Med List #2: Female Contraception, Anxiety, and Muscle Spasms Flashcards
Contraceptives
ethinyl estradiol/norgestimate; ethinyl estradiol/norethindrone/ferrous fumarate; ethinyl estradiol/drospirenone; ethinyl estradiol/norelgestromin; ethinyl estradiol/etonogestrel; medroxyprogesterone; levonorgestrel
Anxiety
clonazepam; alprazolam
Muscle Spasms
cyclobenzaprine
ethinyl estradiol/norgestimate: Brand Name
Ortho Tri-Cyclen; Tri-Sprintec; Tri-ViLibra
ethinyl estradiol/norgestimate: Common Strengths
Three Phases: 0.035mg/0.18mg ; 0.035mg/0.215mg ; 0.035mg/0.25mg
ethinyl estradiol/norgestimate: Common Frequency
One first phase tab daily for 7 days; then one second phase tab daily for 7 days; then one third phase tab daily for 7 days; then one inactive tab daily for 7 days
ethinyl estradiol/norgestimate: Indications/Use
- Oral contraception
- Acne
Claim to Fame: Tri-phasics mimic natural menstrual cycle
Contraceptive: Counseling Tips and Important Info - Side effects for ALL estrogen/progestin medications
- Water retention (bloating, weight gain, breast tenderness)
- Upset stomach/nausea
- Headache
Contraceptive: Counseling Tips and Important Info - Non-FDA approved uses may include
- Regulation of menstrual cycle
- Lessen menstrual flow
- Reduce painful menses
Contraceptive: Counseling Tips and Important Info - Miss a dose?
Take as soon as possible or with next days’ dose (e.g. miss Monday, take 2 on Tuesday)
If you miss 2 or more days, refer to package directions
Contraceptive: Counseling Tips and Important Info - Products containing ethinyl estradiol
Increased cardiovascular risk (DVT, PE, MI).
Not recommended for those:
- +35 y.o.
- smoker
- Hx of stroke/blood clots
Contraceptive: Counseling Tips and Important Info - Tips
- If OC not started day 1 of menses, use additional non-drug contraception first week of therapy
- Take same time each day for max effectiveness
- Some anti-convulsants (ex. divalproex, lamotrigine) may decrease effectiveness of hormonal contraceptives and/or increase chance of seizures
- None of the medications on this list protect against HIV/AIDs/STDs
ethinyl estradiol/norethindrone/ferrous fumarate: Brand Name
Loestrin Fe, Junel Fe, Microgestin Fe
ethinyl estradiol/norethindrone/ferrous fumarate: Common Strengths
0.02mg/1mg/75mg
ethinyl estradiol/norethindrone/ferrous fumarate: Common Frequency
Take 1 active tab daily for 21 days; then 1 iron tab daily for 7 days
ethinyl estradiol/norethindrone/ferrous fumarate: Indications/Use
- Oral contraception
- Acne
Claim to fame: replaces iron lost during menses
ethinyl estradiol/drospirenone: Brand Name
Yaz, Loryna, Jasmiel
ethinyl estradiol/drospirenone: Common Strengths
0.02mg/3mg
ethinyl estradiol/drospirenone: Common Frequency
Active tab daily for 24 days; then 1 inactive tab daily for 4 days
ethinyl estradiol/drospirenone: Indications/Use
- Oral Contraception
- Acne
- Premenstrual Dysphoric Disorder (extreme PMS)
Claim to fame: Only 4 inactive days = shorter menstrual periods
ethinyl estradiol/drospirenone: Counseling Tips and Important Info
Drospirenone lessens the water retention/weight gain SE of estrogen
ethinyl estradiol/norelgestromin: Brand Name
Xulane
ethinyl estradiol/norelgestromin: Common Strengths
0.53mg/4.86mg
ethinyl estradiol/norelgestromin: Common Frequency
Apply 1 new patch each week for 3 weeks; then week 4 is patch free
ethinyl estradiol/norelgestromin: Indications/Use
Contraception
ethinyl estradiol/norelgestromin: Counseling Tips and Important Info
- Same SE profile as OC but more common
- Adhesive may cause skin rash/rotate sites
- Do not cut patch
- Apply to butt, upper torso, stomach, or upper arm
ethinyl estradiol/etonogestrel: Brand Name
NuvaRing
ethinyl estradiol/etonogestrel: Common Strengths
0.015mg/0.12mg/24 hrs ER
ethinyl estradiol/etonogestrel: Common Frequency
Insert 1 ring into vagina on or before day 5 of cycle and leave in for 3 weeks; then remove on week 4 and discard
ethinyl estradiol/etonogestrel: Indications/Use
Contraception
ethinyl estradiol/etonogestrel: Counseling Tips and Important Info
- If ring falls out, rinse with cool water and re-insert within 3 hours
- Don’t remove for intercourse
- Ring is a drug delivery device; not a barrier
medroxyprogesterone: Brand Name
Depo-Provera
medroxyprogesterone: Common Strengths
150mg/mL
medroxyprogesterone: Common Frequency
150 mg deep IM inj in gluteal or deltoid muscle every 3 months
medroxyprogesterone: Indications/Use
- Contraception
- Endometriosis pain, abnormal uterine bleeding, amenorrhea
Claim to fame: No estrogen
medroxyprogesterone: Counseling Tips and Important Info
- Nervousness
- Admin by healthcare professional
- Don’t use >2 years due to potential bone loss
- Spotting or absent menses may result
levonorgestrel (OTC): Brand Name
Plan B One-Step, EContra One-Step
levonorgestrel (OTC): Common Strengths
1.5mg
levonorgestrel (OTC): Common Frequency
Take 1 tab PO ASAP within 72 hours of unprotected sex
levonorgestrel (OTC): Indications/Use
Emergency post-coital contraception
levonorgestrel (OTC): Counseling Tips and Important Info
- Fatigue
- No evidence of interaction w/ antibiotics
- Will not terminate an existing pregnancy
clonazepam: Brand Name
Klonopin
clonazepam: Common Strengths
0.5mg, 1mg, 2mg
clonazepam: Common Frequency
QD, BID, TID, QID
clonazepam: Indications/Use
- Panic disorder
- Seizure disorders
- Off label use: Anxiety
clonazepam: Counseling Tips and Important Info
- Drowsiness
- Fatigue
- Ataxia (clumsy voluntary movement)
- Behavioral problems
alprazolam: Brand Name
Xanax
alprazolam: Common Strengths
0.25mg, 0.5mg, 1mg, 2mg
alprazolam: Common Frequency
BID, TID, or PRN
alprazolam: Indications/Use
- Panic disorder
- Anxiety
alprazolam: Counseling Tips and Important Info
- Confusion
- Drowsiness
- Excessive drowsiness w/ alcohol - avoid
- Do not stop drug suddenly if taking routinely
cyclobenzaprine: Brand Name
Flexeril
cyclobenzaprine: Common Strengths
5mg, 10mg
cyclobenzaprine: Common Frequency
QD, TID, or PRN
cyclobenzaprine: Indications/Use
Muscle spasm
cyclobenzaprine: Counseling Tips and Important Info
- Dry mouth (xerostomia)
- Dizziness
- Drowsiness