EHC 2

Question 1

why do we need to know which contraception a patient is on before giving EHC?

Answer 1

because theres different lengths of time needed for cover to reestablish

Question 2

how many days for COC to reestablish cover??

Answer 2

seven days

Question 3

how many cays for POP to reestablish cover?

Answer 3

in general 2 days

Question 4

which pills in COC are most important?

Answer 4

first and last 7 pills as if you miss these then the 7 days pill free period is elongated and cover is compromised

Question 5

what to advise if they are starting a COC at day 6 or later?

Answer 5

add precautions for 7 days

Question 6

what is quick starting method

Answer 6

if HC is started after days 1-5

Question 7

how long can you get immediate cover if changing from a COC (non ED)-POP

Answer 7

for immediate cover, omit pill free period and start POP immediately- no bleed here

Question 8

how long do you need precautions if changing from a COC (ED)-POP

Answer 8

add precautions for 2/7 if ED(placebo) pills are taken

Question 9

do you have cover in your PFP?

Answer 9

yes if taken previous 21 correctly

Question 10

starting POP: cerazette? precautions for

Answer 10

if you start in days 1-5 then immediate cover

if > day 6 then need precautions for 2/7

Question 11

starting POP: micronor/ noriday? precautions for

Answer 11

no need for precautions, can be taken at any point in the cycle and will be effective immediately

Question 12

changing from POP- COC qlaira

precautions?

Answer 12

needs 9 days precautions

Question 13

changing from POP- COC (incl zoely)

precautions?

Answer 13

additional precautions for 7 days

Question 14

when is COC classed as a missed pill? when is EHC indicated?

zoely and qlaira?

Answer 14

> 24 hours late
if 2 missed in >24 hours
missing one doesnt effect but 2 does
Z&Q: EHC is needed if 1 or more is missed in 12 hours

Question 15

if missed pill for Z or Q then how long do you need to build cover?

Answer 15

Z: 7 days
Q: 9 days

Question 16

when is POP classed as a missed pill?
precautions after this?
when is EHC indicated?

Answer 16

micronor/ noriday: >3 hours late
cerazette/ cerrelle: >12 hours late
precautions for2 days
if 1 or more pills are missed in 3/12 hours and UPSI before 2 more tablets are correctly taken?

Question 17

if someone has missed their COC and its the 23 hour point what pills should they take?

Answer 17

take the missed dose and then 30 minutes later take the next days dose

Question 18

continuing contraception after EHC:

what do you do on the day of taking either LNG or EO

Answer 18

omit today unless already taken

Question 19

continuing contraception after EHC:

LNG continuing?

Answer 19

miss todays

restart tomorrow and continue pill for 7 days with precautions to build cover

Question 20

continuing contraception after EHC:

EllaOne continuing

Answer 20

omit todays and an additional 5 days after as progesterone stops ellaone working
then use additional precautions until the next mensural period
if unrealistic then say precautions for 14 days after taking the pill, 16 days for qlaira and 9 days for POCs.

Question 21

can you take EHC more than once in the same month

Answer 21

yes but must be the same time

Question 22

when to take a pregnancy test?

Answer 22

if period is more than 5 days late for LNG or >7 days for EO