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Nurs 306 / Pharm 2 > Pharm final (Vitamins and Birth Control stuff) > Flashcards

Pharm final (Vitamins and Birth Control stuff) Flashcards

1
Q

What is the view of medicine that focuses on prevention rather than treatment?

A

FUNCTIONAL MEDICINE

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2
Q

What are the three antioxidant vitamins?

A

Vitamin A
Vitamin C
Vitamin E

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3
Q

What are the fat soluble vitamins?

A

ADEK

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4
Q

_____ soluble vitamins are stored in fat and do not need to be _________ everyday

A

FAT soluble; do not need replenished daily

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5
Q

Fat soluble vitamins are easy to _________ on….

A

Overdose

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6
Q

What are the water soluble vitamins?

A

B and C

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7
Q

_______ soluble vitamins are excreted in urine and must be ___________ daily

A

Water soluble vitamins need to be replenished daily

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8
Q

Vitamin A is also known as ________

A

Retinol

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9
Q

What vitamin is key for proper eye and skin health?

A

Vitamin A

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10
Q

What are the possible toxicities for Vitamin A?

A

birth defects
liver injury
bone related (too much vitamin A can lead to improper absorption of Vitamin D)

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11
Q

What are the possible consequences for low Vitamin A?

A

Night blindness
Xeropthalmia
Keratomalacia
Blindness

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12
Q

What are the uses for vitamin A supplement uses?

A

treating eye conditions
stopping diarrhea in a malnourished child
decreases bronchopulmonary dysplasia in infants
measles, acne (isotretinoin) ​

​

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13
Q

What vitamin is necessary for normal body functioning and hormonal and cellular signaling?

A

Vitamin D

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14
Q

Vitamin ____ regulates calcium and phosphorus?

A

D

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15
Q

What are the risk for low vitamin D?

A

Rickets and Osteomalacia

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16
Q

What is the best source of vitamin A?

A

THE SUN

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17
Q

How to you get some vitamin D while being outside?

A

Sunscreen blocks absorption of vitamin D, so be outside for like 10 minutes a day without the sunscreen!!!

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18
Q

Sources of vitamin D?

A

Sardines, liver, eggs, tuna, shrimp
Mushrooms, butter, natural cheese, fortified milk and seeds

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19
Q

What is the better supplementation option for Vitamin D?

A

D3&raquo_space;»> D2

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20
Q

What is the traditional recommendation for D supplementation?

A

400-800 IU a day

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21
Q

What is the current recommendation for D supplemenation?

A

2,000-3,000 IU a day

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22
Q

What should the blood level of vitamin D be??

A

40-60 ng/mL

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23
Q

What vitamin has antioxidant properties?

A

Vitamin E

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24
Q

What are dietary sources of Vitamin E?

A

Fresh greens, seeds, and oils

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25
Q

What are the possible toxicity of Vitamin E?

A

Platelet inhibition that may cause too much bleeding.

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26
Q

What vitamin is necessary for the synthesis of the prothrombin and other clotting factors?

A

Vitamin K

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27
Q

What are the consequences of a vitamin K deficiency?

A

BLEEDING

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28
Q

What are the possible AE of Vitamin K?

A

Hypersensitivity when too quick IV
Hyperbilirubinemia when it is given IM to infants

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29
Q

What is given in the event of a vitamin K OD?

A

Warfarin; people do not normally need Vitamin K supplementation

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30
Q

What vitamin is important in the production of collagen and compound that bind cells together, needed for the adrenal steroids?

A

Vitamin C

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31
Q

What vitamin helps absorb iron?

A

IRON

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32
Q

What are dietary sources of Vitamin C?

A

Citrus, tomatoes, potatoes, strawberries, melons, spinach, and broccoli

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33
Q

What are the consequences of Vitamin C deficiency?

A

Scurvy

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34
Q

What vitamin is also considered Niacin/Nicotinic Acid?

A

Vitamin B3

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35
Q

What is the consequence of Vitamin B3 deficiency?

A

Pellagra: scaling and cracking of sun exposed areas of the skin
GI disturbances: CNS changes

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36
Q

What are the possible toxicities of too much B3/Niacin?

