Contraception Trigger Flashcards
what are the possioble estrogen types found in COC’s
- ethanyl estradiol (MC)
- mestranol
- 17b-estradiol
- estradiol valerate
what are the possible progestins found in COC’s
- norethindrone
- levonorgestrel
- desogestrel
- norgestimate
- drosperinone
this progestin ingredient has less androgenic effects but a higher VTE risk.
what is it? what class is it?
drospirenone
spironolactone analogue
if a patient calls your office and says she has missed 3 doses of her COC’s, how long should you tell her to use barrier contraceptive techniques for? what other advice should you give?
7 days.
if you have had sex in the past 5 days you need to use an emergency contraception
a patient misses one dose of her low-dose monophasic COC’s. what do you tell her to do?
double the dose the next day and use barrier contraception for 7 days.
if you have had sex in the past 5 days you need to use an emergency contraception
a patient misses a single dose of her high dose monophasic COC’s. what do you tell her to do
continue taking the pills as prescribed, no need to double the next dose. conception is unlikely
What are the benefits of using COCs? (8)
- Reduced ovarian cx
- Reduced endometrial cx
- Improved bone mass
- Decreased progression of RA
- Improves acne
- Lower risk of ectopic + PID
- Decreased risk of benign fibrocystic breast dz
- Improvement in dysmenorrhea and premenstrual s/s
i know ima forget these and jensens gonna be like “all of the following except!!!!”
what contraception has high rates of irregular bleeding and increases overall bleeding rate
POCs
which contraception is CI in hepatic neoplasms, active liver dz, breast cx and unexplained vaginal bleeding
POC’s
i would assume COC’s as well, but POC’s specify hepatic neoplasms lol
COCs containing levonorgestrel are known as what for emergency contraceptions
the Yuzpe method
100mcg ethinyl estradiol + 500-600mcg levono
what is it and how is it taken
Yuzpe method (COCs containing levonorgestrel)
2 doses 12 hrs apart.
Main SE of this is nausea and vomiting. its recommended to premedicate for this SE.
what med and dose
Yuzpe method
100mcg ethinyl estradiol + 500-600mcg levono
2 doses 12 hrs apart
What is the Plan B one step AKA? what is the dose?
Aftera
levonorgestrel
2 options:
1500 x 1
750 x 2
which emergency contraceptives prevent the LH surge
levonorgestrel and ulipristal
these DO NOT stop fertilization or implantation
single dose of 1500ug or double of 750ug
levonorgestrel
single dose of 30mg
ulipristal
SE include liver dz, cervical cx, breast cx, and clots
COC’s
which emergency contraceptions inhibit implantation or possibly interfere with sperm function
copper IUD
Levonorgestrel IUD 52mg
if a patient reports she had unprotected. sex 4 days ago but missed her doses of birth control over the past 2 days, what are her options for emergency contraception
copper IUD (5-7 days)
Levonorgestrel IUD (5 days)
which contraceptive method decreases risk of ectopic, PID, and benign fibrocystic breast disease?
COCs
what are the types of transdermal contraceptives? which has a BMI limitation
- orthoevra
- xulane
- zafemy
- twirla (BMI limitation of 30)
a patient presents to you and says she realized her transdermal contraceptive fell off while she was sleeping, but she reapplied it when she woke up. what should you tell her
that she does not need to use a backup method of contraception. she only needs a backup method for a week if it was off for greater than 24hrs.
this contraception method has more dysmenorrhea and breast symptoms than others. it also has the possibility of increased VTE and higher failure rate in obese patients.
transdermal patches
this contraception is given Q 3 months
depot medroxyprogesterone shot
which contraception method can lower endometrial cx by up to 80% and can also lower risks of sickle cell crisis? this also has no increased risk of vascular disease
depot medroxyprogesterone shot
what contraception method has a major side effect of decreased bone density and also takes up to 10 months after cessation to return to baseline fertility
depot medroxyprogesterone shot
MC SE includes irregular menses, Wt gain and HA
nexplanon
CI includes migraine w aura, smoking over 35 and acute liver dz
COC’s
CI for this includes displaced uterus, infections, and wilsons dz
copper IUD
which lenovo IUD only lasts 3 years?
5?
8?
3 - skyla
5 - kyleena
8 - mirena and liletta
which IUDs may help treat heavy menses or dysmenorrhea
Liletta and Mirena
CI in patients who have had a prior ectopic prenancy
progesterone IUDs
which contraceptive method may reduce HIV risk by 90%?
internal female condom
what is the MC and most effective form of pharmaceutical abortion
Mi and Mi
(mifepristone + misoprostol)
<49 days from FDLMP
1st trimester
if a patient comes to you and reports they recently found that they are 17 weeks pregnant, what are their options for abortion
- intra-amniotic instillation
- dilation and evac (MC for 2nd trimester)
- hysterectomy/hysterotomy
MOA is synthetic prostaglandin E1
causes uterine contractions and cervical ripening
cytotec (misoprostol)
