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Ambulatory Care of Women > Contraception > Flashcards

Contraception Flashcards

1
Q

How many pregnancies are unplanned?

A

50%

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2
Q

Most effective contraceptive methods?

A

IUC, implant, vasectomy, female sterilization

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3
Q

Highest rates of complications in abortions?

A

Greater than 20 weeks.

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4
Q

Acronym BRAIDED for informed consent

A

Benefetis, risks, alternatives, inquiry, decision to stop, explanation of method, documentation

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5
Q

What does progesterone do?

A

Provides most benefit. Thickens cervical mucous, blocks LH surge, inhibits capacitation of sperm, decreased tubal motility, and atrophy of endometrium

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6
Q

What does estrogen do?

A

Control cycle, decrease FSH, stabilize endometrium, prevents metrorrhagia

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7
Q

Dose of estradiol?

A

20-50 mcgs/day
20 mcg in patch
15 mcg in ring

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8
Q

What does mestranol do?

A

Metabolized by liver into EE

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9
Q

Perfect and typical rates of failure for contraceptive pills?

A

Perfect=.3

typical =8

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10
Q

Biphasic COC?

A

Mircette

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11
Q

Triphasic COC?

A

Estrostrep, ortho-novum 77, orthotricyclen

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12
Q

Four phasic COC?

A

Natazia

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13
Q

What’s a 365 day active COC?

A

Lybrel. 90 mcg levonorestrel, 20 mcg of EE

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14
Q

Disadvantages of COC?

A

Gallbladder issues. No protection against STIs, daily administration, MI, Stroke, VTE, hypertension, may accelerate development of stones with women who have gallbladder problems

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15
Q

Absolute contraindications to open with COCs?

A

> 35 and smokers, estrogen sensitivites, liver problmes, migraines with aura, uncontrolled hypertension, DM
with vascular involvement, stroke or MI, propensity for blood clots, polycythemia, undiagnosed abnormal vaginal bleeding

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16
Q

Initial exam for initiating OCPs?

A

vitals, breast exam, pelvic, pap 21 y.o. or greater, GC/ chlamydia, urine screen for STIs

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17
Q

How often should you prescribe birth control?

A

1 year

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18
Q

Which pill should you use for COC?

A

Any pill is fine depending on contraindications

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19
Q

What pill to chose in uncomplicated diabetes?

A

Low EE, progestin, androgen

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20
Q

What pill to chose in sickle cell disease?

A

Not a contraindication

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21
Q

What are contraindications to Yaz (Drosperinone)?

A

Hyperkalemia, renal insufficiency, hepatic dysfunction, adrenal insufficiency

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22
Q

When to Start OC, regardless of menstrual cycle?

A

Take pill and use back up for 7 days

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23
Q

When don’t you need backup when starting OC?

A

First day of menses, or within 5 days after menses begins

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24
Q

About starting on Sundays?

A

Take pill on sunday AFTER menses begins, and use backup for 7 says

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25
Q

What do do if missed 1-2 pills? for EE >30

A

Take next pill and offer emergency contraception

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26
Q

What to do if missed 3 or more pills during first 2 weeks of pack? for EE >30

A

Condoms for 7 consecutive days of pills. Offer emergency contraceptions

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27
Q

What do do if missed 3 or mor pills in 3rd weeks? for EE >30

A

Finish active pills and start new pack

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28
Q

What do you do for scan’t bleeding or spotting while on COC?

A

Increase estrogen

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29
Q

What do you dog for acne, oily skin, hirsutism for COC?

A

Increase progestin

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30
Q

What are drugs for acne, oily skin, hirsutism? OCOs

A

Ortho Tricyclen, estrostep, yasmin, desogen, Ovcon-35

31
Q

What do you do for GI (N/V) complaints while on COCs?

A

Take at night, decrease estrogen, or do progestin only

32
Q

What do you do for constipation/bloating?

A

Reduce dose of progestin

33
Q

What do you do for headaches?

