hormonal contraception Flashcards
MOA of hormonal contraception
inhibition of ovulation
FSH suppression (estrogen)
LH suppression (progesterone)
alteration of genital tract environment (progesterone)
what is drosperinone?
progesterone only contraception derived from spironolactone
relies on mucosal changes for contraception
what is depomedroxyprogesterone acetate injection?
depo-provera contraception
IM/SQ q 13 weeks
suppresses ovulation
not for short term contraception
significant weight gain, decrease in bone density, peri-menopause-like symptoms
transdermal patches
ethinyl estradiol/levonorgestrel, ethinyl estradiol/norelgestromin
1x/week for 3 weeks then one week off
decreased efficacy with higher BMI
hormonal IUD MOA
Levonorgestrel
downregulation of estrogen and progesterone receptors, making it insensitive to estradiol
release drug directly into uterine canal
backup method necessary w removal
what is etonorgestrel? implanon
implanted progestin only contraception
suppressess ovulation
what is phexxi?
bioadhesive vaginal gen for on-demand use changes vaginal pH
1h before intercourse
local AEs, UTIs
AEs of contraception
nausea, edema, HA - r/t estrogen
breakthrough bleeding, wt gain, vaginal infections, amenorrhea
increased skin pigmentation, acne, hirsutism
breast cancer? CV disease, thromboembolism, depression, gallbladder disease
CI in smoking >35 years!!!!
CI to hormonal contraception
hx of thrombus
pregnancy
suspected/known hormone-dependent neoplasm
undiagnosed vaginal bleeding
severe liver disease
renal/adrenal insufficiency (drosperinone-containing products)
precautions to hormonal contraceptive use
overweight lipid disorders upcoming elective surgery gallbladder disease migraine w aura contact lens use
hormonal contraception interactions
CYP3A4 inhibitors
rifampin, carbamazepine, phenytoin, barbiturates
anti-epileptics
when does levonorgestrel need to be taken after intercourse?
Plan B
prior to LH surge
within 72 h of intercourse
when can ella (ulipristal) be taken?
up to 5 days after intercourse
mechanism depends on phase when administered
requires a prescription
what is mifeprex/cytotec?
post-coital contraceptions
increases contractions & causes expulsion of tissue
approved within 70 days of gestation
REMS program certificate required to distribute
what is the yutzpe regimen?
like normal birth control for post-coital
2 doses within 72 h of intercourse
nausea common