A

Large doses used for high cholesterol can cause vasodilation, flushing, dizziness, and nausea

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37
Q

What is the use for vitamin B3/Niacin?

A

Topically for acne
Large doses for cholesterol

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38
Q

Vitamin B1 is also known as?

A

Thiamine

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39
Q

What vitamin is important in carbohydrate metabolism, so you need higher levels in pregnancy and lactation?

A

Vitamin B1/Thaimine

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40
Q

What are the two kinds of chronic B1 deficiencies?

A

Beriberi
Wenicke-Korsakoff

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41
Q

What chronic deficiency is associated with fluid accumulation in legs, cardiovascular complications, and ultimately circulatory collapse

A

Wet Beriberi

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42
Q

What is the chronic B1 deficiency that is associated with neuro and motor deficiet, but there are no cardiac complications?

A

Dry beriberi

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43
Q

What is the treatment for WET beriberi?

A

Thiamin replacement; this normally works fast so there is no need for a diuretic

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44
Q

What is the treatment for DRY beriberi?

A

Thiamine replacement; will have a slower recovery than wet beriberi

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45
Q

What is the most common cause of thiamine deficiency?

A

Wenicke-Korsakoff

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46
Q

What are the serious CNS AE of Wernicke Korsakoff?

A

Nystagmus
Diplopia
Short term amnesia
Ataxia

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47
Q

What is the B vitamin that is important for enzyme activity?

A

Riboflavin (B2)

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48
Q

What are the uses of Vitamin B2 (Riboflavin)

A

Deficiency (will see cracked edges of the mouth)
Relief of migraines after 3 months of use

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49
Q

What is the B vitamin that can be low because of poor diet, isozoanid use, or inborn errors of metabolism?

A

Vitamin B6 (Pyridoxine)

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50
Q

What are the consequences of a low B6?

A

Microcytic anemia
Dermatitis
Mouth sores
Cracked lips

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51
Q

What is the B vitamin that if it is too low, it can cause neuro damage?

A

B12 (Cyancobalamin)

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52
Q

What is the B vitamin that is found in many foods but is ESSENTIAL IN PREGNANT WOMEN????

A

Vitamin B9 FOLIC ACID

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53
Q

What herbal supplement is used for symptoms of menopause, almost ass effective as estrogen

A

Black Cohosh

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54
Q

Black cohosh potentiates what?

A

antihypertensive drugs, hypoglycemics, insulin, and estrogen giving them a stronger effects

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55
Q

What are the AE of black cohosh

A

safe for routine use
caution with hepatotoxic drugs
GI symptoms are most common

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56
Q

What herbal supplement is used for nasal allergy symptoms and migraine prevention?

A

Butterbur

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57
Q

What are the AE of Butterbur?

A

bleeding, headaches, fatigue, may have cross sensitivity with ragweed and some flowers

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58
Q

What herbal supplement is a potent antioxidant that is used in cardiac conditions, improves male infertility, statin associated myopathy

A

Coenxyme Q-10

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59
Q

What are the DI that are associated with Coenzyme Q-10

A

ANTAGONIZES the effects of Warfarin

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60
Q

What herbal supplement prevents UTI and helps with odor for urinary incontinence, benefit is only for teens-20s and elderly women

A

Cranberry Juice

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61
Q

What are the AE of Cranberry juice?

A

too much = kidney stones
May increase INR in patients on Warfarin

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62
Q

What is the herbal supplement that commonly used for anti-inflammatory properties, also has immunostimulant effects, not proven

A

Echineacea

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63
Q

What are the possible AE of Echinacea?

A

Fever, N/V, allergic reactions

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64
Q

Long term use of _________ can lead to immunosupression?

A

Echinacea

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65
Q

What is used in migraine prohylaxis?

A

Feverfew

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66
Q

What are the possible AE of Feverfew?

A

AE: well tolerated, mild GI reactions, suppression of platelet aggregation –> bleeding

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67
Q

What is the consideration of Feverfew before surgery?

A

Discontinue 2 weeks before surgery, and do not take with warfarin

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68
Q

What herbal supplement is a plant fiber that is used for dyslipidemia and constipation?

