Oral Contraceptives I

Question 1

Anticonvulsants interaction

Answer 1

Induced metabolism

Decreased efficacy

Question 2

Colesevelam interaction

Answer 2

Reduced absorption

Decreased efficacy

Question 3

Corticosteroids interaction

Answer 3

OCs inhibit metabolism of steroids so increased side effects

Question 4

Penicillins, Tetracyclines interaction

Answer 4

Alters flora, reducing circulation of estrogen

Decreased efficacy and

Question 5

St. John’s Wort

Answer 5

Induce metabolism

Decreased efficacy

Question 6

Theophyline

Answer 6

OCs decrease clearance so increased theophylline side effects

Question 7

Who should use the Minipill?

Answer 7

Unable to tolerate estrogen therapy

Contraindicated to estrogen therapy

Question 8

Progestin only missed one dose

Answer 8

Take 2 tabs as soon as you remembered
Wk1: use back up
Wk2: no

Question 9

Progestin only missed 2-4 doses

Answer 9

Take 2 tablets daily for 2 days only, then take pills as usual
Use back up if wk1/2; start over if wk 3

Question 10

Traditional start for all

Answer 10

1st Sunday after start of menses with back up OR

1st day of menses without back up

Question 11

Quick start method

Answer 11

Start the day of the office visit if negative urine prego test and use 7 day back up
Will delay your period

Question 12

COC Missed 1 dose

Answer 12

Take immediately and take next dose at normal time

Question 13

COC Missed 2 dose in the first 2 weeks

Answer 13

Take 2 for 2 days then resume regular schedule

Use backup for 7 days

Question 14

COC missed 2 doses in the third week or 3 or more missed doses

Answer 14

Take one daily until sunday and then start a new pack

7 day back up

Question 15

Common ADRs

Answer 15

Hair growth
Breakthrough bleeding
Flow changes
Breast tenderness
Vaginal irritation
N/V/D/Constipation
Cramps
Appetite changes
Weight gain
Acne

Question 16

Breakthrough bleeding

Answer 16

Usually resolved after 3rd/4th cycle

Question 17

Breakthrough Bleeding Management

Answer 17

Ensure compliance
Rule out causes
Possible pharmacological adjustments (increase strength or different drug)

Question 18

ACHES stands for

Answer 18

Ab pain
Chest pain
Headaches
Eye probelms
Severe leg pain

Question 19

New Patient counseling

Answer 19

Written and verbal
AE and ACHES
No protection: STDs and HIV
Quick start method
Compliance and missed dose
Drug interactions

Question 20

Contraindications

Answer 20

CV
Liver
Heavy smoker
Breast cancer
Headaches

Question 21

Drospirenone

Answer 21

Increases the risk of VTE or blood clotting but need more studies