tablets
Patches
Vaginal rings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who mustn’t you give Combined Hormonal contraceptives to

A

Not given to 50 years+ of age as safer alternatives exist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the health benefits of CHC

A

Reduces risk of ovarian, endometrial and colorectal cancer
Aligns bleeding patterns
Reduces dysmenorrhoea and menorrhagia
Manages the symptoms of poly cystic ovaries, endometriosis and premenstrual syndrome
Improves acne
Reduces menopausal symptoms
Maintains bone density in peri-menopausal females under 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When do you avoid CHCs

A

Unsuitable if the patient has any of the following risk factors:
- hypertension
- age of 35 years+ who smoke
- women with multiple risk factors for cardiovascular
— smoking
— hypertension
— high BMI (> or equal to 30kg/m2)
— dyslipidemias
— diabetes
- migraines with aura
- new onset migraine without aura during the use of CHC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the two types of CHC preparations

A

Monophasic: fixed amount of an oestrogen and a progesterone in each active tablet

Multiphasic: varying amounts of the two hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the different preparations of oestrogen

A

Ethinylestradiol
Mestranol
Estradiol

17
Q

Why are some CHCs on a 21 regimen and some are on a 28 day regimen

A

Females on a 21 day regimen have a monthly withdrawal bleed during the 7 days hormone free intervals
- withdrawal bleeds do no represent physiological
- some packs come as 28 per month supply ( 21 active and 7 sugar coated with no medicine so this increases coherence)

18
Q

What do you do if you want to switch to a combined hormonal contraceptive

A

From CHC - no additional contraceptive needed

From POP- 7 days extra precaution needed

From levonorgestrel -IUD - 7 days of extra precaution needed

From copper-IUD
- if CHC started on up to day 5 of menstrual cycle: no additional contraception is needed
- if stated after 5 days: 7 days of extra precaution is needed

Other non-hormonal methods- same as copper-IUD

19
Q

Switching from the CHC to other forms of contraception

A

Week 1 of cycle (or day 3-7 of hormone free interval) + NO UnProtected Sexual intercourse since start of Hormonal free interval
- Copper-IUD: no extra precaution
- POP: 2 day precaution
- others: 7 days of precaution

Week 1 (or day 3-7 of hormone free interval) + has UPSI since start of Hormonal Free Interval
- carry on with the CHC until 7 consecutive days taken
- then act as weeks 2 or 3

Weeks 2 or 3- no extra precaution required

20
Q

Reasons to stop CHC

A

Urgent medical review:

Calf pain, swelling and/or redness (DVT)
Chest pain and/or breathlessness and/or coughing (PE)
Loss of motor or sensory function (stroke)
Severe stomach pain (Hepatotoxicity)
Very high blood pressure (haemorrhaging stroke)

21
Q

What other reasons to stop CHC

A

Medical review or to seek advise
-signs of breast cancer, nipple pain
- new onset migraine
- persistent unscheduled vaginal bleeding
- high blood pressure
-High BMI (>35kg/m2)
- DVT or PE
- blood clotting abnormality
- angina, heart attack, stroke or peripheral vascular disease
- AF
- cardiomyopathy

Aged 50+ newly developed contraindication

22
Q

What do you do if you are on CHC and scheduled for surgery?

A

Discontinue at least 4 weeks prior for
-major elective surgery, any surgery to the legs or pelvis
- surgery that involves prolonged immobilisation of a lower limb

Use an alternative method of contraception

CHC recommended 2 weeks after full remobilisation

If discontinuation is not possible (trauma)/ patient is still on CHC
-consider thromboprophylaxsis

23
Q

What are the side effects of CHC

A

Headache
Unscheduled bleeding (breakthrough bleeding)
Mood change
Weight gain
Libido change

24
Q

What is the miss dose rule

A

Missed pill rule apply if the patient omits or has vomited/ had diarrhoea within 2 hours of taking COC or POP- take another one ASAP to aim to be within time period

25
Q

What is the missed pill for POP contraceptives

A

Considered missed id >12 hours for desogestrel or >3 hours for rest
- take the pill as soon as you remember
- take the next pill at the usual time (can mean 2 in one day)
Need protection til 48 hours of pills are taken correctly ( 7 days for desogestrel)
Need EMC if unprotected sex happens between the missed pill and 2 days after restarting medication

26
Q

What is the missed pill rule for CHC

A

Late start after HFI (>9 days since last active pill)
-use emergency contraceptive id unprotected sex has occurred
Take immediately and use condom for the next 7 consecutive days

1 missed pill (48-72 hrs since last active pill)
- take ASAP- no further action needed (provided consistent use in previous 7 active pills)

2+ missed pills (>72hrs since last active pill)
-week 1 of cycle: consider emergency contraception if unprotected sex happens within HFI and week 1, take ASAP and use condom for 7 consecutive dose take
-week2-3 of cycle: no emergency contraceptive pill needed- take asap- 7 day of condom
-if 2+ pills missed in 7 days before hormone free interval carry on taking pill throughout HFI

27
Q

What 3 drugs are emergency contraception

A

Copper -iud
Ulipristal 30mg
Levonorgestrel 1.5mg
Needs to be inserted/ taken as soon as possible

28
Q

Why is copper-iud the first line for emergency contraception

A

First line- most effective form of emergency contraceptive pill
Can be inserted up to 120hrs (5 days) after the first unprotected sex
Can be inserted up to 5 days after the earliest estimated date of ovulation

29
Q

What are the hormonal methods of emergency contraception

A

Levonogestrel - 72 hours (3 Days)

Ulipristal - 120 hours 5 days

Ulipristal is more effective than levonorgestrel for emergency contraception

Unlike the CU-IUD, BMI can reduce effectiveness ( particularly levonorgestrel)
- BMI >26kg/m2 or weight >70kg- either give Ulipristal or a double dose of levonorgestrel

-Ulipristal and levonorgestrel can be used as oral contraception more than once in the same cycle (levonorgestrel has an increase risk of side effects)

2nd dose needed if patient has vomited/diarrhoea in 3 hours

30
Q

When do you reinitiate regular contraception after having an emergency contraceptive pill

A

Levenogestrel
- start regular hormonal contraception immediately
- use condoms until effective 2 days for pop and 7 days for combined

Ulipristal
- wait 5 days after taking Ulipristal before starting regular hormones again
Wear a condom during the 5 days and till treatment is effective
- if during week 1 in females taking regular CHC
- CHC can be reinstated immediately after
-wear condom for 7 days

31
Q

Levongestrel

A

Breast feeding - no delay

Causation in patients with malabsorption

Can cause breast tenderness, D+ V, fatigue and haemorrhaging

Avoid in severe liver impairment

Interaction with CYP INDUCERS

32
Q

Ulipristal

A

Breast feeding - 1 week delay

Causation in patients who are asthmatic controlled by gluccorsteroids

Can cause cycle irregularities , D+ V, altered mood, dizziness

Avoid in severe liver impairment

Interaction with CYP INDUCERS

33
Q

IUD- COpper

A

MRHA warning- risk of uterine perforation
- severe pelvic pain after insertion
- sudden change in period
-pain during intercourse
- unable to feel threads

Check up is needed if you can’t feel the thread
Replace every 5-10 years

Removed in the first trimester of pregnancy

34
Q

Levonorgestrel IUD

A

Reduced pain and bleeding side effects

Replace every 3-10 years

RESPIRATORY DISEASE AND GENITOURINARY DISEASE TOPIC - PRE REG (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions