Final Exam- the basics :)

Question 1

What is the MOA of COCs? (7 marks)

Answer 1

COCs made of estrogen and progestogen (2 marks)
Estrogen suppresses FSH and prevents follicle development (2 marks)
Progestogen inhibits the LH surge and endometrial proliferation. It also causes cervical mucus thickening. (3 marks)

Question 2

List 3 types of contraception drugs/devices (1.5 marks; 0.5 mark each)

Answer 2

COC
Progestogen only tablet
vaginal ring
IUDs : Copper, Levonorgestrel..
Condoms (female or male)

Question 3

Define complimentary medicines (6 marks)

Answer 3

Medicines containing herbs, vitamins, minerals, nutritional supplements, homeopathic or certain aromatherapy preparations. (5 marks) They also contain at least one active ingredient in schedule 14 of the regulations (1 mark).

Question 4

What are listed complimentary medicines? (5 marks)

Answer 4

CMs with low risk ingredients in acceptable amounts and can be used in listed TGA medicines (2 marks). They are assessed for quality not safety (1 mark), the therapeutic indications are restricted to health maintenance and enhancement (2 marks)

Question 5

What is the difference between assisted listed medicines and listed complimentary medicines? (2 marks)

Answer 5

Assessed listed medicines will be included in the ARTG following successful premarket assessment of
efficacy evidence by the TGA

Question 6

What are registered complimentary medicines? (5 marks)

Answer 6

CMs which are high risk due to their ingredients (1 mark), the TGA individually assesses these for safety, quality and efficacy (3 marks) and therapeutic claims are based on evidence (1 mark)

Question 7

What are the three principles to support indications and claims about therapeutic goods?

Answer 7

sponsors must hold adequate evidence to support all
claims they make about a product, claims must be true and valid and the claims must not lead to unsafe or inappropriate use of the product.

Question 8

What is traditional evidence for CMs? (4 marks)

Answer 8

evidence showing a therapeutic use based on extensive history of use (2 marks) It must have evidence demonstrating use for 3 generations (75+ years) in it’s home tradition (2 marks)

Question 9

What is scientific evidence for CMs

Answer 9

provided secondary to human data (1 mark) and can involve RCTs, cohort studies and case control studies (1 mark)

Question 10

True or false : All CMs are required to be manufactured under the Good Manufacturing Practice

Answer 10

True

Question 11

Do L# or R# CMs have theraeputic claim restrictions?

Answer 11

L# (registered CM’s)

Question 12

What are some examples of contraceptive injections and implants, and how do they work?

Answer 12

Depo-Provera (injection) and Nexplanon (implant). They release progestin to prevent pregnancy by suppressing ovulation and thickening cervical mucus

Question 14

What is the primary mode of action for spermicides, and how are they used?

Answer 14

Spermicides are chemical agents that immobilize or kill sperm. They are available in various forms, such as creams, gels, or foams, and are applied to the vagina before intercourse

Question 15

What is the rhythm method of contraception based on, and how is it practiced?

Answer 15

relies on tracking a woman’s menstrual cycle to determine fertile and infertile days. Couples avoid intercourse or use protection during fertile periods.

Question 16

What are the key differences between hormonal and non-hormonal intrauterine devices (IUDs)?

Answer 16

Hormonal IUDs release hormones (e.g., levonorgestrel) to prevent pregnancy, while non-hormonal IUDs (copper IUDs) create an inhospitable environment for sperm.

Question 17

What is a diaphragm, and how is it used for contraception?

Answer 17

dome-shaped barrier device that is inserted into the vagina before intercourse, covering the cervix to prevent sperm from entering the uterus

Question 18

What is the Lactational Amenorrhea Method (LAM), and when is it typically used?

Answer 18

natural contraceptive method used during exclusive breastfeeding to prevent pregnancy, relying on the suppression of ovulation by breastfeeding.

Question 19

How do combined oral contraceptives (COCs) and progestogen-only contraceptives work, and what are the primary differences between them?

Answer 19

COCs contain both oestrogen and progestogen and work by suppressing ovulation and thickening cervical mucus. Progestogen-only contraceptives, such as the mini-pill, primarily thicken cervical mucus and inhibit fertilization, with no oestrogen component

Question 20

What are the three primary mechanisms of action of Combined Oral Contraceptives (COCs)?

Answer 20

COCs work by inhibiting ovulation, reducing the receptivity of the endometrium to implantation, and thickening cervical mucus to form a barrier to sperm.

Question 21

What are some commonly reported adverse effects of COCs?

Answer 21

breakthrough bleeding, breast enlargement and tenderness, headache, fluid retention, and chloasma (skin hyperpigmentation).

Question 22

What are some less common but potentially serious adverse effects associated with COCs?

Answer 22

allergies, hypertension, jaundice, pancreatitis, and an increased risk of conditions such as liver, cervical, and breast cancer, stroke, and venous thromboembolism (VTE).

Question 23

How might COCs interact with hepatic enzymes and what are some examples of inducers of these enzymes?

Answer 23

COCs can be affected by hepatic enzyme inducers like rifampicin, phenytoin, and carbamazepine, potentially reducing their contraceptive effectiveness.

Question 24

What are the contraindications for using COCs?

Answer 24

• less than 6 weeks postpartum, – smoker over the age of 35 who smokes more than 15 cigarettes per day, having complicated valvular heart disease, a history of venous thromboembolism (VTE), ischaemic heart disease, a history of cerebrovascular accident, uncontrolled hypertension (above 160/100mmHg), current breast cancer, diabetes with retinopathy, neuropathy, or nephropathy, severe cirrhosis, and liver tumours.

Question 24

Name a dietary supplement that can interact with COCs and potentially reduce their effectiveness.

Answer 24

St. John’s Wort is a dietary supplement that can interact with COCs and diminish their effectiveness.

Question 24

Why is COC use contraindicated in smokers over the age of 35?

Answer 24

due to an increased risk of cardiovascular complications and thromboembolic events associated with smoking and oestrogen-containing contraceptives.

Question 25

Why is effectiveness an essential factor when choosing contraception?

Answer 25

Effectiveness is crucial because it determines the reliability of preventing unintended pregnancies and plays a significant role in the selection of a contraceptive method.

Question 26

Why does an individual’s medical history play a role in selecting contraception?

Answer 26

medical history, including conditions like hypertension, cardiovascular diseases, and prior adverse reactions to contraceptives, can impact the safety and suitability of specific methods.

Question 26

How can different life stages influence the choice of contraception?

Answer 26

Different life stages, such as adolescence, parenthood, or menopause, may necessitate adjustments in contraceptive methods to align with changing reproductive and lifestyle needs.

Question 27

Why is it important to weigh the risk versus benefit of each contraceptive method when making a choice?

Answer 27

essential to find a balance between preventing pregnancy, managing health conditions, and minimizing potential side effects or risks associated with a particular contraceptive choice.

Question 27

Why is it essential to educate patients on how to start, change, and stop using contraceptives?

Answer 27

Proper guidance ensures that individuals use their chosen method correctly, whether they are initiating contraception, transitioning to a different method, or discontinuing it.

Question 27

What are the key patient education points regarding contraception after childbirth?

Answer 27

Patients should be informed about postpartum contraceptive options, the timing of initiation, and the considerations for breastfeeding or non-breastfeeding mothers.

Question 27

Why is it important to educate patients about what to do in the event of a missed contraceptive pill?

Answer 27

Knowing the appropriate steps to take after missing a pill helps minimize the risk of contraceptive failure and unintended pregnancies.

Question 28

What should patients be advised about if they experience vomiting and diarrhoea while using oral contraceptives?

Answer 28

Patients should be educated on the importance of taking extra precautions (e.g., using a backup method) when they experience vomiting or severe diarrhoea, which can affect contraceptive absorption.

Question 29

Why is it crucial to inform patients about potential drug interactions with their contraceptives?

Answer 29

Patients should be aware of how certain medications, like antibiotics or anticonvulsants, may interact with contraceptives and reduce their effectiveness, prompting the need for additional contraceptive measures or alternative methods.