Fertility Control Flashcards
How do pharmacotherapeutic agents modify fertility?
Drugs prevent pregnancy either target:
A. Menstruation B. Implantation
Drugs soften out the peaks during hormone cycles
What are the different therapeutic agents used to manage contraception?
Hormones
- Oestrogen
- Progestogen
In the form of:
- Combined oral contraceptive
- Progestogen only pills (mini pill)
- Oral emergency contraception (morning after pill)
what is a Combined oral contraceptive and MOA
= combined pill with oestrogen and progestogen
- most effective form of contraception - taken daily 21 o 28 day cycle
MOA = Suppression of ovulation by inhabitation of GnRH hormone
What are the phasic options for COCs?
Monophasic: contain same amount of oestrogen and progestogen throughout each 21 active tablets
Multiphasic: most commonly triphasic (skip periods x3)
Contradictions of COCs
people who cannot take
- Less than 6 weeks postpartum (affects breast milk)
- Smoking over 35 and history of VTE
- ischemic heart disease
- breast cancer
- diabetes
- liver tumour
Risks with COCs (Adverse effects)
- allergy
- hypertension
- janudice
- VTE
- stroke
- Pancrereatitis
Indications for COCs
when cocs should be used
- Benefits outweight risks
- relive menstruation related problems
- prevention of:
- ovarian and endometrial cancers
- ovarian cysts- pelvic inflammatory disease
Drug interactions with oestrogen?
Hepatic enzyme (CYP3a4) inducers e.g. Rifampicin, phenytoin
= need high dose of CC
What is the progestogen-only pill?
= Mini pill
- only progestogen
- less effective
- taken continuously (no inactive)
- regular withdrawal bleed may not occur
- useful is oestrogen is to be avoided
e.g. Levonorgestrel
MOA of progestogen-only pill?
MOA = thickens cervical mucus, makes difficult for sperm to penetrate and reach ovum
Indications for progestogen-only pill?
- women who are unable to take oestrogen
- breast feeding (dose not impact breast milk)
Adverse effects of progestogen-only pill?
- menstral irregularities
- depression
- weight gain
