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PHCY320 > MW Lecture 11 > Flashcards

MW Lecture 11 Flashcards

1
Q

OC supply criteria?

A

a. Has been prescribed the same type of OC within the last 3 years
b. Not developed risk factors
c. Aged 16-39 for COC or 16-52 for POP

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2
Q

Pharmacist supply COCs

A

Ethinylestradiol + norethisterone

Ethinylestradiol + levonorgestrel

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3
Q

Pharmacist supply POPs

A

Desogestrel
Levonorgestrel
Norethisterone

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4
Q

Criteria for switching between OCs

A 
Formulation is not available in NZ
If breastfeeding (COC to POP)
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5
Q

Is pharmacist supply of OCs funded?

A

No

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6
Q

Contraindications to OCs (general)

A

Breast cancer
Severe cirrhosis, active hepatitis, tumours
Undiagnosed vaginal bleeding

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7
Q

Contraindications to COCs

A 
Hx MI, ischaemic heart disease or vascular disease (DVT, PE)
Hx Stroke
Migraines with aura or without aura if 35+ years
Hypertension
Smoker (>15 cigs/day) and 35+ years
Uncontrolled inflammatory bowel disease
Active systemic lupus erythematosus
Active cancer
Less than 6 weeks postpartum
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8
Q

OC counselling

A 
When to start pill
When you are protected
Timing of doses
Missed pill (time)
Missed pill (sugar pills)
Adverse effects management
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9
Q

Common OC adverse effects

A 
Nausea
Breakthrough bleeding
Breast tenderness
Weight gain
Migraines
Acne
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10
Q

OCs danger signs (ACHES)

A 
Abdominal pain (severe)
Chest pain (severe), SoB
Headaches (severe)
Eye problems (blurred vision, flashing lights, blindness)
Severe leg pain (calf or thigh)
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11
Q

What is the ECP medicine?

A

Levonorgestrel tablet

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12
Q

What is the day of ovulation in the cycle?

A

14 days (12-16) before next period starts

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13
Q

How long can sperm survive?

A

Max 7 days

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14
Q

How long can egg survive?

A

Max 12-24 hours

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15
Q

Missed COC on first week

A

7 day rule is essential and ECP needed if unprotected sex during 7 days before missed pills

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16
Q

Missed COC on second week

A

No additional precautions

17
Q

Missed COC on third week

A

Miss 7 day break and no additional precautions

18
Q

OCs interactions

A

Rifampicin
Antiepileptics (carbamazepine, phenytoin)
HIV drugs
St John’s Wort

19
Q

How does POP work?

A

Increases the viscosity of cervical mucus

20
Q

Time frame for taking COC

A

12 hours

21
Q

Time frame for taking POP

A

3 hours

22
Q

Time for COC to work

A

7 days

23
Q

Time for POP to work

A

2 days

24
Q

ECP options

A

Copper uterine device

Emergency contraceptive pilol

25
Q

Benefits of Cu IUD for emergency contraception

A 
Works up to 5 days after intercourse
Not affected by weight
Few contraindications
Can be left for future contraception
Funded
26
Q

ECP mechanism of action

A

Interferes with sperm motility

May delay ovulation

27
Q

Levonorgestrel efficacy

A

98-99%

28
Q

ECP increased risk of failure

A

High fertility risk
Subsequent UPSI in same cycle
High BMI/weight
Taken post fertilization

PHCY320 (4 decks)

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