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OTC > Exam 4 - Prevention of Pregnancy and STIs - Julia’s Quizlet > Flashcards

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

1
Q

Healthy behaviors for women of reproductive age

A
  • 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)

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2
Q

Pregnancy

A

Viable egg is available for fertilization by a sperms

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3
Q

Conception

A

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

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4
Q

STIs

A

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)

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5
Q

Non-curable but vaccine-preventable STI disease

A

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

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

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6
Q

Vaccines for STI prevention

A

HPV
Hep B vaccine

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6
Q

Curable STI diseases

A

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

(Totally Nasty Guys Gave Her Syphillis)

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6
Q

NONcurable STIs

A

Aids
Genital herpes (HSV1/HSV2)

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7
Q

Facts about HPV prevention vaccine

A

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

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8
Q

Which ages does the ACIP recommend the HPV vaccine for

A

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

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8
Q

What are the longterm complications of Hep B

A

Hepatitis
Cirrhosis
Hepatic carcinoma
Possibly death

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9
Q

How is Hep B transmitted

A

Contact w/ blood or other body fluids

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

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9
Q

Hep B vaccine recommendations

A

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

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

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10
Q

Potential candidates for Hep B

A

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)

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11
Q

What age group is at higher risk for Hep B

A

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

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12
Q

What are the primary goals of using contraceptives

A

Prevent unintended pregnancy
Prevent STIs

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13
Q

NonRx contraceptive products

A

Male condoms
Contraceptive sponge
Vaginal spermicides
Emergency contraception
Female condoms

(Make Cute Videos Every Friday)

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14
Q

Fertility awareness methods

A

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

(Having Children Can Suck Longterm)

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15
Q

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

A

Male condoms

(skins, rubbers)

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16
Q

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

A

True

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17
Q

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

A

Non-latex condoms

Usually made up of polyisoprene and polyurethane

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18
Q

What lubricants are safe for use with latex condoms

A
  • 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)

19
Q

Lubricants NOT safe for use w/ latex condoms

A

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)

19
Q

Facts about condom use

A

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

Breakage rate range: 0-22%

20
Q

Lamb cecum condoms

A

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

21
Q

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

A and C

21
Q

Behaviors associated w/ increased risk of condom breakage

A

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)

22
Q

Dental dams

A

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

23
Q

Female condoms

A

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

24
Q

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

A

E

25
Q

Vaginal spermicides

A

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

26
Q

Effective spermicides

A

Nonoxynol-9
Octoxynol-9
Menfegol

27
Q

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

A

True

28
Q

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

A

False

29
Q

Contraceptive sponge

A

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

30
Q

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

A

False

31
Q

Who is the contraceptive sponge more designed for

A

Nulilparous women (have NOT had children)

32
Q

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

A. ONE condoms

(Because there is ONE kind approved)

32
Q

Who is NOT recommended to use the contraceptive sponge

A. Men
B. Parous women
C. Nulliparous women
D. Women over 30

A

A and B

32
Q

Emergency contraceptive pills

A

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

33
Q

When do emergency contraceptives work best

A

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

34
Q

Laws about emergency contraceptives

A

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

35
Q

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

A

All are true

35
Q

What is the AI in emergency contraceptives

A

Levonorgestrel

A single tablet that is 1.5 mg

35
Q

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

A

True

36
Q

What are the drug interactions that can affect EC effectiveness?

A

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

37
Q

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

A

Ella (ulipristal acetate)
Copper IUD

38
Q

Types of EC on the market

A

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

39
Q

How soon should ECs be taken

A

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

40
Q

OTC brands available of levonorgestrel

A

New Day
My Way
Plan B One Step
Preventeza
Opcicon One Step
EContra One Step

(Not Making People Pregnant Or Evil)

41
Q

What is coitus interruptus

A

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

42
Q

Patient counseling points for prevention of pregnancy and STIs

A

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

43
Q

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

A

Maryland
West Virginia
California
Oregon
Hawaii
Colorado
Idaho
Utah
DC
New Mexico

(Many Women Can Obtain Hormonal Contraceptives If Use Deemed Necessary)

44
Q

Example of app used to detect ovulation

A

Natural cycle app

OTC (21 decks)

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