Emergency Contraception Flashcards
Does emergency contraception require a counselling room?
Yes
What are 4 red flags for referral with emergency contraception ?
- Greater than 72 hours since unprotected intercourse with levonorgestrel (120 for ulipristal)
- Suspected sexual assault.
- Possible pregnancy and abdominal pain.
- Contraindications for example, pregnancy.
Does emergency contraception have a PSA Self-Care Card?
Yes (Contraception)
What are the directions for Levonorgestrel 1.5mg (Postrelle 1) for emergency contraception?
Adults, > 16 years: 1 tablet STAT. *Must take within 72 hours of unprotected intercourse (Sooner the better).
What are the directions for Ulipristal Acetate 30mg (EllaOne) for emergency contraception?
Adults > 16 years: 1 tablet STAT *Must take within 120 hours (5 days) of unprotected intercourse (Sooner the better).
What is the recommended structure of questioning for emergency contraception?
- Introduce yourself and offer privacy
- Has the patient had unprotected intercourse? When?
- Check regular adherence to COCP: Missed pills, timing in cycle.
- Identify red flags.
- Check other medications
- Check medical conditions
- Provide clear counselling information: Explain efficacy, directions, possible adverse effects (N+V), if vomiting occurs within 2 hours, re-dose.
- Continue COCP from tomorrow for levonorgestrel (after 5 clear days for ulipristal), 7 days additional protection required.
- Ask if the patient has any questions and assess their understanding
Is levonorgestrel safe in pregnancy?
No
Is levonorgestrel safe in breastfeeding?
Yes
What is the age range for levonorgestrel?
Adults > 16 years.
Is ulipristal safe in pregnancy?
No
Is ulipristal safe in breastfeeding?
Yes
What is the age range for ulipristal?
Adults > 16 years.
What are 15 pieces of non-pharmacological advice for emergency contraception?
- Use a physical barrier method such as male/female condoms.
- Use a fresh condom each time you have sex
- Use of water based lubricant
- with rubber condoms to reduce risk of breaking
- Advice surrounding use of
- long term contraceptive methods for example, oral pill, IUD, implant
- Taking a pregnancy test within 7 days (for peace of mind for patient).
- The tablet should be taken as soon as possible after unprotected intercourse.
- If vomiting occurs within 2 hours of taking the tablet, an additional tablet will need to be taken
- You need to use a barrier method for at least 7 days of active tablets once restarting COCP.
- Your next period should occur around the anticipated date but can occur one week before or after that time. If late by > 1 week, recommend urine pregnancy test.
- You may notice some spotting with use.
- If pregnancy occurs after taking EC, consult your doctor and let them know that you used the EC (increased risk of ectopic pregnancy)
- Common side effects include nausea and vomiting, breast tenderness, vaginal bleeding and headache
- A copper IUD is an effective alternative to levonorgestrel for EC, and is effective if inserted within 5
