Female health Flashcards
1
Q
DISCUSS COC (combined oral pill) and CLINICAL PHARM
A
MOA:
Efficacy of COCs is suppression of ovulation by inhibition of gonadotropin-releasing hormone (GnRH) from the hypothalamus, as well as inhibition of both luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and disruption of the mid-cycle LH
Combined oral contraceptives (COCs) contain both an oestrogen (usually ethinylestradiol) and a progestogen
Indications:
- preventing ovulation
Adverse effects:
- Menstrual irregularities
- Venous thromboembolism (VTE
- Breast cancer
- Mood changes
- Cardiovascular risk (stroke)
- Cervical cancer
Warning/caution:
- ▴cardiovascular disease (age >35 years; risk factors; migraine with aura
- ▴family history
Contraindications:
- ✗breast cancer
- ✗known thrombogenic mutation
- increased BMI >35kg/g causes thrombotic risk
Interactions:
- Antibiotics
- ▴Cytochrome P450 inducers carbamazepine reduce efficacy of coc
- of ▴lamotrigine may be reduced, potentially impairing seizure control
Monitoring:
- Explain that the usual method of taking the pill (with either no pills or inactive pills in days 22–28) results in a withdrawal bleed each month
- Baseline assessment should include a relevant history, BP check and body mass index
- She should then be seen yearly to discuss health changes and for BP and BMI checks.
