contraception

Question 1

IUD should be avoided in who?

Answer 1

pelvic inflammatory disease patients

Question 2

what is COC

Answer 2

progesterone and oestrogen.

Question 3

common ingredient oestrogen only

Answer 3

ethinylestradiol , mestranol

Question 4

progesteron content?

Answer 4

desogesterel, gestodene, levongesterel, norethiserone,

Question 5

advantages COC?

Answer 5

• reduces risk of endomentrial cancer
• reliable and reversible
• reduce dysmenorrhoea and menorrgoea
• reduce pre menstiural tension
  less symptomatic fibroids and function ovarian cysts
• reduce begnin breast disease and pelvic inflammatory disease

Question 6

monophasic?

Answer 6

means fixed amount of oestrogen and progesterogen

Question 7

phasic?

Answer 7

varying amounts of oestrogen and progestogen throughout the pack

Question 8

low strength 20mcg ethinylestradiol used for?

Answer 8

used for women with risk factors for circulatory

Question 9

ethinylestradiol and desogesterel/ dropirenone or gestodene used for who?

Answer 9

used for women with SE, such as acne, headache, depression, breast symptoms, breakthrough bleeding

Question 10

drospirenone derrivative of what?

Answer 10

spironolactine - so risk of hyperkalemia

Question 11

what are the egs of COC

Answer 11

microgynon
- yasmin
cilest
femodette

Question 12

who are phasic COCs used for

Answer 12

women who hace breakthrough bleeding or do not have withdrwal bleeding

Question 13

what happens if undergoing surgery?

Answer 13

stop oestrogen 4 weeks before major ellective surgery and all surgery to legs. offer progesterogen only contraceptive and once mobile then can restart

Question 14

what is elective surgery?

Answer 14

planned surgery

Question 15

if unplanned surgery and cant stop oestrogen 4 weeks before hand what do you do?

Answer 15

offer unfractioned LMWH and graduated stockings

- THROMBOPROPHYLAXIS

Question 16

what conditions require oral contraceptives and HRT to be stopped immediately

Answer 16

• sudden sever chest pain radiating to left arm
• sudden breathlessness - cough with blood stained sputum
• pain in calf stomach
  very strong long headaches
• jaundice
  liver enlargments
• hypertension
  prolonged immolity after surger
• severe neurological effects
• unexplained swelling of leg

Question 17

Cautions of COC

Answer 17

increase risk of VTE
increase risk of breast and cervical cancer
- the risks disappear after stopping

Question 18

what advice to give with COC

Answer 18

travel, increased risk of DVT if more than 3 hours

• reduce risk by excersizing during journey and wearing graduated compression hosiery
• if and D and V take another pill ASAP if happens within 2 hours of taking pill

Question 19

define missed pill?

Answer 19

24 hours or more
12 hours is for qlaira

critical time is at beginning or end of cycle

Question 20

what to do if missed pill?

Answer 20

take as soon as remeber
take next one at normal time even if it means taking 2 pills
if one missed no precaution required if take next one as soon as remember

Question 21

what to do if 2 or more pills missed?

Answer 21

espec if this happens in first 7 days, may no longer be protected
take an active pill as soon as remebered, abstain from sex or use protection for next 7 days
if these 7 days run beyond end of pack, start the next packet at once and OMIT the pill free interval or the 7 inactive tablets ED pills

Question 22

when is EHC Used in missed pills?

Answer 22

if 2 or more COC tablets from the first 7 days and had sex since finishing last packet

Question 23

when are progesterone only contraceptives used?

Answer 23

suitable when oetrogens are CI - VT , heavy smokers, hypertension above 160/95, vulvular disease, diabetes, migraines with aura

Question 24

how do progesterone only work

Answer 24

they alter cervical mucus to prevent sperm penetration and ovulation in some women

Question 25

what do desogestrel do?

Answer 25

inhibits ovulation

Question 26

parenteral progesteron only contraceptive e.g.

Answer 26

medroxyprogesterone acetone. long acting , given by injection.

Question 27

IUD EG?

Answer 27

mirena 0 effects local and hormonal

Question 28

IUD CAN BE USED WHEN?

Answer 28

when women have heavy periods

Question 29

advantages of mirena IUD over copper IUD

Answer 29

reduction in blood losss | improvement in any dysmenorrhea and reduction in pelvic disease

Question 30

all progesterone only contraceptives are suitable to coc when?

Answer 30

before major elective surgery

Question 31

spermicidal contraceptives?

Answer 31

used as additional, not effective alone it has 2 componants spermide and vehicle not reccomended for use with condoms or those at high risk of sti or hiv

Question 32

when can IUD be insetered

Answer 32

5 days after sex or 5 after earliest calculated ovulation

Question 33

iud not effected by?

Answer 33

other drugs and bmi

Question 34

when do you have to give levonelle doubled unliscensed ?

Answer 34

when bmi greater that 26 or weight more than 70 or would just give ella one

Question 35

what is the counselling advice for ehc

Answer 35

if vomitting occurs in 3 hours need another pill (ellaone) - next period may be early or late - barrier contraception needed till next period - seek medical attention if any lower abdo pain - could be extopic pregnancy - return in 3-4 weeks if period missed, is light, too heavy or brief. take the pregancy test

Question 36

levongesterol when do you have to take another pill?

Answer 36

normal contraceptive take after 2 hours of vommiing ehc - take after 3 hours of vommitting

Question 37

when can take coc again after ehc?

Answer 37

5 days

Question 38

what can effectiveness of all pocs and cocs and ehc be reduced by?

Answer 38

ENZYME INDUCERS : carbamepine, phenytoin, phenobarbital st johns wart rifampacin rifabutin

Question 39

which contraceptive methods are uneffected by enzyme inducers?

Answer 39

iud medroxyprogesterone norethisterone non hormonal contraceptives

Question 40

Are precautions required when cocs are used with antibacterials

Answer 40

no, unless the induce liver enzymes and unless d and v occur.

Question 41

parental progestogen only contraceptives se?

Answer 41

troublesome bleeding oesteoperosis can can reduce bone moneiral density only use in adults when other measures are inappropriare

Question 42

e.g of parental progestogen only contraceptives?

Answer 42

noristerat, nexplanon, implanon

Question 43

any precautions with parental progestogen only contraceptives

Answer 43

delay first injection to 6 weeks after giving birth to reduce risk of bleeding