A

Flaxseed?

69
Q

What is the interaction of flaxseed with other meds?

A

Take 1 hour before meds or 2 hours after other medications

70
Q

What is the herbal supplement that lowers BP, antiplatlet, and may reduce risk of cancer?

A

Garlic

71
Q

TO BE EFFECT….. (for Garlic to be useful)

A

must be raw, 1-2 cloves daily, most garlic products do not contain the active ingredient

72
Q

What are the possible AE of Garlic?

A

Minimal
Bad breath, GI issues, strong platelets for a risk of bleeding

73
Q

What is the herbal supplement that is used for vertigo, N/N, and RA?

A

Ginger root

74
Q

What are the possible AE of ginger root?

A

CNS depression, Cardiac arrythmias, stimulation of the uterus

75
Q

What are drug interactions for ginger root?

A

Suppress platelet aggregation, lower blood sugar

76
Q

What herbal supplement shows possible improvement for PAD, dementia, and other conditions?

A

Gingko Bilboa (leaves only)

77
Q

What are the possible drug interactions for Gingko Bilboa?

A

Can suppress coagulation, promote seizures, and lowers the seizure threshold

78
Q

What is the herbal supplement that is used for osteoarthiritis?

A

Glucosamine

79
Q

What are the possible AE of Glucosamine?

A

GI disturbances, increased risk of bleeding, and caution with shellfish allergy

80
Q

What tea has the most caffeine?

A

Green –> black tea –> oolong tea

81
Q

What is the use for green tea?

A

Mental clarity, weight loss, reduce the risk of cancer

82
Q

What are the possible AE of Green tea?

A

Caffeine OD, HA, N/V, insomnia, increased HR and urination

83
Q

What are the possible drug interactions that are associated with green tea?

A

Vasodilation, Vitamin K may interact with Warfarin

84
Q

What herbal supplement is associated with the use for IBS, intestinal bacterial overgrowth, abdominal pain, tension headaches

A

Peppermint

85
Q

What are the possible AE of Peppermint?

A

GERD, allergic reactions, perianal burning and renal problems

86
Q

What herbal supplement can be used for diarrhea, UC, IBS, and reduction for H. Pylori for PUD?

A

Probiotics

87
Q

What are the possible AE of probiotics

A

DO NOT GIVE TO PATEINTS WITH A CENTRAL LINE –> Risk for fungal infection

88
Q

What administration consideration should be kept in mind when giving probiotics?

A

Give 2 hours after antibacterial or antifungal drug

89
Q

What are food sources for probiotics?

A

Fermented foods, sauerkraut, yogurt, kefir, miso soup, pickles, kimchi, tempeh, kombucha, natto, chocolate

90
Q

What is the herbal supplement that is found in wine, grape skin, grape juice, blueberries, cranberries, and peanuts –> antioxidant

A

Resveratol

91
Q

What are the drug interactions associated with Resveratol

A

antiplatelet actions, mimics estrogen  must be used with caution in women with estrogen dependent breast CA, increases insulin sensitivity

92
Q

What are the essential omega fatty acids because they cannot be created in the body

A

Omega 3 and Omega 6

93
Q

What omega fatty acid can be made in the body

A

Omega 9

94
Q

What is the omega 3 fatty acid that is found in flaxseed, nuts, and green leafy veggies?

A

Alpha-linolic acid

95
Q

What is the omega 3 fatty acid that is found in fatty fish, mackeral, and some fish oils?

A

DHA (Docosahexaenoic acid)

96
Q

What is the omega 6 fatty acid that is found in many vegetables and vegetable oils, no need to supplement

A

Linoleic Acid

97
Q

What is the omega 6 fatty acid that is found in borage, primroses, and black currant oil, very minimal in the diet

A

Gamma-linoleic acid (GLA)

98
Q

What is the omega 6 fatty acid that is found in eggs, fish, meat, and not normally requiring supplementation?

A

Arachidonic Acid

99
Q

You need to have a 3:1-6:1 ratio of Omega-___ and Omega-___ above inflammatory

A

Omega 6 ; Omega 3

100
Q

What is the herbal supplement that may be effective in treating BPH, antiplatelt and antiadrenergic effects?

