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Pharmacotherapy 2 - Final Exam > Contraceptives Study Guide > Flashcards

Contraceptives Study Guide Flashcards

1
Q

Progestin-Releasing IUD (Mirena) MoA

A

Endometrial atrophy&raquo_space; Inhibit implantation; Cervical mucous thickening

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2
Q

Progestin-Releasing IUD (Mirena) Effects

A

Decreased menstrual blood loss & severity of dysmenorrhea

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3
Q

Progestin-Releasing IUD (Mirena) Cautions

A

Multiple sex partners ^ risk of PID; Copper allergy; Wilson’s disease

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4
Q

Progestin-Releasing IUD (Mirena) Disadvantages

A

Risk of ectopic pregnancy; Rare - Uterine perforation

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5
Q

2 Classes of OCPs

A

Combination (Estrogen & Progestin); Progestin-only

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6
Q

Monophasic OCPs

A

All active pills have identical amts of hormones

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7
Q

Biphasic & Triphasic OCPs

A

Different amts of hormones in active pills to mimic natural cycle and reduce AEs

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8
Q

Estrogen MoA

A

Suppress production of FSH&raquo_space; prevent selection & emergence of dominant follicle

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9
Q

Lowest Ethinyl Estradiol Dose

A

20 mcg

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10
Q

Effects of Lower Ethinyl Estradiol Dose

A

^ risk of spotting; less margin of error for missed tabs; minimizes estrogen related side effects

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11
Q

Highest Ethinyl Estradiol Dose

A

35 mcg

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12
Q

Estrogen Side Effects

A

Spotting; peripheral edema; HTN; Hypertriglyceridemia; THROMBOEMBOLISM

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13
Q

Progestin MoA

A

Inhibits ovulation by suppressing LH surge; Thickens cervical mucous

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14
Q

Drug with Most Progestin Activity

A

Levonorgestrel

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15
Q

Progestin with Most ANDROGENIC Activity

A

Norgestrel/Levonorgestrel

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16
Q

OCPs safe during lactation

A

Progestin-only pills (“minipills”)

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17
Q

Progestin Side Effects

A

Mood changes; Gallbladder dysfunction

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18
Q

Androgenic Side Effects of Progestin

A

Increased appetite/wt gain; Acne; Hirsuitism; ^LDL & Dec HDL

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19
Q

Non-contraceptive benefits of most OCPs

A

Decreased risk of endometrial/ovarian CA; ectopic preg; Iron def anemia; Acne

20
Q

Benefit of Combined OCPs

A

Prevention of ovarian cysts

21
Q

Risks of Combined OCPs

A

Increased risk of CV events; HTN; VTE; Breast/Cervical CA; Glucose intolerance; Gallbladder dz; Hepatic tumors

22
Q

OCP contraindications

A

Thromboembolic dz; Cerebrovascular dz; CV dz; Impaired liver function; Breast CA; Smokers > 35; Personal or Familial Hypertriglyceridemia

23
Q

Adverse effects of Too Much Estrogen

A

Nausea; Breast tenderness; HTN; Melasma; HA

24
Q

Adverse effects of Too Little Estrogen

A

Early/mid cycle spotting; Hypomenorrhea

25
Q

Adverse effects of Too Much Progestin

A

Breast tenderness; HA; Fatigue; Mood changes

26
Q

Adverse effects of Too Little Progestin

A

Late cycle spotting

27
Q

Adverse effects of Too Much Androgen

A

Increased appetite; wt gain; Oily skin; Acne; Hirsuitism; ^LDL & Dec HDL

28
Q

Combination OCP MoA

A

Inhibits ovulation; Reduced penetration of egg by sperm; Reduced implantation; Thickened mucus to prevent sperm penetration; Slowed tubal motility

29
Q

OCP “Starter Set” (EE & Norgestimate)

A

Ortho-Cyclen; Ortho Tri-Cyclen; Ortho Tri-Cyclen Lo

30
Q

Starting OCPs

A

Start pills during first five day of cycle; use backup method for one week after starting pills

31
Q

When to use backup birth control

A

Use for 7 days if more than 2 pills are missed

32
Q

Drugs Decreasing Effectiveness of OCPs

A

ABX, esp. rifampin; Anticonvulsants

33
Q

Meds affected by OCPs

A

Anticoagulants; Insulin; Hypoglycemics; TCAs

34
Q

Extended & Continuous OCPs

A

Seasonale (84 active tabs); Seasonique (84 active tabs); Lybrel (continuous)

35
Q

Seasonale AE

A

More intercycle spotting

36
Q

Seasonique Advantage

A

Helps with menstrual symptoms & migraines

37
Q

Disadvantage of Transdermal Patch (Ortho-Evra)

A

Increased failure rate in pts > 200 lbs; may have more thromboembolic risks

38
Q

Disadvantage of Vaginal Ring (Nuvaring)

A

^ incidence of vaginitis & vaginal d/c; back up required until ring is in for 7 consecutive days

39
Q

Minipill Disadvantages

A

Higher rate of unintended preg; Spotting is common; Must take at same time every day; > 3 hrs late requires backup for 48 hr

40
Q

DepoProvera Cautions

A

Undiagnosed abNL vaginal bleeding; Liver dz; Severe depression; Severe CV disease

41
Q

DepoProvera Advantages

A

Safe while lactating; Less risk of thromboembolism

42
Q

DepoProvera Disadvantages

A

Decreased bone density

43
Q

Emergency Contraceptive MoA

A

Inhibit/delay ovulation; Interferewith fertilization or tubal transport; Prevent implantation by altering endometrial receptivity; ineffective after pregnancy has occurred

44
Q

Best Emergency Contraceptive

A

High dose progestin = Levonorgestrel

45
Q

Emergency Contraceptive Timing

A

Best w/in 24 hr of unprotected sex; Labeled for use up to 72 hr after sex

Pharmacotherapy 2 - Final Exam (10 decks)

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