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Year 4 Prescribing > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the three methods of combined hormonal contraception

A

Tablets patches and rings

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2
Q

What age is too old for the combined contraception

A

50

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3
Q

Name 7 health benefits of Combined hormones contraception

A

Reduced risk of ovarian endometrial and colorectal cancer
Predictable bleeding patterns
Reduced dysmenorrhea and menorrhagia
Management of symptoms of PCOS endometriosis and premenstrual syndrome
Improves acne
Reduced menopausal symptoms
Maintaining bone mineral density in perimenopausal females under 50yo

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4
Q

What does the term monophonic and multiphase mean in relation to combined contraception

A

Monophasic - fixed amount of oestrogen and progesterone

Multiphasic - varying amounts of the two hormones

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5
Q

What is the general dose of ethinylestradiol in the first line pill in combination with what type of progesterone

A

Monphasic 30micrograms in combination with levonorgestrel or norethisterone

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6
Q

Ethinylestradiol is in … units

A

Micro grams

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7
Q

Estradiol is in what units

A

Mg

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8
Q

What are alternative ways to use the pill in terms of hormone free intervals

A

21 days in 4 days off
9 weeks on 4-7 days off
21 days on then 4 days off when breakthrough bleeding occurs
Continuous use with no hormone free days

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9
Q

What should be checked annually on the pill

A

BP and BMI

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10
Q

When should the pill be stopped and recommenced with surgery

A

Stop 4 weeks prior

Continue two weeks after

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11
Q

How do oral progestogen only preparations work

A

Alter cervical mucous to prevent spleen penetration and may inhibit ovulation

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12
Q

How do desogesterel only preps work

A

Inhibit ovulation

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13
Q

What is the main reason for giving progesterone over combined pill

A

When oestrogen is contraindicated

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14
Q

What is the medical name for Depo

A

Medroxyprogesterone acetate

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15
Q

What may occur after discontinuation of depo

A

Delayed return of fertility and irregular cycles

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16
Q

How long does it take for fertility to return after depo

A

3-6 months but can take up to a year

17
Q

Is the implant combined or progesterone

A

Progesterone

18
Q

How long does the implant work for

A

3 years

19
Q

IUS is

A

Progesterone only - levonorgestrel

20
Q

IUS how long does it take for fertility to return

A

Rapid

21
Q

Contraindications to combined contraceptives

A 
Heart disease breast cancer hepatocellular carcinoma 
Known thrombophlebitis mutations 
Less than 6 weeks postpartum 
Migraine with aura
Previous or current VTE 
Stroke /TIA
PVD 
Smoking aged >35 
SLE
Be cautious with BRCA mutation 
BMI>35 
Cervical neoplasia
22
Q

Side effects of combined pills

A

Acne fluid retention weight gain headaches irregular bleeding nausea

23
Q

Which cancers does the pill increase the risk of

A

Breast

Cervical

24
Q

When does the risk of breast cancer diminish after the use of cocp

A

Disappears after 10 years of using the pill

25
Q

When do you get an increase in risk of cervical cancer

A

If using for longer than 5 years

Diminishes after 10 years

26
Q

Can you use cocp while breast feeding

A

Avoid until weaning or for 6 months after birth

27
Q

When can you start the pill after giving birth

A

3 weeks or 6 weeks with risk factors

28
Q

When can you start taking the pill

A

If starting on day six or later you need barrier protection for the first 7 days

29
Q

When is the critical time for loss of contraceptive protection

A

When a pill is omitted at the beginning or end of a cycle (which lengthens the pill free interval)

30
Q

If a woman misses a pill she should take it ….. and the next one taken …..

A

As soon as possible ….. taken at normal time even if it means taking two together

31
Q

When does a pill count as missed

A

If greater than 24 hours or later

32
Q

If 2 or more missed particularly in the first seven days …..

A

Barrier protection

33
Q

If two or more missed and barrier protection used for 7 days but the 7 days end up running beyond the end of the packet

A

Take the next packet immediately and don’t take a break

34
Q

What is the main contraindication for progesterone only pill

A

Acute porphyria

Breast cancer

35
Q

What is a suitable alternative contraception prior to surgery

A

Progesterone only pill

Year 4 Prescribing (28 decks)

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