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NAPLEX Prep > Contraception and Infertility > Flashcards

Contraception and Infertility Flashcards

1
Q

what are the hormone changes in the follicular phase? What days of the cycle is this?

A

FSH leads to follicle development and an inc in estrogen
estrogen causes inc FSH and LH
day 0-14

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2
Q

what are the hormone changes in the ovulatory phase? Which days of the cycle is this

A

day 14 x 24-36h
LH increase triggers egg release from ovary

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3
Q

what are the hormone changes in the luteal phase? Which days is this?

A

progesterone dominates
day 14-28

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4
Q

what are the folic acid, Ca and vit D requirements during preg

A

600mcg folic acid a day
1000mg/day Ca
600IU (15mcg)/day Vit D

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5
Q

which BCs are highest efficacy

A

IUD, nexplanon implant, sterilization male or female

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6
Q

second most efficacious BC

A

depo, pill, patch, ring, diaphragm

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7
Q

third most efficacious BCs

A

male condom
female condom
pulling out
sponge

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8
Q

lest efficacious BCs

A

spermicide
cycle tracking

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9
Q

what does “Lo” mean

A

</= 35mg estrogen per pill!!

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10
Q

what does 24 mean for pills?

A

24 days active, 4 days placebo

this is shorter, some placebo times are >4 days

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11
Q

what does Tri mean

A

triphasic, 3 different types of hormone doses (7/7/7)

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12
Q

what are the monophasic BCs

A

sprintec-28
cryselle-28
yasmin 28
Yaz
microgestin fe 1/20
junel fe 1/20
Apri

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13
Q

what is the only quadriphasic BC

A

Natazia

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14
Q

what does 1/20 mean

A

there is a 7 day placebo week

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15
Q

what are the advantages of drosperinone?
what products have drosperinone?
What should we monitor

A

unique progestin that is also a mild K sparing diuretic that will dec bloating, PMS sx
low androgenic activity (good for acne, hirsutism)
in Yasmin, Yaz, Nextellis
Slynd is drosperinone only!
Monitor potassium!!

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16
Q

which BCs are E and P

A

ring
pill
patch

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17
Q

which BCs are progesterone only

A

POPs (Slynd, Errin, Camila, Nora-Be)
depo provera
non-copper IUDs

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18
Q

how do POPs/mini-pills work

A

suppress ovulation, thicken cervical mucus, thin endometrium

19
Q

besides drosperinone, what progesterone has the second lowest androgenic activity

A

norgestimate

20
Q

what are patients who are good candidates for progesterone only BCs

A

migraine w aura
estrogen CI (>35 who smoke or have CVD)
breastfeeding
HTN
mood changes

21
Q

what patients are good candidates for drosperinone

A

targeting acne or hirsutism
targeting bloating
no concern for hyperkalemia
estrogen CI

22
Q

adverse effects of depo shot

A

dec MBD
need to supplement with Ca and Vit D

23
Q

how should patients take POPs

A

must take QD within a 3 hour window

24
Q

who are not good candidates for drosperinone

A

liver or renal failure
hyperkalemic
clot risk

25
Q

side effects of estrogen

A

nausea
breast tenderness
bloating
weight gain
thrombosis

ACHES (abd pain, chest pain, HA, eye issues, swelling)

26
Q

estrogen is CI in

A

> 35 who smoke or have CVD
hx DVT, PE, stroke, CVD, thrombosis of heart valve
ovarian cancer
liver cancer
breast cancer
migraine w aura
DM w vascular disease
use with Mavyret for Hep C

27
Q

estrogen/progesterone patches are CI in

A

BMI >/=30 2/2 inc clot risk (Xulane, Zafemy) and dec efficacy (Twirla)

28
Q

which drugs dec BC efficacy

A

mostly inducers of CYPs
rifampin
AEDs (tegretol, trileptal, phenytoin, primidone, topamax, lamicatal, barbiturates)
SJ wort
tobacoo
ritonavir
colesevelam

29
Q

when starting a COC, how long should a backup form of contraception be used

A

7 days

30
Q

when starting a POP, how long should backup be used

A

48 hours

31
Q

if a patient missed their COC last night at 9 pm, what should they do? Are backup and/or EC needed?

A

has been less than 48 hours/less than 2 missed
take missed pill ASAP, take scheduled one at 9pm as usually regardless if theres two pills in one day
no EC or backup needed

32
Q

if a patient missed last two COCs at 9pm and it is now 10am next day, what should they do?

A

take 1 pill ASAP and continue regularly scheduled one that night at 9pm
EC needed if unprotected sex in last 5 days
backup x7d

33
Q

if a patient missed their Slynd dose by 8 hours, what should they do? Are backup and/or EC needed?

A

take missed dose ASAP as well as scheduled dose for later that day
EC needed if unprotected sex in last 5d
backup x48h

34
Q

what are the options for emergency contraception

A

copper IUD
levonorgestrel (Plan B)
My Way
Ullipristal (Ella)

35
Q

what time window does a patient have to use Plan B

A

3 days (72 h)

36
Q

what time window does a patient have to use Ella (Ullipristal)

A

5 days

37
Q

which ECs are RX

A

Ella
IUD needs office visit

38
Q

which ECs are OTC

A

My Way / Plan B

39
Q

what time window does a patient have to receive a copper IUD as EC

A

5 days

40
Q

what is the dose for Plan B/My Way

A

1.5mg levonorgestrel x1

41
Q

what is the dose for Ella (Ullipristal)

A

30mg x1

42
Q

what are common SE of EC

A

nausea/vomiting

43
Q

infertility is defined as

A

inability to conceive after 1 year of unprotected sex

44
Q

what drugs are typically used for infertility tx

A

clomiphene
gonadotropins
aromatase-i (letrozole)

NAPLEX Prep (57 decks)

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