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Phar 508 > Contraception > Flashcards

Contraception Flashcards

1
Q

What is the estrogen component of OCs

A

ethinyl estradiol

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2
Q

T/F: Estrogenic portions of OCs only work on estrogen receptors while progestins have the exact same effect as progesterone

A

False: Estrogenic portions only work on estrogen receptors while progestins work on progestational, androgenic and estrogenic activity BUT are not equivalent to progesterone

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3
Q

What dictates androgenic activity of hormonal contraceptives

A

Sex hormone binding globulin (SHBG)

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4
Q

What is a specific progestin MOA, what are other MOAs

A

slows ovum transport, inhibit ovulation by suppressing LH surge, inhibit implantation by increasing uterine secretions, , thickend cervical mucus, atrophic endometrium

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5
Q

What is a specific estrogenic MOA, what are other MOAs

A

Accelerats ovum transport to fallopian tubes, inhibits ovulations by suppressing release of FSH and LH, increase uterine secretions inhibiting implantion, induction of leutolysis

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6
Q

T/F: Estrogen allows for a more regulated period with more controlled bleeding

A

True

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7
Q

What are disadvantages of estrogen/progestin contraceptives

A

daily administration, hypertension, risk for stroke or MI, thromboembolic risk, metabolic risk

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8
Q

What is an advantage of multiphasic OCs

A

Decrease breakthrough bleeding

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9
Q

How long does it take to return to ovulation when using combined oral contraceptives, patches, nuva ring

A

Around 3 months

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10
Q

T/F: If a patient has side effects they should not change their therapy until 3 months have passed

A

True

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11
Q

What side effects will happen throughout therapy

A

Headache, fatigue/anxiety, decreased libido. Acne

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12
Q

What are side effects of excess estrogen

A

Nausea, edema/bloating, headaches during active pills, breast tenderness/increased breast size

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13
Q

What are side effects of excess progestin

A

Moodiness, headaches between pill packs, vaginal candidiasis

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14
Q

What are side effects of excess androgens

A

Increased appetite, noncyclic weight gain, acne

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15
Q

What are side effects of estrogen deficiency

A

hot flashes/vasomotor symptoms, early and midcycle spotting and breakthrough bleeding, decreased libido

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16
Q

What are side effects of progestin deficiency

A

weight loss, heavy menstrusal flow, late breakthrough bleeding with spotting, delayed onset of menses

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17
Q

What are severe warning signs that say a patient should stop their contrception and see a physician immediately (Hint: Severe ACHES)

A 
A- Abdominal pain
C- Chest pain
H- Headaches
E- Eye problems
S- Severe leg pain
18
Q

What happens if a patient misses 1 OC in time in thier cycle

A

Take missed OC immediately and next regularly scheduled time

19
Q

What happens if a patient misses 2 OC in the first 2 weeks in their cycle, third week

A

Take 2 OC daily for next 2 days then resuming taking OCs on regular schedule/ if Sunday start Take 1 OC daily until Sunday then dispose of current pack once at placebo pills to begin new pack OR Dispose of current current OCs and begin new OC

20
Q

What happens if a patient misses 3 OCs at any time

A

if Sunday start Take 1 OC daily until Sunday then dispose of current pack once at placebo pills to begin new pack OR Dispose of current current OCs and begin new OC

21
Q

T/F: If a patient misses 2 or 3 doses of OCs they should use back-up even if they start a new pack when they menses

A

False: If a patient misses 2 or 3 doses of OCs they use back up UNLESS they start a new pack when they menses

22
Q

What is pack stacking, what does it do, what is the most important recommendation

A

Take all active pills and then throw out placebo of pack1 to start active pills of pack 2, extend the cycle, break 3-4 month intervals for menses

23
Q

T/F: Progestin only pills have 28 acitve pills with no placebo

A

True

24
Q

What is the strict guidelines for taking progestin only pills

A

Must be taken every day at the same time within a 3 hour window AND backup contraception must be used for 48 hour window if is taken more than 3 hours late

25
Q

What are advantages of taking progestin only pills

A

Patients with contraindications to estrogen, patients older than 35, breastfeeding

26
Q

When does ovulation occur for progestin only pills

A

after one month

27
Q

For the xulane patch what are the instructions

A

Apply once a week for 3 weeks each month with no patch on the fourth weeks for menses

28
Q

What are key counseling points for the xulane patch

A

Rotate patch site, safe with bathing and swimming, do not apply topical products around patch site, higher estrogen exposure with lower estrogen pea k

29
Q

When should xulane patches be avoided

A

Greater than 90 kg

30
Q

What are disadvantages of xulane patch

A

Skin irritation, patch detachement, one strength

31
Q

What should be done if xulane falls off within 24 hours, greater than 24 hours

A

Reapply to same place or replace with new patch, start new patch and use backup for one week

32
Q

How should the nuva ring be used, what happens when n the patient would like to have intercourse

A

Insert one ring every 3 weeks then remove the fourth week for menses, may be removed up to 3 hours for intercourse

33
Q

What medication is injected every 3 months and usually has no menses, how long does it take to return to ovulation

A

Depo-provera, 9 months

34
Q

What is the disadvantages of Depo

A

Heavy breakthrough bleeding when started, weight gain, bone loss with use greater than two years

35
Q

What are the eonogestrel implants and how long do they last, what is the biggest side effect

A

Nexplanon and Implanon, every 3 years, infrequent bleeding

36
Q

Which product has an MOA of preventing implantation and impairing sperm motility, how long is it, how effective, biggest side effect

A

Copper IUD, 10 years, over 99%, heavy menses

37
Q

T/F: Emergency Contraception will NOT prevent implanation

A

True

38
Q

When are combined hormonal contraceptions use highly contraindicated

A

Breastfeeding (21 days postpartum), Severe liver cirrohosis, History of DVTs, Diabetes (over 20 years or with neuropathy), gallbladder disease, headaches WITH aura

39
Q

When are IUDs use highly contraindicated

A

Distroted uterine cavity, Cervical cancer, endometrial cancer, persistently elevated beta-hCG levels or malignant disease

40
Q

When is an IUD the only recommened option for birth control

A

Current breast cancer

Phar 508 (21 decks)

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