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pre reg > contraception > Flashcards

contraception Flashcards

1
Q

IUD should be avoided in who?

A

pelvic inflammatory disease patients

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2
Q

what is COC

A

progesterone and oestrogen.

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3
Q

common ingredient oestrogen only

A

ethinylestradiol , mestranol

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4
Q

progesteron content?

A

desogesterel, gestodene, levongesterel, norethiserone,

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5
Q

advantages COC?

A
  • 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
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6
Q

monophasic?

A

means fixed amount of oestrogen and progesterogen

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7
Q

phasic?

A

varying amounts of oestrogen and progestogen throughout the pack

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8
Q

low strength 20mcg ethinylestradiol used for?

A

used for women with risk factors for circulatory

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9
Q

ethinylestradiol and desogesterel/ dropirenone or gestodene used for who?

A

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

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10
Q

drospirenone derrivative of what?

A

spironolactine - so risk of hyperkalemia

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11
Q

what are the egs of COC

A

microgynon
- yasmin
cilest
femodette

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12
Q

who are phasic COCs used for

A

women who hace breakthrough bleeding or do not have withdrwal bleeding

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13
Q

what happens if undergoing surgery?

A

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

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14
Q

what is elective surgery?

A

planned surgery

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15
Q

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

A

offer unfractioned LMWH and graduated stockings

- THROMBOPROPHYLAXIS

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16
Q

what conditions require oral contraceptives and HRT to be stopped immediately

A
  • 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
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17
Q

Cautions of COC

A

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

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18
Q

what advice to give with COC

A

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
19
Q

define missed pill?

A

24 hours or more
12 hours is for qlaira

critical time is at beginning or end of cycle

20
Q

what to do if missed pill?

A

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

21
Q

what to do if 2 or more pills missed?

A

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

22
Q

when is EHC Used in missed pills?

A

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

23
Q

when are progesterone only contraceptives used?

A

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

24
Q

how do progesterone only work

A

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

25
Q

what do desogestrel do?

A

inhibits ovulation

26
Q

parenteral progesteron only contraceptive e.g.

A

medroxyprogesterone acetone. long acting , given by injection.

27
Q

IUD EG?

A

mirena 0 effects local and hormonal

28
Q

IUD CAN BE USED WHEN?

A

when women have heavy periods

29
Q

advantages of mirena IUD over copper IUD

A

reduction in blood losss

improvement in any dysmenorrhea and reduction in pelvic disease

30
Q

all progesterone only contraceptives are suitable to coc when?

A

before major elective surgery

31
Q

spermicidal contraceptives?

A

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

32
Q

when can IUD be insetered

A

5 days after sex or 5 after earliest calculated ovulation

33
Q

iud not effected by?

A

other drugs and bmi

34
Q

when do you have to give levonelle doubled unliscensed ?

A

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

35
Q

what is the counselling advice for ehc

A

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
36
Q

levongesterol when do you have to take another pill?

A

normal contraceptive take after 2 hours of vommiing

ehc - take after 3 hours of vommitting

37
Q

when can take coc again after ehc?

A

5 days

38
Q

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

A

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

39
Q

which contraceptive methods are uneffected by enzyme inducers?

A

iud
medroxyprogesterone
norethisterone
non hormonal contraceptives

40
Q

Are precautions required when cocs are used with antibacterials

A

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

41
Q

parental progestogen only contraceptives se?

A

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

42
Q

e.g of parental progestogen only contraceptives?

A

noristerat, nexplanon, implanon

43
Q

any precautions with parental progestogen only contraceptives

A

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

pre reg (6 decks)

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