Exam 4 - Prevention of Pregnancy and STIs - Julia’s Quizlet Flashcards by Cassie Kellogg

Healthy behaviors for women of reproductive age

Maintain healthy diet and weight
Take folic acid
Be physically active regularly
Abstain from alcohol if pregnant/planning to be
Quit tobacco use
Use effective contraception
Refrain from excessive alcohol drinking
Take ONLY medications prescribed by your doctor
Talk to your healthcare provider about screening and proper management of chronic diseases
Visit your HCP for healthcare recommendations for your age and pregnancy
Reproductive age (15-44 years)

(Moms To Be Are QUeens - Really Taking Their Vitamins Right)

How well did you know this?

Not at all

Perfectly

Pregnancy

Viable egg is available for fertilization by a sperms

How well did you know this?

Not at all

Perfectly

Conception

6 day window that begins 5 days before ovulation through the day of ovulation

Peak risk for accidental pregnancy occurs w/ unprotected intercourse the day before ovulation

How well did you know this?

Not at all

Perfectly

STIs

Affect both men and women

Women are more likely to develop reproductive consequences as they are typically asymptomatic

Reproductive consequence examples:
- chronic pelvic pain
- PID
- pregnancy complications
- infertility
- malignancies

(Makes sense because men don’t give a shit if they destroy you to get some cooch)

How well did you know this?

Not at all

Perfectly

Non-curable but vaccine-preventable STI disease

Genital warts (HPV) - usually 3 dose series if given before 14 years old

Hepatitis B - now usually given at birth up to 6 months

How well did you know this?

Not at all

Perfectly

Vaccines for STI prevention

HPV
Hep B vaccine

How well did you know this?

Not at all

Perfectly

Curable STI diseases

Trichomoniasis
Nongonococcal urethritis (in men)
Gonorrhea
Genital chlamydial infection
Hep C
Syphillis

(Totally Nasty Guys Gave Her Syphillis)

How well did you know this?

Not at all

Perfectly

NONcurable STIs

Aids
Genital herpes (HSV1/HSV2)

How well did you know this?

Not at all

Perfectly

Facts about HPV prevention vaccine

HPV infection is the most common STI in the US

3 vaccines (gardasil 9 - valent HPV vaccine)

Indicated for females and males ages 9-26 years old to prevent cervical, vaginal, vulvar, and anal cancers

How well did you know this?

Not at all

Perfectly

Which ages does the ACIP recommend the HPV vaccine for

Recommends for ages 11-12

If the child is vaccinated when child is 9-14 years old, 2 dose series: 1st shot, then second one 6-12 months after

Can get the vaccine up to age 45 now

People older than 11-12 need the 3 dose series

How well did you know this?

Not at all

Perfectly

What are the longterm complications of Hep B

Hepatitis
Cirrhosis
Hepatic carcinoma
Possibly death

How well did you know this?

Not at all

Perfectly

How is Hep B transmitted

Contact w/ blood or other body fluids

79% of new infections occurs in individuals w/ high risk sexual behaviors or IV drug use

How well did you know this?

Not at all

Perfectly

Hep B vaccine recommendations

Recommended at birth, 1 month, and 6 months of age

Those who missed initial dose at birth can do the 3 dose series

How well did you know this?

Not at all

Perfectly

Potential candidates for Hep B

International travelers

HCPs/EMS

Multiple sex partners

IV drug users

Liver disease

Diabetes

End stage renal disease

Residents of drug
abuse/correctional facilities

HIV infection/residents of HIV treatment facilities

(I Have MILDER Hepatitis)

How well did you know this?

Not at all

Perfectly

What age group is at higher risk for Hep B

Ages 30-49 because they may have never received the Hep B vaccine

How well did you know this?

Not at all

Perfectly

What are the primary goals of using contraceptives

Prevent unintended pregnancy
Prevent STIs

How well did you know this?

Not at all

Perfectly

NonRx contraceptive products

Male condoms
Contraceptive sponge
Vaginal spermicides
Emergency contraception
Female condoms

(Make Cute Videos Every Friday)

How well did you know this?

Not at all

Perfectly

Fertility awareness methods

Home tests for ovulation prediction
Calendar methods
Cervical mucus methods
Symptothermal methods
Lactational amenorrhea method

(Having Children Can Suck Longterm)

How well did you know this?

Not at all

Perfectly

Which non-rx contraceptive product is the MOST important barrier contraceptive that helps protect against STIs?

Male condoms

(skins, rubbers)

How well did you know this?

Not at all

Perfectly

(T/F): the FDA regulated condoms as medical devices and they must been performance standards for integrity and strength

True

How well did you know this?

Not at all

Perfectly

Which type of condom is reserved for those w/ allergies as they have shown significantly higher breakage rates and higher pregnancy rate

Non-latex condoms

Usually made up of polyisoprene and polyurethane

How well did you know this?

Not at all

Perfectly

What lubricants are safe for use with latex condoms

Silicone based lubricants (astroglide)
Replens inserts
Saliva
Water based lubricants (KY jelly)
Contraceptive foams/gels
Glycerin
Water

(Sex Really Sucks When (it) Can’t Get Wet)

Lubricants NOT safe for use w/ latex condoms

Edible oils (olive, peanut, corn, canola, safflower, butter, margarine)

Topical oils (baby oil, mineral oil, massage oil)

Hemorrhoidal ointments

Petroleum jelly

Vaginal creams (monistat, estrace, vagisil, premarin)

(Evolving To HPV)

Facts about condom use

Use-related failure rate: 18 pregnancies per 100 women during first year of use

Breakage rate range: 0-22%

Lamb cecum condoms

Pregnancy prevention ONLY Presence of pores in membrane may allow passage of viral organisms can (can allow HIV and Hep B) Do NOT degrade w/ oil based lubricants More expensive Conduct heat well and are very strong

