Lecture 4 Exam 5

Question 1

Hormones in copper IUD

Answer 1

none

Question 2

hormones in levonorgestrel pill

Answer 2

progestin

Question 3

hormones in ulipristal acetate

Answer 3

no hormones but does work on progestin receptors

Question 4

how long should we wait to restart hormonal birth control if ulipristal acetate is used? why?

Answer 4

5 days, this is because of possible interactions between progestin in COC and ulipristal acetate

Question 5

even though package on levonorgestrel says 3 days, how long can plan B be used

Answer 5

5 days

Question 6

Among the emergency contraceptives, which drugs maintain the same level of efficacy? which one drops?

Answer 6

Ulipristal acetate and copper IUD maintain efficacy
levonorgestrel decreases

Question 7

Up to when can we do medication abortion?

Answer 7

70 days (10 weeks)

Question 8

when does gestation start?

Answer 8

first day of last period

Question 9

contraindication of medication abortion?

Answer 9

Current IUD
corticoteroids

Question 10

two drugs for medication abortion

Answer 10

Mifepristone (mifeprex)
Misoprostol (cytotec)

Question 11

what kind of drug is mifepristone

Answer 11

selective progesterone receptor modulator

Question 12

mifepristone effect on progesterone, effect on uterine contractility?

Answer 12

competitively inhibits action of progesterone at progesterone receptor sites, increases uterine contractility.

Question 13

effect of mifepristone on cervix

Answer 13

increases cervical softening

Question 14

Misoprostol and mifepristone effect on cervix and uterus

Answer 14

cervical softening and uterine contractility

Question 15

approved dose of misoprostol

Answer 15

2 x 200 mg of mifepristone in each cheek

Question 16

counseling points on misoprostol

Answer 16

may cause bleeding heavier than menses

Question 17

when to contact professional for misoprostol

Answer 17

heavy bleeding, chills, fever

Question 18

adverse effects of misoprostol

Answer 18

nausea, vomiting, pain

Question 19

8 step pharmacist prescribing procedure

Answer 19

birth control screening
pharmacist review
screen for pregnancy
check BP (if BP> 140/90 provide referral)
counseling
identify different methods patient is eligible for (estrogen only vs estrogen + progesterone)
assess preference
method counseling

Question 20

how to handle irregular bleeding with COC

Answer 20

take pill at same time each day
Ibuprofen 800 mg PO TID x 5 days
mefanemic acid 500 mg po TID X 5 days
change pill formulation

Question 21

how to handle irregular bleeding with Impalnt/IUD

Answer 21

Ibuprofen 800 mg X 5 days
mefanemic acid 500 mg x 5 days
1 month of COC
estrogen (ethinyl estradiol)

Question 22

how to control heavy/prolonged bleeding

Answer 22

Ibuprofen 800 mg x 5 days
estrogen (ethinyl estradiol) or combined pills
tranexamic acid

Question 23

how to treat breast tenderness

Answer 23

lower estrogen dose
supportive bra

Question 24

how to handle acne

Answer 24

Topical treatment
drosperinone
switch to combined pill