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Pharm II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

when does pregnancy begin (when can bhcg be measured)?

A

implantation

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2
Q

when is the peak fertility window?

A

day 9-15 of cycle

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3
Q

7 main categories of contraception

A
  1. surgical sterilization
  2. IUD
  3. barrier methods
  4. E/P method
  5. progestin only
  6. emergency contraception
  7. natural family planning
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4
Q

what needs to be considered when prescribing birth control?

A
  1. reversibility
  2. effectiveness
  3. contraindications
  4. secondary benefits
  5. AEs
  6. cost
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5
Q

which methods are immediately irreversible?

A
  1. copper IUD
  2. condom
  3. natural family planning
  4. birth control pills
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6
Q

which 5 birth control methods are the most effective?

A
  1. progesterone implant
  2. vasectomy
  3. LNG-IUD
  4. tubal ligation
  5. copper IUD
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7
Q

which 5 birth control methods are the least effective?

A
  1. spermicide
  2. natural family planning
  3. withdrawal
  4. female condom
  5. sponge
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8
Q

which time frames are considered long acting (in terms of needing to think about it)?

A
  1. once

2. Q3-10 yrs

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9
Q

which contraceptive method is reversible but takes 6 months?

A

DMPA

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10
Q

what are the CIs to EP pills?

A
  1. current breast disease
  2. severe cirrhosis
  3. hx of DVT/PE
  4. DM nephropathy/retinopathy/neuropathy
  5. headache w/aura
  6. HTN
  7. CVD
  8. seizure d/o
  9. strokes
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11
Q

which contraceptive methods are most expensive?

A

diaphragm, condoms, DMPA

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12
Q

which contraceptive method can be delivered as short acting or long acting?

A

progestin only

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13
Q

how often is DMPA delivered?

A

Q3mon

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14
Q

how often are progestin IUDs good for?

A

3-5 years

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15
Q

which contraceptive method can be delivered as an injection, implant, IUD, or pill?

A

progestin only

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16
Q

how do EP methods work?

A
  1. suppress follicle development
  2. thickens cervical mucus
  3. inhibits ovulation
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17
Q

how does progesterone specifically act as a contraceptive?

A
  1. LH suppression
  2. thickens cervical mucous
  3. atrophic endometrium
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18
Q

how does estrogen specifically act as a contraceptive?

A
  1. FSH suppression

2. altered tubular transport

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19
Q

what can estrogen alone cause?

A

endometrial cancer

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20
Q

what can progestin alone cause?

A

acne, mood swings

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21
Q

what are the 3 methods of EP delivery?

A
  1. pill
  2. ring
  3. patch
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22
Q

what is the point of the triphasic EP pill and what causes this multiphasic nature?

A

to mimic nature (caused by progestin)

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23
Q

what are the common SE of EP?

A
  1. N/V
  2. HA
  3. breast enlargement/tenderness
  4. libido alteration
  5. breakthrough bleeding
  6. acne, oily skin, hirsutism
  7. hair loss
24
Q

what are the secondary benefits of EP?

A
  1. acne
  2. menstrual cycle control
  3. lighter/shorter periods
  4. improved cramps
  5. bone protection
  6. decr risk for ovarian and endometrial cancer
25
Q

what are the types of IUD?

A
  1. copper IUD

2. LNG-IUD

26
Q

how do IUDs work?

A

inhibit fertilization & secondarily inhibit implantation

27
Q

how does the copper T act?

A

reduces sperm motility and viability

28
Q

how does the LNG-IUD work?

A

inhibits ovulation, thickens cervical mucus, reduces sperm motility and viability

29
Q

CI for IUDs

A
  1. current STI
  2. unexplained uterine bleeding
  3. large deforming fibroids
  4. Wilson’s
  5. copper allergy
30
Q

what are the SE of an IUD?

A
  1. uterine perforation
  2. expulsion
  3. cramping
  4. PID
  5. heavy menses (copper)
  6. irregular spotting (LNG)
31
Q

what are two benefits of barrier contraception over hormonal?

A

most dont require prescription and they offer STI protection

32
Q

what 2 types of barriers are there?

A

chemical and physical

33
Q

what are the types of chemical barriers?

A
  1. today sponge
  2. spermicides
  3. diaphragm and cervical cap
34
Q

when is natural family planning esp not the best method?

A

if you have irregular cycles (<21 days or >28 days)

35
Q

what is natural family planning?

A

selective abstinence

36
Q

what are the forms of emergency contraception?

A
  1. levonorgestrel (OTC)
  2. Ulipristal
  3. copper IUD
  4. combo EP pills (need to take multiple)
37
Q

which emergency contraceptives are good for 120 hours?

A

ulipristal and copper IUD

38
Q

how do hormonal emergency contraceptives work?

A

delay ovulation and may interfere with sperm migration and function at all levels of genital tract

39
Q

for which patients may EC not work?

A

overweight (copper IUD will work)

40
Q

what are the side effects of EC?

A
  1. uterine bleeding
  2. N/V
  3. HA
  4. abd pain
41
Q

which EC may cause early abortion?

A

ulipristal

42
Q

what is medication abortion?

A

mifepristone

43
Q

what needs to be done after admin mifepristone?

A

US to confirm

44
Q

which contraceptive cannot be used while breastfeeding?

A

EP pill

45
Q

what are common problems with DMPA?

A

weight gain and decr bone density

46
Q

for which women are estrogen alone pills ok?

A

those w/o a uterus

47
Q

What is a w/d bleed?

A

when a woman takes the placebo pills in the EP pack

48
Q

how is the nuvaring managed?

A

slow release and needs to be taken out Q3wks

49
Q

how does copper IUD affect risk of PID?

A

not more risk than average person except for first month after insertion

50
Q

what is NEVER a contraceptive method?

A

ovulation sticks

51
Q

between the calendar method and monitoring cervical mucus, which is more effective?

A

monitoring cervical mucus

52
Q

what is the failure rate with the calendar method?

A

25%

53
Q

how does EC work?

A

delays ovulation by giving lots of progesterone to stop LH surge and tricks your body into thinking it already ovulated

54
Q

what will EC not do?

A

prevent pregnancy if implantation has already occurred

55
Q

what is the second effect of the ECs?

A

makes the endometrium an inhospitable environment for implantation

56
Q

with a positive pregnancy test which EC method can be used?

A

mifepristone/misoprostol (b/c implantation has already occurred

Pharm II (2 decks)

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