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Pharm > Contraception > Flashcards

Contraception Flashcards

1
Q

How are failure rates listed?

A

From “best/typical” use

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2
Q

Primary MOA of hormonal contraceptives (HC)

A

Inhibition of ovulation

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3
Q

What are the hormonal components of HC

A

Estrogen (synthetic -> ethinyl estradiol (E2))

Progestins (synthetic -> levonorgestrel)

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4
Q

What are some common groupings of oral contraceptive (OC) products?

A 
Monophasic 
Biphasic
Triphasic
Quadriphasic
Progestin only (mini pill)
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5
Q

What is a hematologic benefit of HC?

A

Increased hemoglobin (some OCs contain Fe2+)

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6
Q

What is a fetal benefit of HC?

A

Reduced risk of neural tube defects (some OCs contain folate)

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7
Q

What are some perimenopausal benefits of HCs?

A

Decrease vasomotor sx

Increased bone mineral density

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8
Q

Adverse effects of HC

A

VTE

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9
Q

RFs of VTE on HC

A 
Obesity
Smoker
HTN
DM
Surgery
Previous DVT
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10
Q

When risk of VTE what kind of HC are you supposed to use?

A

Progestin only

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11
Q

Which HC has the least risk of VTE?

A

Levonorgestrel

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12
Q

What is cancer associated w/ and how were HC altered to deal with that?

A

Unopposed estrogen

Decreased estrogen

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13
Q

What does decreasing estrogen do to efficacy of HC?

A

Increased risk of failure -> pregnancy

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14
Q

What are HC users w/ HTN at greater risk of?

A

MI or stroke

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15
Q

When are HCs not recommended?

A

Smokers > 35 years
HTN
Migraines

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16
Q

What can we do to deal with less serious SEs of HCs

A

Adjusting E2 or progestin content

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17
Q

Which transdermal patch is no longer available?

A

Evra

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18
Q

What do transdermal patches do?

A

Deliver EE and norelgestromin daily

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19
Q

How do you dose the patch?

A

1 patch weekly for 3 weeks

Then 1 week w/o a patch

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20
Q

When are transdermal patches less effective?

A

In women > 90 kg

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21
Q

What is the med content of the vaginal ring?

A

EE and etonogestrel

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22
Q

How do you dose the vaginal ring?

A

Leave the NuvaRing in place for 3 weeks

Then take out for 1 week

23
Q

Benefits of vaginal ring/NuvaRing

A

Rapid return to fertility after removal

Less nausea, acne, irritability, and depression

24
Q

What is the injectable HC, how is it delivered, and how is it dosed?

A

DMPA -> progesterone
IM q 3 months
SC q 3 months

25
Q

What is the benefit of injectable HC?

A

Improved adherence over OCs

26
Q

What are some issues with the injectable HC?

A

Decreased bone density (supposed to DC after 2 years of use)

Delayed fertility

27
Q

What are the subtypes of long acting reversible contraception (LARC)?

A 
Subdermal implant
Intrauterine device (nonhormonal -> copper; hormonal)
28
Q

How long can you use the nexplanon subdermal implant?

A

3 years

29
Q

What does nexplanon contain for x ray visualization?

A

Barium

30
Q

Is Nexplanon affected by BMI?

A

Nope

31
Q

Is Nexplanon safe immediately postpartum/abortion?

A

Yes :D

32
Q

How long can you use a copper IUD?

A

10 years

33
Q

What is the greatest benefit of copper IUDs?

A

They are the MOST effective form of emergency contraception

may be inserted up to 10 days post intercourse

34
Q

What is the main SE of copper IUDs?

A

Increased menstrual bleeding

35
Q

How long can you use hormonal IUDs?

A

3-5 years

36
Q

What is the benefit of hormonal IUDs over copper?

A

Less menstrual bleeding

37
Q

What are the two types of emergency contraception pills?

A

Progestin ECPs

Antiprogestin ECPs

38
Q

How is Progestin dispensed, what is an example, and how long after sex do you take it?

A

OCT -> no age restriction
Levonorgestrel (plan b)
72 hours

39
Q

How is antiprogestin dispensed, what is an example, and when do you take it after sex?

A

Rx only
Uliprostal acetate
5 days after sex

40
Q

Which emergency contraceptive is more effective?

A

Antiprogestin

41
Q

Is it better to wait out the time period after sex or go get the meds sooner?

A

Get them sooner -> prompt is prudent

42
Q

What is mifepristone RU-486?

A

An abortifacient

43
Q

How is mifepristone given?

A

W/ other prostaglandins

44
Q

Give an example of a mifepristone agent

A

PO misoprostol

45
Q

What is the success rate of mifepristone?

A

> 90% w/ pregnancies < 49 days

46
Q

What is E2 mainly metabolized by?

A

CYP3A4

47
Q

What do 34A inducers do?

A

Increase HC metabolism -> increasing risk of pregnancy

48
Q

What are some examples of 34A inducers:

A

Anticonvulsants
Antiretrovirals (HIV)
St. John’s wort

49
Q

What is the risk of pregnancy w/ IUD?

A

18%

50
Q

What is a risk of IUDs?

A

Uterine perforation

51
Q

What is the risk of expulsion of an IUD immediately after placenta delivery?

A

3-27%

52
Q

What is the risk of expulsion of an IUD 10 min -48 hours after placenta delivery?

A

11-27%

53
Q

What is the risk of expulsion of an IUD 4-8 weeks post partum?

A

0-6%

Pharm (32 decks)

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