What is recommended if a tear/break occurs w/ a condom? A. Immediately insert spermicidal foam/jelly into the vagina B. Immediately insert spermicidal vaginal film/suppository as their quick time for dissolution may increase product efficacy C. Consider emergency contraception ASAP and within 72 hrs, use foam/jelly w/ high concentration spermicide into the vagina D. Do nothing. Likelihood of pregnancy/STI transmission is very rare

A and C

Behaviors associated w/ increased risk of condom breakage

Incorrect placement of condom/failure to squeeze air from the receptacle tip Contact w/ sharp objects Reuse of condom Increased duration, intensity, or frequency Prior history of condom breakage/slippage Self-reported problems w/ fit Use of oil based lubricant w/ latex condom History of STI (If Condom RIPS, Use Ham)

Dental dams

Latex/polyurethane sheets used between the mouth and vagina/anus during oral sex

Female condoms

Polyurethane female condoms (approved in 2003) FC2 nitrile, a synthetic latex (approved in 2009) If you use a female condom and a male condom at the same time, there is a higher risk for breaking

Which of the following is a true statement about use of a female condom? A. Use a male condom w/ female condom to help decrease risk of pregnancy B. Female condoms do NOT prevent pregnancy, they only decrease STI risks C. Female condoms can be used for many acts of intercourse D. Water based lubricants are the only lubricant that can be used w/ this condom E. During intercourse, make sure the penis enters the vagina inside the pouch and that the outer ring remains outside the vagina

Vaginal spermicides

Use surface active agents to immobilize and kill sperm - gels and foams act as a physical barrier against sperm Effective spermicides: nonoxynol-9 (manufactured/sold in US), octoxynol-9, menfegol Nonoxynol-9 comes in spermicidal foams, gels/jellies, suppositories, film, sponge

Effective spermicides

Nonoxynol-9 Octoxynol-9 Menfegol

(T/F): efficacy improves greatly if spermicides are used w/ barrier methods such as diaphragms, cervical caps, or condoms

True

(T/F): vaginal spermicides protect against HIV and other STIs

False

Contraceptive sponge

Circular, small, disposable sponge made of polyurethane permeated w/ spermicide nonoxynol-9 One time use Does not provide protection against STIs Failure rate for contraceptive depends on whether the woman is parous (has had children) or nulliparous (has NOT had children) Can be inserted 24 hrs in advance Must remain in place for 6 hours after intercourse Increased TSS risk

(T/F): the contraceptive sponge protects against HIV and other STIs

False

Who is the contraceptive sponge more designed for

Nulilparous women (have NOT had children)

Which of the following is the FDA approved condom for anal sex A. ONE condoms B. KY jelly C. Nonoxynol-9 condom D. Trojan condom

A. ONE condoms (Because there is ONE kind approved)

Who is NOT recommended to use the contraceptive sponge A. Men B. Parous women C. Nulliparous women D. Women over 30

A and B

Emergency contraceptive pills

Hormonal method of contraceptions that can be used to prevent pregnancy following an unprotected act of sexual intercourse

When do emergency contraceptives work best

When taken ASAP after unprotected sex, but some studies show that it may be effective up to 3 days after Should repeat dose if vomiting occurs within 2 hours

Laws about emergency contraceptives

Pharmacy law changes No longer required to be BTC No age limit to purchase Available OTC

Which is a true statement about OTC ECs? SATA A. AI is one levonorgestrel containing tablet B. Can cause thickening of cervical mucus and interfere w/ transport of egg/sperm C. Most common ADE is N/V D. If a woman vomits within 2-3 hrs of taking the dose, she should repeat the dose E. BMI > 26 may decrease effectiveness

All are true

What is the AI in emergency contraceptives

Levonorgestrel A single tablet that is 1.5 mg

(T/F): emergency contraceptives work by delaying/inhibiting ovulation

True

What are the drug interactions that can affect EC effectiveness?

CYP3A4 inducers (ie carbamazepine, phenytoin, rifampin, st johns wart, topiramate) could reduce ulipristal and levonorgestrel efficacy Labeling advises against the use of ulipristal in patients taking CYP3A4 inducers

What are the two types of ECs that muSt either be prescriber or implanted by a doctor

Ella (ulipristal acetate) Copper IUD

Types of EC on the market

ParaGuard - copper IUD; works the best and is almost 100% effective Ella - less effective if over 195 lbs Plan B/generic - less effective if over 165 lbs

How soon should ECs be taken

ParaGuard IUD - within 5 days Ella - ASAP, sooner = more effective, can be up to 5 days Plan B - ASAP, can be up to 3 days

OTC brands available of levonorgestrel

New Day My Way Plan B One Step Preventeza Opcicon One Step EContra One Step (Not Making People Pregnant Or Evil)

What is coitus interruptus

Withdrawal method (pull out method) Pregnancy can still occur because pre-ejaculation secretions may contain millions of sperm Requires considerable self-control of the man Potential for diminished failure by couple due to it being interrupted and NO STI PREVENTION

Patient counseling points for prevention of pregnancy and STIs

Emphasize consistent use of contraception w/ each sexual encounter Male condoms and female condoms are the preferred methods for prevention of STIs Sexually active women who miss a menstrual period are encouraged to perform a home pregnancy test/seek medical attention Symptoms of an STI in a sexually active individual require medical referral

Which states grant pharmacists the ability to provide hormonal contraception without a prescription

Maryland West Virginia California Oregon Hawaii Colorado Idaho Utah DC New Mexico (Many Women Can Obtain Hormonal Contraceptives If Use Deemed Necessary)

Example of app used to detect ovulation

Natural cycle app