Contraceptives Flashcards
What can contraceptives be used for aside from preventing pregnancies
Menstrual cycle regulation
Reduction of premenstrual symptoms
Tx of acne
What are the Estrogen contraceptives
Ethinyl estradiol
Mestranol (prodrug of above)
What are the Progestin contraceptives? Rank from highest to lowest androgenic activity
Levonorgestrel and Norgestrel
Norethindrone
Desogestrel and Norgestimate
Drospirenone (anti-androgenic)
What are the non-hormonal contraceptives
Barrier
IUD
Sterilization
What are the combined oral contraceptives
Monophasic
Biphasic
Triphasic
What is in Monophasic
Fixed dose in each pill
What is in Biphasic and Triphasic
Variable proportions of each hormone
How do combined oral contraceptives work
Suppress FSH and LH (prevent ovulation)
How does Progestin act
Thickens cervical mucus
Impairs implantation
How do you limit AE of oral combined contraceptives
Low doses
What do combined oral contraceptives have a protective effect over
Endometrial/Ovarian CA Benign breast disease Ovarian cysts PID Acne
What is the most common combined oral contraceptive cycle
21 active 7 placebo
What are the most common AE of combined oral contraceptives
Nausea, bloating
Breakthrough bleeding
What are the most notable AE of combined oral contraceptives
Hirsuitism Oily skin Acne Melasma Amenorrhea Dyslipidemia
What is the CVD effect of combined oral contraceptives
Increased VII, X and fibrinogen
What are the main combined oral contraceptives contraindications
Thromboembolic disease Stroke,CAD BreastCA,estrogendependentneoplasm Hepatictumorsorliverdisease Abnormaluterinebleeding Heavysmokingover 35
What are the minor contraindications for combined oral contraceptives
Migraine HTN Diabetes Fibroids Breast feeding Smoking
What do you not want to give with combined oral contraceptives
P450 inducers
Broad spectrum ABx - Rifampin
What are the Pregestin Pills
Norgestrel
Norethindrone
What is the advantage of progestin pills over combined OCPs
No thromboembolism
What do Progestin pills do
Decrease dysmenorrhea
Decrease menstrual blood loss
Decrease PMS Sx
How do Progestin pills act
Block ovulation in 60-80% of cycles
Thickening of cervical mucus
Endometrial alterations to impair implantation
Progestin pill AEs
Unscheduled bleeding
Spotting
What are the Non-Oral Hormonal Contraceptives
Patch Ring Progestin injection Progestin implant Intrauterine systems
What’s in the patch
Ethinyl estradiol
Progestin
What’s in the ring
Transvaginal patch basically
Ethinyl estradiol
Progestin
What’s the Progestin injection
Depo-Provera
Contains DMPA
How often do you get the Progestin injection
IM every 3 months
Progestin injection AE
Menstrual irregularities
Weight gain
Loss of bone mineral density (BLACK BOX)
Where is the Progestin implant placed
Under skin in upper arm
AE for Progestin implant
Irregular menstrual bleeding
How long does the Progestin implant last
3 years
What does the Polyethylene Intrauterine system contain
Levonorgestrel
How long does the Intrauterine system last
5 years
Hormonal methods of post-coital contraception
Levonorgestrel
Ulipristal acetate
High dose norgestrel
How is Levonorgestrel administered in post-coital contraception
Before 72hrs and 12hrs after that
What does Ulipristal acetate do
Inhibit/Delay ovulation
How and what non-hormonal post-coital contraception is used
Copper IUD
Insert within 5 days
