Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacotherapy 4271 > Contraception (Final) > Flashcards

Contraception (Final) Flashcards

1
Q

list some natural methods for non-hormonal contraception

A
  • calendar (prevent pregnancy by knowing when you’re ovulating)
  • basal body temperature
  • cervical mucus method
  • lactational amenorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

this is the temporary postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding (< 4hr daytime and 6 nighttime) and the baby is < 6 months

A

lactational amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

this is a barrier method; concern with allergies to latex or lanolin

A

condoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

this is a barrier method; may be inserted up to 8 hours before sex. more resistant than external condoms. hypoallergenic (made of nitrile polymer)

A

internal condom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

this is a barrier method; may be isnerted up to 2 hours prior to sex and should leave in for at least 6 hours after sex. it is reusuable (for ab. 1-2 years). spermicide is REQUIRED for use. risk of TSS if left in for > 24 hours

A

diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

this is a barrier method; can be inserted up to 1 hour prior to sex and should leave in for at least 6 hours after sex. risk of TSS and vaginal discharge/odour if left in for > 48 hours. it is reusable for up to 1 year

A

cervical cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

this is a barrier method; can be inserted anytime, should leave in for at least 6 hours after sex. contains spermicide (N9). single-use only. risk of vaginosis if left in for more than 30 hours

A

sponge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

this contains N9 which immobilizes or kills sperm. should be inserted 15 mins before sex. risk of abbrations/irritation, which can increase risk of infections

A

spermicide
e.g. VCF contraceptive foam & film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

this is less effective than N9. it helps seal the diphragm and lowers vaginal fluid pH which slows down sperm. may cause less vaginal irritation than N9. may be less effective at preventing pregnancy than a diaphragm + spermicide

A

lactic acid buffering gel
e.g. Contragel & Caya Gel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

this is the most effective method of emergency contraceptive. it creates a cytotoxic environment that produces an inflammatory response that prevents fertilization

A

copper IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the onset of action for a copper IUD

A

effective immediately upon insertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the contraindications for a copper IUD

A
  • pregnancy
  • unexplained vaginal bleeding
  • current STI’s
  • PID
  • unknown distorted uterine cavity
  • post-sepsis
  • active intrauterine disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the s/e of a copper IUD

A

mostly just inital pain and cramping or irregular bleeding due to inflammatory response. no hormones therefore not many other s/e :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what happens to FSH levels when a follicle is developing (during menstruation and follicular/proliferative phase)

A

FSH decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens to LH levels when a follicle is developing (during menstruation and follicular/proliferative phase)

A

LH stays the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what happens to estrogen levels when a follicle is developing (during menstruation and follicular/proliferative phase)

A

estrogen stays the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what happens to progesterone levels when a follicle is developing (during menstruation and follicular/proliferative phase)

A

progesterone stays the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what happens to FSH levels when the follicle has matured, at the time of ovulation

A

FSH slightly increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what happens to LH levels when the follicle has matured, at the time of ovulation

A

LH levels spike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what happens to estrogen levels when the follicle has matured, at the time of ovulation

A

estrogen levels increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens to progesterone levels when the follicle has matured, at the time of ovulation

A

progesterone levels stay the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what happens to FSH levels during the luteum/secretory phase, when the corpus luteum is developing

A

FSH levels stay the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what happens to LH levels during the luteum/secretory phase, when the corpus luteum is developing

A

LH levels stay the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what happens to estrogen levels during the luteum/secretory phase, when the corpus luteum is developing

A

estrogen levels are decreased but then start to increase again

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what happens to progesterone levels during the luteum/secretory phase, when the corpus luteum is developing

A

progesterone levels spike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what happens to FSH levels during regression of the corpus luteum as the next cycle starts to begin

A

FSH levels slightly increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what happens to LH levels during regression of the corpus luteum as the next cycle starts to begin

A

LH levels stay the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what happens to estrogen levels during regression of the corpus luteum as the next cycle starts to begin

A

estrogen levels increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what happens to progesterone levels during regression of the corpus luteum as the next cycle starts to begin

A

progesterone levels decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

this hormone in hormonal contraceptives prevents the release of FSH and keeps the ovaries inactive

A

estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

this hormone in hormonal contraceptives supresses the mid-cycle peaks of FSH and LH, increases the thickness and decreases the volume of cervical mucus which helps decrease sperm motility, it inhibits the development of the uterine lining and may inhibit ovulation in some women

A

progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what generation are the following progestins used in COC:
Norgestimate & desogestrel

A

3rd gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what generation are the following progestins used in COC:
norethindrone & ethynodiol

A

1st gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what generation are the following progestins used in COC:
levonorgestrel & norgestrol

A

2nd gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what generation are the following progestins used in COC:
drospirenone & dienogest

A

4th gen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

this generation of progestins is associated with the most androgenic activity therefore more androgen s/e such as weight gain, acne, etc.

