Contraception

Question 1

what is the most commonly used spermicide agent?

Answer 1

nonoxynol-9

Question 2

what are the disadvantages of spermicide?

Answer 2

• no protection against STD
• high failure rate
• irritation
• messy

Question 3

a diaphragm should be used in conjunction with what other method?

Answer 3

spermicide

Question 4

what is the role of progestin in hormonal contraception?

Answer 4

• inhibits ovulation

- increases thickening of cervical mucous

Question 5

what is the role of estrogen in hormonal contraception?

Answer 5

• maintain the endometrium

- prevent unscheduled bleeding

Question 6

what are the three types of formulations for hormonal contraception?

Answer 6

• fixed dose (monophasic)
• combination phasic
• daily progestin (mini pill)

Question 7

the progestin component of hormonal contraception consists of derivatives of what compounds?

Answer 7

testosterone or progesterone

Question 8

drospirenone is derived from what compound?

Answer 8

17-a-spironolactone

Question 9

what are the effects of drospirenone?

Answer 9

anti-androgenic and anti-mineralocorticoid activities

Question 10

how is drospirenone anti-androgenic?

Answer 10

inhibits ovarian androgen production like other progestins, and it also blocks androgen receptors in the skin

Question 11

what is the pharmacological aim of the estrogen component of hormonal contraception?

Answer 11

use the lowest possible dosage to achieve satisfaction, cycle control, and fewest side effects

Question 12

what is the MOA of combination oral contraceptives?

Answer 12

• suppression of ovulation: progestational agent MOST effective
• estrogen suppresses FSH secretion, progesterone suppresses LH secretion

Question 13

what is the MOA of progestin oral contraceptives?

Answer 13

• thickens cervical mucous
• inhibits sperm migration
• inhibits implantation

Question 14

what are the metabolic effects of estrogen in OC?

Answer 14

• nausea
• breast tenderness
• fluid retention

Question 15

what are the metabolic effects of progestin in OC?

Answer 15

• weight gain
• acne
• adverse mood changes

Question 16

what is the rate of venous thromboembolism with OC compared to pregnancy?

Answer 16

1:1000

Question 17

combination OCs should not be prescribed in what population?

Answer 17

• women over 35 who smoke cigarettes or other nicotine

- migraines with aura

Question 18

which drug classes can interact with OCs?

Answer 18

• barbiturates
• sulfonamides
• cyclophosphamide
• rifampin

Question 19

what is the MOA of emergency contraception? when must it be taken?

Answer 19

disruption of ovulation

within 72 hours of coitus

Question 20

what is the most common long acting contraceptive steroid? what is the MOA?

Answer 20

depo-medoxyprogesterone

• inhibits ovulation
• thins endometrium
• thickens cervical mucous

Question 21

nexplanon is what type of contraceptive?

Answer 21

progestin implant

Question 22

what is the MOA of a progestin implant? how long is it effective?

Answer 22

daily release of progestin causes

• ovulation suppression
• cervical mucous thickening
• atrophic endometrium

36 months

Question 23

what are the noncontraceptive health benefits of implants?

Answer 23

• decreased risk of iron deficiency anemia, PID, endometrial cancer
• decreases ovulation pain
• reduces symptoms of endometriosis and primary dysmenorrhea

Question 24

what is the MOA of a copper IUD?

Answer 24

• local, sterile, inflammatory reaction within uterine cavity
• impedes sperm penetration / migration

Question 25

what are the adverse effects of IUD?

Answer 25

• uterine bleeding

- uterine perforation