A

Saw Palmetto

101
Q

What is the herbal supplement that is used to reduce hot flashes, can reduce risk of estrogen dependent breast CA, but should not be used with antiestrogen medications (tamoxifen)

A

Soy

102
Q

What herbal supplementation is used for depression?

A

St. John’s Wart

103
Q

What are the possible AE of St. John’s Wart?

A

allergies, CNS disturbances, GI discomfort, phototoxic at high doses

104
Q

St. John’s Wart interacts with……..

A

MANY OTHER DRUGS; do not give with SSRI

105
Q

What herbal supplement is a mild sedative, helps with anxiety will potentiate CNS depression with other drugs?

A

Valerian

106
Q

What is the harmful supplement that leads to veno-occlusive disease and liver damage?

A

Comfrey

107
Q

What is the harmful supplement that can lead to severe hepatic damage?

A

Kava

108
Q

What is the harmful supplement that can elevate BP, and stimulate the heart and CNS

A

Ma Huang

109
Q

What is the harmful supplement that impairs brain development in adolescence, increase risk of psychiatric conditions and suicide in adults

A

Cannabis

110
Q

RA is a disease where there is no cure… Therapy is directed at __________ symptoms and maintaining ________

A

Reduce symptoms
Maintain mobility

111
Q

What is the general first line treatment for RA?

A

NSAIDS

112
Q

What is the difference between 1st line and 2nd line NSAIDS in RA?

A

2nd generation has less GI irritation

113
Q

What are the 2 glucocorticoids that can be used in the treatment of RA?

A

Prednisone and Prednisolone

114
Q

When giving glucocorticoids for RA, keep in mind it is ______________ dosing so it can cause lots of SE

A

Pharmocological dosing

115
Q

What is the most rapid acting DMARD, that is used second line, but it is the first line DMARD?

A

Methotrexate

116
Q

What is the MOA of Methotrexate?

A

Suppresses B and T lymphocytes

117
Q

How long does it take methotrexate to work?

A

3-6 weeks; it is given once a week at a low dose

118
Q

What are the possible AE of methotrexate?

A

Hepatic fibrosis
Bone marrow suppression
GI ulceration
pneumonitis

119
Q

What are the 3 important things to monitor for a patient on Methotrexate?

A

LFT
Kidney function
CBCs

120
Q

You need to give _____ ______ with methotrexate?

A

folic acid

121
Q

What is the second line DMARD for RA?

A

Etanercept

122
Q

_______ is used after methotrexate

A

Etanercept

123
Q

__________ is more effective than methotrexate but has worse AE

A

Etanercept

124
Q

What are the AE of Etanercept

A

Risk of serious infection allergic reaction
heart failure
hematological disorders
liver injury
CSN demyelination
TB, and SJS in the first 28 days

125
Q

What are the two tests that need to be monitored for a patient taking etanercept?

A

CBC and LFT

126
Q

WHAT IS THE MAJOR TEACHING POINT FOR A PATIENT TAKING ETANERCEPT?

A

NO LIVE VACCINES BC OF IMMUNE SUPPRESSION

127
Q

What is the DMARD that cannot be given to patient’s with a sulfa allergy

A

Sulfasalazine

128
Q

What is the DMARD that reduces RA symptoms and slows disease progression but can cause an infusion reaction?

A

Rituximab

129
Q

What is the DMARD that is normally given after etanercept?

A

Abatacept

130
Q

What are the possible AE of Abatacept?

A

HA
URI
Nasopharyngitis
Nausea and infections

131
Q

What is the hormone that is important in the maturation and function of female sex organs?

A

Estrogen

132
Q

What are the 3 metabolic effects of Estrogen?

A

Increases bone mass
Improves cholesterol levels
Causes blood coagulation

133
Q

What are the AE of estrogen

A

Cancers of the female repro system
cardiac events due to clotting

134
Q

What are the uses of estrogen?

A

Menopause
Female hypogonadism
Female acne

135
Q

What are the 4 routes for estrogen administration?

A

PO
Transdermal
Vaginal
IV

136
Q

What are the two selective estrogen receptor modulators?