A

2nd gen - levonorgestrel and norgestrol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what estrogens are available in COCs

A

ethinyl estradiol and estetrol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In this type of combination birth control pill, each active pill contains the same amounts of estrogen and progestin.

A

monophasic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

oral contraceptive pills have 3 different doses of progestin and estrogen that change approximately every 7 days.

A

triphasic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

oral contraceptive pills that deliver the same amount of estrogen each day while progestin dose is increased halfway through cycle.

A

biphasic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what formulation (mono, bi or triphasic) should be used if using back to back hormone (no period)

A

monophasic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

this COC contains a plant derived native estrogen - estetrol & drospirenone

A

Nextstellis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

true or false: Nextstellis may be less effective in patients with a BMI > 30

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

true or false: pelvic exam, pap smear or STI screening are required before initiating COC

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what are some risk factors that should be looked for when taking a patients medical hx prior to prescribing COC

A
  • smoker
  • obesity
  • history of MI, stroke, angina or VTE
  • uncontrolled HTN
  • dyslipidemia
  • uncontrolled DM
  • migraine with aura
  • hx of breast cancer
  • hx of liver disease
  • IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

true or false: if a patient is less than 35 and smokes > 15 cigs/day, hormonal contraception should not be used

A

false - age < 35, the number of cigs does not matter
the advantages generally outweigh the risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

true or false: if a patient is >35 and smokes < 15 cigs/day, hormonal contraception should not be used

A

kinda true! - theoretical risks usually outweigh the advantages, take pt by pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

true or false: if a patient is > 35 and smokes > 35 cigs/day, hormonal contraception should not be used

A

true
unacceptable health risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

true or false: the risk of thromboembolism is greater in obese patients

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

which hormonal contraceptive option has weight gain as a possible side effect

A

depo-provera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

true or false: ethinyl estradiol is an inhibitor of CYP 3A4

A

false - inducer, therefore lowers levels of CYP 3A4 substrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

true or false: ethinyl estradiol is a CYP 3A4 substrate, therefore inducers such as phenytoin will increase the metabolsim of ethinyl estradiol furthermore decreasing its effectiveness

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

true or falase: if a patient is on a strong CYP 3A4 inducer, then the preferref treatment is Depo-Provera q 12-13 weeks or LNG IUD

A

false - Depo Provera q 10 weeks or LNG IUD
q 12-13 weeks is normal regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

when gathering a patients menstruation history, what are some questions you should ask?

A
  • has the patients reached menarche
  • when was their last period
  • has the patient has unprotected sex since their last period
  • does the patient have undiagnosed vaginal bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what are the criteria that can rule out pregnancy

A

no signs or symptoms of pregnancy AND one of the following:
- exclusively breastfeeding, amenorrheic and < 6 months postpartum
- no intercoirse since last menses
- correctly using reliable contracpetion
- < 7 days after menses
- < 7 days after abortion or miscarriage
- < 4 weeks postpartum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what are the two options for conventional dosing for COC

A

1 tablet daily x 21/7, then 7 days of no pills

1 tablet daily x 28/7 (last 7 tablets are non-hormonal)

*can take continuously but should avoid multiphasic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what are some advantages of extended/continuous use COC

A
  • decrease dysmenorrhea
  • may improve other sxs associated with menstrual cycle
  • convenient (delays or eliminates menstruation)
  • good adherence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are some disadvantages of extended/continuous use COC

A
  • possible delay in the recognition of pregnancy
  • unscheduled bleeding and spotting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

if a patient misses their COC pill that they were supposed to take <24 hours ago, what should they do?

A

take 1 active pill ASAP and continue pack as usual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

if a patient misses their COC pill that they were supposed to take >24 hours ago, what should they do?

