Contraception Flashcards
what is the most commonly used spermicide agent?
nonoxynol-9
what are the disadvantages of spermicide?
- no protection against STD
- high failure rate
- irritation
- messy
a diaphragm should be used in conjunction with what other method?
spermicide
what is the role of progestin in hormonal contraception?
- inhibits ovulation
- increases thickening of cervical mucous
what is the role of estrogen in hormonal contraception?
- maintain the endometrium
- prevent unscheduled bleeding
what are the three types of formulations for hormonal contraception?
- fixed dose (monophasic)
- combination phasic
- daily progestin (mini pill)
the progestin component of hormonal contraception consists of derivatives of what compounds?
testosterone or progesterone
drospirenone is derived from what compound?
17-a-spironolactone
what are the effects of drospirenone?
anti-androgenic and anti-mineralocorticoid activities
how is drospirenone anti-androgenic?
inhibits ovarian androgen production like other progestins, and it also blocks androgen receptors in the skin
what is the pharmacological aim of the estrogen component of hormonal contraception?
use the lowest possible dosage to achieve satisfaction, cycle control, and fewest side effects
what is the MOA of combination oral contraceptives?
- suppression of ovulation: progestational agent MOST effective
- estrogen suppresses FSH secretion, progesterone suppresses LH secretion
what is the MOA of progestin oral contraceptives?
- thickens cervical mucous
- inhibits sperm migration
- inhibits implantation
what are the metabolic effects of estrogen in OC?
- nausea
- breast tenderness
- fluid retention
what are the metabolic effects of progestin in OC?
- weight gain
- acne
- adverse mood changes
what is the rate of venous thromboembolism with OC compared to pregnancy?
1:1000
combination OCs should not be prescribed in what population?
- women over 35 who smoke cigarettes or other nicotine
- migraines with aura
which drug classes can interact with OCs?
- barbiturates
- sulfonamides
- cyclophosphamide
- rifampin
what is the MOA of emergency contraception? when must it be taken?
disruption of ovulation
within 72 hours of coitus
what is the most common long acting contraceptive steroid? what is the MOA?
depo-medoxyprogesterone
- inhibits ovulation
- thins endometrium
- thickens cervical mucous
nexplanon is what type of contraceptive?
progestin implant
what is the MOA of a progestin implant? how long is it effective?
daily release of progestin causes
- ovulation suppression
- cervical mucous thickening
- atrophic endometrium
36 months
what are the noncontraceptive health benefits of implants?
- decreased risk of iron deficiency anemia, PID, endometrial cancer
- decreases ovulation pain
- reduces symptoms of endometriosis and primary dysmenorrhea
what is the MOA of a copper IUD?
- local, sterile, inflammatory reaction within uterine cavity
- impedes sperm penetration / migration
what are the adverse effects of IUD?
- uterine bleeding
- uterine perforation