A

Tamoxifen and Raloxifene

137
Q

What is the hormone that is used in menopause, uterine bleeding, amenorrhea, infertility, endometrial carcinoma, and hyperplasia?

A

Progestin

138
Q

What are the AE of Progestin?

A

Tetrogenic
Breast cancer and tenderness
Gynecological issues and bloating
Depression

139
Q

What is the most common symptoms of Menopause

A

Hot flashes and night sweats

140
Q

What are the benefits of estrogen therapy in treatment of menopause?

A

Helps with the annoying symptoms

141
Q

What are the risks of estrogen therapy in treatment of menopause?

A

Endometrial cancer
Breast cancer
Cardiac events
Gallbladder disease

142
Q

What are the benefits of Progestin therapy in the treatment for Menopause?

A

Reduces estrogen induced irregular bleeding and endometrial carcinoma

143
Q

What are the risks of progestin therapy in the treatment for menopause?

A

Bloating, weight gain, unpredictable uterine bleeding at first.

144
Q

The use of unopposed estrogen is only to be used in they have had a ____________

A

Hysterectomy (other wise they need progestin as well)

145
Q

What is the PO progesterone tablet

A

Aygestin

146
Q

If a patient has a high risk of VTE, you should use a non oral route of hormones at the _________ dose possible

A

LOWEST

147
Q

If a patient has a high risk of breast cancer, you should use a _________________ treatment in menopause

A

NONHORMONAL

148
Q

If a patient has a high risk of CVD, you should use a _________ treatment for menopause

A

NON HORMONAL

149
Q

If a patient has a moderate risk of CVD, you should use __________ estrogen with appropriate use of progesterone

A

TRANSDERMAL

150
Q

What are the three considerations for birth control selection?

A

Efficacy
Safety
Person preferences

151
Q

What are the two main types of OCs?

A

Combination OC -estrogen and progestin
Progestin only OC

152
Q

What are the 3 MOAs of OCs

A
  1. Suppress Ovulation
  2. Thickening of cervical mucous
  3. Alters the endometrial lining to prevent implantation of a fertilized egg
153
Q

What are the possible AE of Combined OCs

A

Thromboembolic disorders
Cancers
Tetragenic

154
Q

What are the benefits of OC use?

A

Suppressed dysmenorrhea
Endometriosis
Acne
Hirsutism
Less ovarian cysts and PID

155
Q

What are the COC methods

A

Oral
Patch
Vaginal ring

156
Q

What are the methods of Progestin only OCs?

A

PO
Injection
Implant
Intrauterine

157
Q

What are the contraindications for combination oral contraceptives?

A

Smoker for over 35 years
Risk for PE and DVT
Migraines with aura
clotting risk
CVD and breast cancer.

158
Q

What are COC AE?

A

N/V
Acne
Breakthrough bleeding
ACHES- clotting

159
Q

What is the MOA of progestin only contraceptives

A

Thickens cervical mucous

160
Q

What is the important consideration regarding taking the POC

A

Must take the dose at the same time every day

161
Q

If the POC is taken 3 hours late, they need to use __________

A

backup contraception for 48 hours

162
Q

What are the AE for progestin only contraceptives?

A

Changing in bleeding patterns
breast tenderness

163
Q

What are the possible AE of the DEPOT Provera injection

A

Weight gain
Mood issues
Long term fertility issues
Decrease in BMD if given over 5 years

164
Q

What are the possible AE of the DEPOT Provera injection

A

Weight gain
Mood issues
Long term fertility issues
Decrease in BMD if given over 5 years
- need to take Ca and Vitamin D

165
Q

What is the intrauterine progestin progestin only contraceptives?

A

Mirena (left in uterus for 5 years)

166
Q

What is the progestin implant in the arm?

A

Nexplanon

167
Q

How long is nexplanon left in the arm?

A

3 years

168
Q

What is the chemical surfactant that kills sperm by destroying the cell membrane?

A

Spermicides

169
Q

What is the nonhormonal contraceptive that changes sperm motility and maintains vaginal pH?

A

Vaginal gel

Nurs 306 / Pharm 2 (4 decks)

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