A

see product monograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

true or false: progestin only pills must be taken within a 3 hour window daily for 28 days with NO hormones free interval

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

true or false: when starting a POP, 2 days of backup is required if you start on day one of menses

A

false - no back up required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

true or false: when starting a POP, 2 days of backup is required if you start >5 days after onset of menses

A

false - backup required for 7 days

64
Q

true or false: when starting a POP, 2 days of backup is required if starting on another day other than day 1 of menses or <5 days after onset of menses

A

true

65
Q

true or false: if a dose of POP is missed or delayed by > 3 hours, the patient should use backup for 48 hours

A

true

66
Q

true or false: if patient has episode of diarrhea/vomiting within 3 hours of taking POP dose, they should use back up for 48 hours

A

true

67
Q

what are some s/e associated with POP

A

specific for progestin:
- shorter menstrual cycle
- androgenic s/e (e.g. acne, weight gain)

any hormone:
- breast tenderness
- h/a
- nausea
- mood disturbances

68
Q

what are some CI’s to using POPs

A
  • current breast cancer
  • avoid with active systemic lupus and conditions associated with malabsorption
69
Q

this type of oral contraceptive is usually prescribed when estgrogen is contraindicated or less appropriate
- common in post partum because doesnt affect milk supply and doesnt increase risk of blood clot

A

progestin only

70
Q

what is the dosing regimin for the vaginal ring

A

insert one ring q 3 or 4 weeks

71
Q

true or false: backup is needed if starting the vaginal ring on day 1 of menses

A

false

72
Q

true or false: backup is needed if starting the vaginal ring immediately

A

true

73
Q

when would a patient require backup in terms of missed dose of the vaginal ring

A
  • removal for > 3 hours
  • > 48 hours delayed insertion
  • inserted for more than 28 days
74
Q

what are some s/e of vaginal ring

A
  • h/a
  • vaginitis
  • leukorrhea

other: nausea, breast tenderness

75
Q

what are some advanatges of the vaginal ring compared ot oral contraceptives

A
  • daily action not required therefore increased compliance
  • better for patients who have trouble taking oral medications due to adherence or issues with GI absorption
  • less nausea, acne, emotional effects and unscheduled bleeding than COC
  • shorter duration of menstrual bleeding than with patch
76
Q

what is the dosing for the transdermal patch

A

apply one patch once weekly x 3 weeks than one week patch free

77
Q

true or false: backup is required when starting the patch on day 1 of menses

A

false

78
Q

true or false: backup is required if starting the patch immediately

A

true

79
Q

when would a patient require backup in terms of missed dose of the patch

A
  • patch detached > 24 hours
  • first patch delayed by >24 hrs
  • > 7 day hormone free interval
80
Q

what are some s/e associated with the transdermal patch`

A
  • breast sxs
  • h/a
  • nausea
  • application site reactions
81
Q

true or false: the transdermal patch is less effective in those > 90kg

A

true

82
Q

what is the dosing for Depo-Provera

A

one injection IM every 12-13 weeks

83
Q

true or false: backup is needed if starting depo-provera immediately

A

yes - 7 days

84
Q

true or false: backup is needed if starting depo in first 5 days of menses

A

false

85
Q

when would a patient require backup if they missed a dose of depo-provera (think of timeline you get dose)

A

if injection interval is >14 weeks, use backup for 7 days

86
Q

what are some common s/e associated with depo-provera

A
  • Irregular bleeding for first few months
  • amenorrhea after one year
  • weight gain (often seen in 1-3 months; if no weight gain after 3 months prob wont happen)
  • bloating
  • mood changes
  • h/a
87
Q

true or false: pharmacists can prescribe and administer depo provera

A

true

88
Q

true or false: depo provera is a type of comibined hormonal contraceptive

A

false - progestin only

89
Q

what are some contraindications for depo-provera

A
  • breast cancer
  • unexplained vaginal or urinary tract bleeding
90
Q

true or false: there is a delay in fertility once you stop taking depo provera

A

true - 6-12 months

91
Q

what is the dosing for hormonal IUDs

A

inserted into the uterus by healthcare provider once q 5 years

92
Q

true or false: backup is needed if getting IUD inserted on within 7 days of menses

A

false

93
Q

true or false: backup is needed if getting IUD inserted immediately

A

true

94
Q

true or false: hormonal IUDs are a combined hormonal contraceptive

A

false - progestin only

95
Q

what are some CIs associated with progestin only iUD

A
  • pregnancy
  • unexplained vaginal bleeding
  • current STI’s
  • PID
  • unknown distorted uterine cavity
  • post-sepsis
  • active intrauterine disease
    ^ same as copper IUD +
  • breast, cervical or endometrial cancer
96
Q

what are some s/e associated with progestin only IUD

A
  • irregular bleeding in first 3-6 months
  • amenorrhea or decrease in amount of menstrual bleeding
  • expulsion of IUD
  • pain/cramping following insertion
97
Q

true or false: pharmacists can prescribe IUDs

A

false - b/c we cannot insert them

98
Q

true or false: there is a delay in fertility once an IUD is removed

A

false - fertility may return immediately

99
Q

this medication may be used for women with a narrow cervical canal who will be getting an IUD inserted

