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Pharm 2 > Contraception > Flashcards

Contraception Flashcards

1
Q

2 first generation progesterones

A 
megestrol acetate 
medroxyprogesterone acetate (depo)
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2
Q

2 second generation progesterones

A

aka estranges
norethindrone
ethynodiol

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3
Q

3rd generation progesterone

A

norgestrel, levonorgestrel
desogestrel
norgestimate
dienogest

**less androgenic effects

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4
Q

nonsteroidal progesterone

A

drospirenone

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5
Q

what is drospirenone derived from?

A

spironolactone

worry about K+ levels with drospirenone

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6
Q

how does progesterin work?

A

makes secretions viscous - prvt sperm get into uterus
prvts LH surge - no ovum released
decrease tubal motility
thins endometrium - lowers implantation probability

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7
Q

4 progestin metabolic effects

A

increased insulin secretion + peripheral resistance
increase lipase
increased fat deposition
increased LDL, HDL

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8
Q

when is progesterone indicated?

A

pregnancy maintance
dysfunctional uterine bleeds
post meno pause HRT
contraception

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9
Q

CI progestin

A 
migrane severe 
DVT or PE 
unexplained bleeding  
breast cancer 
liver dz that is active
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10
Q

progestin ADR

A

acne, hirsutism, high LDL, insulin resistance
Vaginal bleed
DVT
Depo - bone loss

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11
Q

estrogen MOA

A

inhibits FSH release - fertilization does not actually happen

prvts follicle development which = ovulation

enhances LH surge

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12
Q

estrogen helps most with __

A

cycle control - timing

good for ipt with irregular cycles

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13
Q

10 contraindications OCP

A
  1. H/o: stroke, clot, thrombophlebitis, VTE, valvular heart dz
  2. DM with vascular involvement
  3. migraine with aura
  4. uncontrolled HTN
  5. major surgery with prolonged immobilization
  6. breast cancer
  7. liver dz
  8. age is over 35 - smoking more than half pack
  9. pregnant (breast feed less than 6 wks post birth)
  10. thrombogenic mutations
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14
Q

if there is a drug interaction with OCP use __

A

backup method

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15
Q

drug interactions OCP

A
  1. rifampin - lowers OCP efficacy
  2. phenobarb, phenytoin, carbamazepine (AED)
    - use IUD, DMPA, implant instead
  3. ABX? tetracycline, PCN
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16
Q

estrogen contraceptive adr

A

HA, breast tenderness
DVT clot
N

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17
Q

progesterone adr

A

acne hirsutism

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18
Q

if too much estrogen

A

can get dysmenorrhea, menorrhagia or uterine growth

- lower OCP, IUD, IUD, etend cycle

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19
Q

estrogen deficiency

A

early cycle BTB - increase dose

20
Q

if see amenorrhea

A

suggests low estrogen -

check for pregnancy then higher OCP

21
Q

see high appetite, weight gain, bloating

A

progestin excess

22
Q

progestin deficiency =

A

late cycle BTB

23
Q

nuvaring is

A

etonogestrel

insert vaginally leave for 3 weeks

24
Q

minipill

A

progestin only pill - norethindrone

25
Q

POP is ___ with breastfeeding

A

OK

26
Q

POP timeline

A

most take dose at same time (within 3 hours) or = late

27
Q

depo provera is a___injection

A

medroxyprogesterone acetate

28
Q

____ is safest 30 days after delivery in breast feed women

A

Depo-Provera : medroxyprogesteone acetate injection

29
Q

DMPA ADP

A

worry about depression

low BMD

30
Q

implants use

A

etonogestrel - same as nuva ring but under skin

31
Q

___ may be less effective for obese

A

implants

32
Q

ADR implant

A

irregular bleeding
HA, vaginitis, weight gain, acne, breast and abdominal pain
***NO BONE AFFECT

33
Q

before IUD do what?

A

pelvic exam

STI testing

34
Q

YUZpe

A

high dose birth control pill: ee and levonorgestrel

one dose within 72 hours, then 12 hours

35
Q

yuzpe adr

A

N/V

36
Q

Ulipristil Acetate MOA

A

selective progesterone modulator
inhibits or delays ovulation
inhibits folliculogenesis and rupture

37
Q

UA directions

A

take within 120 hours unprotected

ADR: HA/N/ acne, dizzy fatigue

38
Q

plan B

A

levonorgestrel

39
Q

MOA: plan b

A

inhibit/delay ovulation
prevents fertilization
*impairs sperm transport and corpus luteum function
may inhibit implantation

40
Q

___ has higher ectopic risk

A

levonorgestrel

41
Q

always get ___ before emergency contraception

A

pregnancy test

42
Q

RU-486

A

mifepristone

43
Q

moa mifepristone

A

progesterone and cortisol receptor antagonist

44
Q

other RU-486 indications

A

control hyperglycemia secondary to Cushings syndrome who cant have surgery or meds fail

45
Q

misoprostol is given 2 days after mifepristone why?

A

to empty uterus
cramps dizz N/V diarrhea abdominal pain
*follow up within 2 wks to confirm end of pregnancy
watch sepsis sx

Pharm 2 (9 decks)

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