Contraception Flashcards

1
Q

State some points that would make the ideal contraception.

A
  • 100% effective and forgettable
  • 100% safe with no unwanted side effects
  • 100% convenient and unrelated to sex
  • 100% reversible
  • protection from STIs
  • non contraceptive benefits
  • cheap
  • acceptable to all cultures and religions
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2
Q

What are some risk factors for teenage pregnancy?

A
  • Poverty (strongest risk factor)
  • Looked after children
  • Children with teenage mothers
  • Low education achievement
  • Poor transition from school to work (at age 16)
  • Mental health problems
  • Sexual abuse
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3
Q

What are the two ways of unwanted pregnancy?

A
  • Unprotected sex

- Failure of contraception i.e. Pill, IUD, Barrier

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4
Q

What are the outcomes for unwanted pregnancy for:

  • upto 72 hours
  • upto 5 days
  • upto 24 weeks
A
  • Levonelle
  • EllaOne or IUD
  • Termination - use Mifepristone (antiprogestogenic - sensitises myometrium to Prostaglandins)
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5
Q

For termination, what would you give?

A

Upto 24 weeks.
Giver single dose of Mifepristone (anti progestogenic - sensitises myometrium to prostaglandins), followed by a prostaglandin.

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6
Q

What are some stages that people think life begins at?

A
  • Fertilisation
  • Implantation
  • Quickening
  • Brain activity
  • Viability of the foetus
  • Birth
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7
Q

What are the current abortion laws?

A
  • You can get a termination up until 24 weeks if there is a risk to the woman’s or her child’s physical or mental health
  • There is no limit if the women’s health or life is massively threatened or if the child is likely to be born with severe physical or mental abnormalities
  • no consent needed from doctor or partner or family
  • no consent needed for under 16 in some circumstances
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8
Q

Why does a foetus not have rights in the eyes of the law?

A
The foetus is not a person in the eyes of the
law, and so does not have the same legal
protection as persons. Only once outside
the womb, the baby acquires full legal
status.
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9
Q

What is the Gradualist view?

A
  • The fertilised egg has no intrinsic moral value
  • It becomes valuable during its development
  • It follows;
    a) early abortions is probably acceptable
    b) late abortions may be more difficult to justify
    c) at some point abortion may be immoral depending on where the line is drawn
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10
Q

What is the Potential view?

A

An embryo is a potential person
Scientists that cures cancer… mass murderer?
Also, every sperm or egg is a potential person: do they merit the same production?

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11
Q

How do EHCs work?

A
  • Suppress ovulation
  • Change the viscosity of cervical mucus
  • Alter the state of endometrium to prevent implantation
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12
Q

What is the efficacy of Levonelle between 49-72 hours after UPSI?

A

58%

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13
Q

What is the efficacy of Levonelle between 25-48 hours after UPSI?

A

85%

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14
Q

What is the efficacy of Levonelle between 0-24 hours after UPSI?

A

95%

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15
Q

What would you give for above 72 hours after UPSI?

A
  • EllaOne (upto 5 days)
  • IUD (upto 5 days)
  • They are POM drugs
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16
Q

How does EllaOne or IUD work?

A

Acts as a synthetic progesterone receptor modulator.

It delays ovulation but can also cause disintegration of endometrium - loss of implanted eggs

17
Q

At what time is there an issue, regarding combined pill?

A

Missing two or more of 1st 7 pills

18
Q

At what time is there an issue, regarding Progesterone-only pill?

A

Missing one or more, more than 3 hours after usual taking (however, Cerazette - 12 hour window)

19
Q

What do you do if a patient is worried they are pregnant?

A
  • Check the dates and nature of the last period - is it light?
  • Refer
  • Reassure
  • Has the EHC been used since the last period? It’s safe but may cause menstrual disruption
20
Q

What medications contradict with the pill?

A

Antibiotics e.g. rifampicin, griseofulcin
Ritonavir
St Johns Wort
Anticonvulsants/ Benzos: Carbamazepine, Phenytoin, , Primidone

21
Q

When should EHC not be supplied?

A
  • D & V
  • Crohn’s disease
  • Requesting for an advanced supply as it is POM
  • Allergy
  • Severe hepatic dysfunction
22
Q

What are some counselling points for EHC?

A
  • If vomiting within 3 hours of taking, take a second dose
  • It is not 100% effective
  • There will be some menstrual changes
  • Will need to consider the rest of the cycle also. The EHC only covers for a short while
  • There is still risk from STI
  • Consider contraception
23
Q

If a person is taking an antibiotic or medication that interacts with EHC, what do you do?

A
  • Suggest alternative form of contraception that is not affected i.e. IUD
  • Suggest additional form of contraception e.g. Condoms