A

misoprostol

100
Q

this medication may be used for post-insertion pain of an IUD

A

oral NSAIDs

101
Q

what is the dosing for the subdermal implant

A

inserted subdermally q 3 years

102
Q

true or false: backup is needed if starting implant within 5 days of menses

A

false

103
Q

true or false: backup is needed if starting implant immediately

A

true - 7 days

104
Q

what are some CI’s for the subdermal implant

A
  • < 18 y/o
  • pregnancy
  • current or past hx of thrombosis
  • liver tumors / liver disease
  • abnormal vaginal bleeding
  • breast cancer
105
Q

what are some s/e assoicated with the subdermal implant

A
  • changes in menstrual bleeding
  • mood swings
  • weight gain
  • h/a
  • acne
  • breast tenderness
  • abdominal pain
  • post insertion site pain or reaction
  • chloasma (yellow rash on face)
106
Q

true or false: pharmacists can prescribe subdermal implant

A

false - b/c we cannot insert it

107
Q

true or false: the subdermal implant tends to be less effective in people who are overweight

A

true

108
Q

true or false: a medical blood pressure check up is required after insertion

A

true - RPh can do this!

109
Q

true or false - there is a delay in fertility after removal of implant

A

true - but only 7-14 days thus recommend immediate backup

110
Q

this is the use of a druf or device to prevent an unwanted pregnancy that may occur after unprotected sex

A

emergency contraception (EC)

111
Q

what are some indications for emergency contraception

A
  • no contraceptive method used or incorrect use
  • condom slip or break
  • displacement of cervical cap or diaphragm
  • removal, displacement or missing IUD
  • missed COC, especially in the first week of pack or if starting a new pack late
  • > 3 hours late taking POP
  • removed intravaginal contraceptive ring for > 3 hours during an in ring week
  • removed patch for > 24 hours during a patch week
  • > 14 week interval between depo shots
  • ejaculation on external genitalia
  • sexual assault
112
Q

this emergency contraceptive contains Levonorgestrel 1.5mg. it inhibits ovulation and fertilization

A

non prescription EC e.g. Plan-B, Contingency One)

113
Q

in what time period is Levonorgestrel 1.5mg the most effective

A

within 24 hours (still has decent efficacy up to 72 hours)

114
Q

what are some s/e of Levonorgestrel EC

A
  • nausea
  • vomiting (may take gravol 1 hr before taking)
  • dizziness
  • fatigue
  • headache
  • breast tenderness
  • lower abdominal pain
  • spotting/breakthrough bleeding
  • altered timing of next cycle
115
Q

true or false: pharmacists can prescribe Levonorgestrel EC

A

true - but can get oTC

116
Q

if a patient vomits within this time period of taking Levonorgestrel EC, when should they repeat the dose

A

2 hours

117
Q

true or false: hormonal contraception initiation needs to be delayed after EC use

A

false - can be started the day of or day after EC use

118
Q

true or false: if a patient has a contraindication to COC they cannot use hormonal EC

A

false - b/c risk of having a clot in pregnancy is much higher than one dose of EC

119
Q

true or false: Levonorgestrel EC is the best choice of EC for patients who are breastfeeding

A

true

120
Q

this type of EC delays ovulation. it is a selective progesterone receptor modulator

A

ulipristal acetate EC

121
Q

in what time period is ulipristal acetate EC the most effective

A

up to 5 days post intercourse

122
Q

if a patient vomits within this time period of taking ulipristal acetate EC, when should they repeat the dose

A

3 hours

123
Q

what are some s/e associated with ulipristal acetate EC

A

same as levo
- nausea
- vomiting (may take gravol 1 hr before taking)
- dizziness
- fatigue
- headache
- breast tenderness
- lower abdominal pain
- spotting/breakthrough bleeding
- altered timing of next cycle

124
Q

what is a possible CI to using ulipristal acetate

A

preferably avoid in pateints who have used hormonal contraception or levo EC in the past 7 days

125
Q

true or false: ulipristal acetate is less effective in people with BMI > 30

A

false - best oral EC in these patients

126
Q

true or false: resuming hormonal contraception or initiation needs to be delayed after ulipristal use

A

true - do not initiate or resume regular hormonal contracpetion for at least 5 days after taking ulipristal

127
Q

true or false: ulipristal is safe to use in breastfeeding

A

false - it is recommended to pump and discard milk for one week after taking ulipristal

128
Q

this is the most effective EC. it is effective up to 7 days post intercourse; continues long term contraception after insertion

A

copper IUD

129
Q

true or false: copper IUD is less effective in patients with a BMI > 30

A

false - most effective option for these patients

130
Q

true or false: copper IUD is a safe EC option in breastfeeding

A

true

131
Q

this is a method of emergency contraception that uses a combination of ethinyl estradiol and levonorgestrel, specifically 1 mg of norgestrel (or 0.50mg of levonorgestrel) and 100 mcg of ethinyl estradiol ASAP and again in 12 hrs.

