Lecture 4 Exam 5 Flashcards
Hormones in copper IUD
none
hormones in levonorgestrel pill
progestin
hormones in ulipristal acetate
no hormones but does work on progestin receptors
how long should we wait to restart hormonal birth control if ulipristal acetate is used? why?
5 days, this is because of possible interactions between progestin in COC and ulipristal acetate
even though package on levonorgestrel says 3 days, how long can plan B be used
5 days
Among the emergency contraceptives, which drugs maintain the same level of efficacy? which one drops?
Ulipristal acetate and copper IUD maintain efficacy
levonorgestrel decreases
Up to when can we do medication abortion?
70 days (10 weeks)
when does gestation start?
first day of last period
contraindication of medication abortion?
Current IUD
corticoteroids
two drugs for medication abortion
Mifepristone (mifeprex)
Misoprostol (cytotec)
what kind of drug is mifepristone
selective progesterone receptor modulator
mifepristone effect on progesterone, effect on uterine contractility?
competitively inhibits action of progesterone at progesterone receptor sites, increases uterine contractility.
effect of mifepristone on cervix
increases cervical softening
Misoprostol and mifepristone effect on cervix and uterus
cervical softening and uterine contractility
approved dose of misoprostol
2 x 200 mg of mifepristone in each cheek
counseling points on misoprostol
may cause bleeding heavier than menses
when to contact professional for misoprostol
heavy bleeding, chills, fever
adverse effects of misoprostol
nausea, vomiting, pain
8 step pharmacist prescribing procedure
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
how to handle irregular bleeding with COC
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
how to handle irregular bleeding with Impalnt/IUD
Ibuprofen 800 mg X 5 days
mefanemic acid 500 mg x 5 days
1 month of COC
estrogen (ethinyl estradiol)
how to control heavy/prolonged bleeding
Ibuprofen 800 mg x 5 days
estrogen (ethinyl estradiol) or combined pills
tranexamic acid
how to treat breast tenderness
lower estrogen dose
supportive bra
how to handle acne
Topical treatment
drosperinone
switch to combined pill