A

Check BP, r/o migraine, stroke, d/c COCs, lower estrogen and progestin

34
Q

What do you do for eyes?

A

salaine drops, send to ophthalmologist

35
Q

What do you do for mastalgia?

A

Better bra and reduce estrogen and progesterone

36
Q

Whgat do you do for melanoma, chloasma?

A

Caused by estrogen stimulating melanocytes, do progestin only pill

37
Q

What drug can act with other potassium sparing drugs to cause hyperkalemia?

A

Drospireone

38
Q

What will St. John’s wart do?

A

decrease hormone levels of COC

39
Q

Warning signs for COCs? ACHES

A 
Abdominal Pain
Chest Pain
Headaches
Eye Problems
Severe Leg Pain
40
Q

Who shouldn’t take Orthoevra (Norelgestromin/EE)?

A

Patch- women over198 pounds

41
Q

How often do you change Orthoevera?

A

Every week

42
Q

What are those on Orthoevera at increased risk for?

A

Blood clots

43
Q

How long do you have to go without that patch that you need to use back up EC for 7 days?

A

Greater than 2 days

44
Q

How often do you insert nova ring?

A

every month

45
Q

How long can nuva ring be out for?

46
Q

Risk of pregnancy with plan B?

47
Q

What does plan B contain?

A

1.5 mg levonorgestrel

48
Q

Contraindications to Plan B?

A

Pregnancy, hypersensitivity, undiagnosed genital bleeding

49
Q

When should you take plan B?

A

Within 72 hours. 120 hours OK but reduced effectiveness.

50
Q

Ingredient in EllaOne?

A

Ulipristal acetate 30 mg

51
Q

How soon can you take ellaOne?

A

5 days. Effectiveness 62-85%

52
Q

What else can you use for emergency contraception?

A

Paragard, IUD upt o 5 days

53
Q

How long do you use protection after ellaOne?

54
Q

How long do you use progestin for Emergency contraception??

55
Q

Advantages of progestin only methods for COC?

A

can use if breastfeeding, scant or menses, decrease dysmenorrhea, decrease cyclic mood changes, headaches, nausea, reversible, low risk of ectopic pregnancy

56
Q

Disadvantages of progestin only COC

A

irregular menses, weight gain, breast tenderness, increased risk for ovarian cysts, possible increased risk for VTE

57
Q

What to do if you missed one Progestin only COC?

A

take next pill, if more than 3 hours use back up for 48 hours

58
Q

What to do if you missed 2 or more pills?

A

use back up. Take 2 pills per day for 2 days

59
Q

Warning signs for progestin only COC? Abdominal pain and regular cycles than delayed peirods

A

abdominal pain: ectopic pregnancy, ovarian cysts

Regular cycles than delayed periods: r/o pregnancy

60
Q

How often do you give Depo Provera?

A

every 12 weeks IM

61
Q

What is the fail rate for Depo Provera?

62
Q

What is good about depo Provera for specific populations?

A

Fewer sickle cell crises

Decreased endometriosis and fibroids

63
Q

What can occur with DepoProvera?

A

Amenorrhea

64
Q

Major important side effects or warnings for DepoProvera?

A

Osteopenia

65
Q

Cumulative index with pregnancies for implant?

66
Q

What medications shouldn’t you take with Implanon?

A

HIV drugs, St. John’s Wart

67
Q

Main reason why people discontinue implanon?

A

bleeding irregularities

68
Q

3 necessities for sterilization?

A

21 years of age
Mentally comptenet
Waiting 30 days after signing

69
Q

Advantages of female sterilization and disadvantages?

A

Decrease ovarian cancer and increase ectopic pregnancies

70
Q

Rate of conception if no method for birth control is used?

71
Q

How does estrogen contribute to clotting?

A

decreases antithrombin III

72
Q

How does progestin inhibit androgens?

A

decreases LH

73
Q

How long do you leave caps and sponges and spermacide in after intercourse?

74
Q

How long is egg and sperm viable for

A

egg- 24 hours

Sperm 72 hours

Ambulatory Care of Women (8 decks)

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