Device placed in FP to cause occlusion (sterilization) - device in fallopian tubes - use another BC for 1st 3mo

Contraceptive TBL Flashcards by Kalin .

Best IUD for nulliparous women

Skyla (smallest)

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Paragard FDA approved for how long?

Effective for how long?

FDA: 10y
effective: up to 20y

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Mirena FDA approved for how long?

Effective for how long?

FDA: 5y
effective: 7y

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Skyla FDA app for how long?

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Liletta FDA app for how long?

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Hormone in hormonal IUD?

levonorgestrel

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IUD to tx heavy menstrual bleeding

Mirena

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AEs for hormonal IUD

uterine perf
irregular/inc bleeding 1st 3-6mo
infection w/ insertion
ovarian cyst

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AE for copper IUD

heavy bleeding/cramping
uterine perf
infection
ovarian cyst

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What is Essure?

Device placed in FP to cause occlusion (sterilization)

device in fallopian tubes
use another BC for 1st 3mo

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Nexplanon active ingredient

progestin etonogestrel

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(most) OCP ingredients

ethinyl estradiol, progestin (less progestin)

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which has a lower total hormone dose per cycle - monophasic or multiphasic pills?

multiphasic

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which has less bleeding effects/AEs - mono or multi phasic pills?

SAME for both

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how many periods/year on a 21/7 pill pack?

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advantage of extended cycle contraceptives?

fewer menstrual sx (HA, blot, pain)

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non-contraceptive benefits of pills

dec risk ovarian + endometrial Ca
less dysmenorrhea
dec. ectopic pg
dec. benign breast dz
dec. free T (less acne/hirsutism)

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what type of BC to tx PCOS?

OCP combo pills

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desogestrel and orgestimate are types of ….

progestins (claim to have less androgen activity than previous progestins)

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AEs of combo OCP w/ higher estrogen

breast tenderness
breast enlargement
if very high (>50mcg)… increased MI, ischemic stroke (CI in unctrolled HTN/smokers)

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AEs of combo OCP w/ lower estrogen

bleeding disturbance

- VTE

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AEs of extended cycle OCP

spotting

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estrogen-containing OCP CI in ___

>15 cigs/day
>35 yo w/ HTN, CHD, HF, CVA, DM w/ end-organ damage, migraines, @ risk for VTE)
Hx breast Ca
Hx thromboembolic d/o
Hx liver dz

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Indication for minipill

BF women
estrogen CI women
if estrogen poorly tolerated

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Drugs that dec effectiveness of OCPs

- rifampin - HIV antivirals - anticonvulsants - St John wrost - pcn/tetracycline - unproven

Active ingredient of injectables

medroxyprogesterone

AE injectables

wt gain amenorrhea/irreg bleeding dec boen mineral density

How soon can you get pg after last injection?

6-12 mo (median 10 mo)

Patch active ingredients

ethinyl estradiol + norelegestromin

Patch less effective in women weighing >

90kg

Patch AE

skin irritation, breakthru bleeding

Who gets a higher dose of hormones - those on patch or pill?

patch

How to use patch?

3 weeks on/1 off | arm, butt, back, low abd

active ingredient vaginal ring

ethinyl estradiol + etonogestrel | e-tono - tone - ringtone

how long can you take the ring out w/o needing back up contraception

how long to use backup contraception after leaving the ring out for >3h

AE ring

discomfort HA vaginal discharge

which has more nausea, dpn, acne, irritiability- ring or OCP?

OCP

what % of pg can emergency contraception prevent?

50-80%

Plan B one step, Next Choice One Dose are what type of ECP?

progestin only | active ingredient: levonorogestrel

progestin only ECP effective for

72h (possible up to 5d)

ECP SE

HA abd pain breast tenderness N/V

Ella is a

antiprogestin ECP | active ingred: ulipristal acetate

Ella effective for

Most effective ECP?

Ella

1st line ECP for overwt/obese

Ella

Copper IUD works as ECP for up to how long after conception

If you vomit __h after taking ECP you need another dose

<1h

When to put diaphragm in

6h before sex, til 6h after

Max time to have the diaphragm in

24h

Max time to have cervial cap in

48h

How to use spermicide w/ the cap/diaphragm

- once before sex w cap | - before each act of intercourse w/ diaphragm

What kind of condom doesnt protect against viral infection

lamb intestine

What kind of condom is most likely to break

polyurethane

What kind of condom may be most effective at preventing STI and can be used w/ oil based lube

female condom

How long is the sponge effective after you put it in and leave it there

24h

Max time to leave in sponge to avoid infection

24-30h

What area of anatomy does spermicide have to be in contact w/

cervix

how long before sex to use spermicide

which devices require no compliance by woman, and thus most effective

implant, IUD, sterilization

most cost effective

implant/IUD

most effective emergency contraceptive

copper IUD

Which binds least strongly to estrogen receptor ?

E3 (estrone/estriol)

where is estrogen produced before ovulation

follicle by theca + granulosa cells

where is estrogen produced after ovulation

LUTENIZED granulosa +theca cells of coprus luteum

Aromatase (CYP19A1) does what 2 conversions?

androstenedione > estrone | testosterone > 17Bestradiol

what does estrogen do to your lipid profile?

^HDL + triglycerdies | dec LDL and cholesterol

what does estrogen do to your blood coag factors?

^ Factor 2, 7, 9, 10, plasminogen | decr antithrombin 3