Emergency Contraception Flashcards
What percentage of pregnancies in women <25 years old end in abortion?
43.9%
Mechanism of levonorgestrel
Delays or inhibit ovulation early in the cycle prior to LH surge
Levonorgestrel delays ovulation for about ___ days, so you want to use barrier method for ___ days after taking ECP.
2-3 days; 7 days (beyond the 5 days of sperm lifespan)
What is the expected pregnancy rate? and the average effectiveness of ECP in percentages?
Pregnancy rate is 4%; 50-60% effective
When do you need to use EC when on depo-provera?
If you it’s been more than 14 weeks since you’re last injection
When do you need to use EC when on progestin only pill?
If missed for more than 3 hours
When do you need to use EC when on combination OC?
1st week - missed pill for 1 day or more
2nd/3rd week - missed pill for more than 3 days
When do you need to use EC when on Evra patch?
1st week - detached for more than 1 day
2nd/3rd week - detached for 3 or more days
When do you need to use EC when on NuvaRing?
1st week - more than 3 hours
2nd/3rd week - 3 or more hours
What is the dose and regime for levongestrel as ECP?
0.75mg 2 tabs stat (or 1 tab q12h)
Which combination OC are used for ECP?
Alesse and Minorvral
What is the dose and regimen for combination OC as ECP?
EE 0.1mg + LNG 0.5mg or EE 0.1mg + Norgestrel 1mg
repeat in 12 hours
How long does it take for ECP to be absorbed?
1 hour
What dose of gravol would you recommend for antiemetic?
50mg
What is the Infant Act of BC?
<19 years of age can give consent to HCP without consent from parent
What is the Child, Family, and Community services act?
Obligation to report abuse of a child
What warrants a referral to the physician?
No menses after 3 weeks, STI, possible abuse, initiation of BCP
What schedule is levonorgestrel?
Schedule 3 but if unlabelled for ECP use then schedule 2
What is the mechanism of ulipristal?
It prevents follicle rupturing and inhibits ovulation when given just before ovulation
What is the dose and regimen of ulipristal for ECP?
30mg taken within 120 hours
What is ulipristal indicated for?
Uterine fibroids so EC is off label use
What is the mechanism of copper IUDs?
- Prevents implantation
- Destroys oocyte in fallopian tubes
- Decreases motility, viability, and fertilizing ability of the sperm
What is a major risk of concern with copper IUD?
PID - but risk drops to baseline after 3 weeks
Within what time frame is copper IUD effective?
Within 7 days
What are the SE of copper IUD?
More pain and more bleeding