A

yuzpe regimen

132
Q

in what timeline is the yuzpe regimen effective

A

within 72 hours post intercourse

133
Q

if a patient vomits within this time period of using yuzpe regimen EC, when should they repeat the dose

A

2 hours

134
Q

this medication is used for medical termination of a developing intrauterine pregnancy with a gestational age up to 9 weeks as measured from the first day of the last menstrual period in a presumed 28 day cycle

A

Mifegymiso

135
Q

what is the dosing for Mifegymiso for the termination of pregnancy

A

mifeprisone PO followed by misoprostol bucally 24-28 hrs after

136
Q

this medicaiton in Mifegymiso blocks progesterone receptors, causing the endometrium to no longer sustain the growing embryo; the lining of the uterus then breaks down, and bleeding begins. is also triggers an increase in PG levels and dilates the cervix

A

Mifepristone

137
Q

this medication in Mifegymiso induces contractions, relaxes the cervix leading to evacuation of the intrauterine content

A

misoprostol

138
Q

when should a patient be followed up with a physician after taking mifepristone

A

7-14 days

139
Q

true or false: return to fertility is delayed after taking Mifegymiso

A

false - return to fertility expected immediately

140
Q

what are the red flags for prescribing any type of hormonal contraceptive

A
  • history of breast cancer
  • severe liver disease
  • liver cancer
  • active viral hepatitis
  • at high risk for heart attack or stroke - SLE
  • undiagnosed vaginal bleeding
141
Q

what are the red flags for prescribing estrogen, that would result in a prescription for POP, LARC or DMPA

A
  • diabetes with microvascualar disease OR >20 years
  • uncontrolled hypertensions SBP >160 or DBP > 100 or hypertension with vascular disease
  • migraine with aura
  • DVT/PE risk
  • complicated vascular disease
142
Q

patients under what age need to be referred for prescribing of contraception

A

under 12

143
Q

this medication is not recommended for patients under the age of 18 due to a possible impact on bone mass in people who are still growing

A

depo-provera

144
Q

based on the product monograph of these three types on hormonal contraceptive, they are not recommended for those under the age of 18

A

patch
implant
ring

145
Q

the pediatric society recommends this form of contraception no matter what age

A

IUD

146
Q

the canadian contraception consensus guidelines recommend this method of contraception in post partum individuals regardless of breastfeeding status

A

progestin only

147
Q

although the risk of VTE us the same in breastfeeding and non-breastfeeding women, the use of _______ is generally not recommended before 6 months post-partum in women who are breastfeeding

A

CHC

148
Q

what should you do if a patient is started on a CHC, and they have complaints of increased acne

A

switch to higher EE or a progestin with less androgenic activity

149
Q

what should you do if a patient is started on a CHC and they have complaints of increased bloating

A

switch progestin to drospirenone which has weak postassium sparing diuretic effects

150
Q

what should you do if a patient is started on a CHC and they have complaints of breast tenderness, weight gain or headaches

A

switch to lower EE dose or progestin with less androgenic activity

151
Q

what should you do if a patient develops migraines ir their migraines worsen after being on a CHC, what should you do

A

switch to progestin-only contraceptives

152
Q

what should you do if a patient is started on a CHC and they have complaints of nausea

A

switch to a lower estrogen dose

153
Q

what should you do if a patient is on a CHC but they’re having breakthrough bleeding early in their cycles (after a 3 month trial)

A

switch to a higher estrogen dose

154
Q

what should you do if a patient is on a CHC but they’re having breakthrough bleeding late in their cycle (after 3 month trial)

A

switch to a higher progestin dose or a progestin that has higher progestin activity

155
Q

what are some options for a patient who is having breakthrough bleeding who is on a progestin only contraceptive method

A
  • switch to low dose COC x 1-3 days
  • add estrogen x 10-20 days (oral conjugated estrogen or estradiol)
  • add NSAIDs x 5-7 days
  • add tranexemic acid 2-3 tabs 3-4 times a day for several days; routine use is not recommended
156
Q

which progestin generation has the most progestrone and androgen effects

A

second

157
Q

which first generation progestin thst has higher progesterone effects but less androgen effects
a) norethindrone
b) ethynodiol diacetate

A

norethindrone

Pharmacotherapy 4271 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions