Emergency contraception adolescent patients–understanding usage

Question 1

What are the various reasons for use of emergency contraception?

Answer 1

It is used to prevent pregnancy after having unprotected sex which may include sex without contraceptive method, incorrect usage of contraception, forced sex for from sexual assault.

Question 2

What are the 2 types of emergency contraception?

Answer 2

Oral medications or an intrauterine device

Question 3

Does emergency contraception because abortions?

Answer 3

No it does not cause abortion since that does not interfere with an existing pregnancy.

Question 4

What are the 3 oral medications used for emergency contraception?

Answer 4

Ulipristal acetate (UPJ)
Levonorgestrel (LNG)
YUZPE method

Question 5

What family of medications is ulipristal acetate?

Answer 5

It is an oral progesterone receptor agonist–antagonist

Question 6

Describe the prescription use?

Answer 6

It can be used up to 120 hours after unprotected sex. It is only available by prescription

Question 7

What are some of the side effects to counsel the patient about and possibly need to test for?

Answer 7

Headache, nausea, and abdominal pain are the most common side effects. Patient’s menstrual cycle may be delayed after taking UPA, therefore a pregnancy test should be obtained if the menstrual cycle does not occur within 3 weeks of taking UPA.

Question 8

FDA approved emergency contraception LNG is what type of med?

Answer 8

And emergency contraceptive oral progestin.

Question 9

What is the maximum time frame to administer the medicine, LNG after unprotected sex?

Answer 9

Can be used up to 72 hours after unprotected sex.

Question 10

What should the patient be appraised about regarding the menstrual cycle etc.

Answer 10

The menstrual cycle may occur sooner than expected. A pregnancy test should be obtained if the menstrual cycle does not occur within 3 weeks of taking LNG. The patient may have heavier menstrual bleeding and spotting. It is over-the-counter without a prescription but may be expensive.

Question 11

YUZPE FDA approved for emergency contraceptive?

Answer 11

It is an off label use of combined oral contraceptive pills

Question 12

What to drugs and dosing quantity should the two contraceptive pills contain and how are they dosed?

Answer 12

The pill should each contain at least 100 mcg of ethinyl estradiol and at least 500 mcg levonorgestrel, and the patient takes 2 doses of OCPs 12 hours apart

Question 13

One of the most common side effects with the Yuzpe method?

Answer 13

Nausea and vomiting therefore premedicating with antiemetic may be helpful.

Question 14

What devices used for intrauterine emergency contraceptive?

Answer 14

The copper IUD is the most effective type of emergency contraception.

Question 15

How soon should the copper IUD be placed for emergency contraceptive reasons and what is its advantage?

Answer 15

It should be placed by a trained professional within 5 days of unprotected sex. It has the additional benefit of providing maintenance contraception.

Question 16

What of the common side effects associated with the copper IUD?

Answer 16

Heavy menstrual bleeding and dysmenorrhea.

Question 17

What are the contraindications for copper IUD placement?

Answer 17

Wilsons disease, active cervical/pelvic infection or abnormal anatomy that prevents insertion.

Question 18

What increases the efficacy of oral emergency contraceptives?

Answer 18

The efficacy increases the sooner they are taken.

Question 19

What would decrease the oral emergency contraceptives efficacy?

Answer 19

If the patient is overweight.

Question 20

Does the efficacy of copper IUDs change with timing of placement and are they affected by the patient’s weight status?

Answer 20

Copper IUDs have similar efficacy at any point prior to his time limit and it is not affected by the patient’s weight.

Question 21

Are hormonal IUDs approved for emergency contraception?

Answer 21

They are not approved

Question 22

What is the absolute contraindication for emergency contraceptive use?

Answer 22

Pregnancy is the only absolute contraindication for emergency contraceptive use although the use of emergency contraceptive and has been shown not to affect already established pregnancies pregnancies

Question 23

When should maintenance hormonal contraception be started after initiating or giving emergency contraception?

Answer 23

Maintenance hormonal contraception can be started, or resumed immediately after starting LNG or theYuzpe method but it should be delayed for 5 days after starting the UPA since it may interfere with its mode of action.

Question 24

Why is it important to use a condom or abstinence for at least 7 days after starting maintenance hormonal contraception?

Answer 24

Because there is a delay in ovulation after taking oral contraceptives

Question 25

What should patients be reminded about emergency contraceptives and STDs?

Answer 25

Emergency contraceptives do not protect against STDs. STD screening for gonorrhea and chlamydia is needed prior to copper IUD insertion. STD screening and a review of maintenance contraception should be recommended for any patient visit for emergency contraception.