Pharmacology Flashcards
If 1 pill missed of COCP ?
Take pill even if have to take 2 pills in one day and carry on as normal
No emergency contraception needed
If 2 pills missed of COCP in week 1?
Emergency contraception needed (if has had intercourse in the pill free week or week 1)
Take the last pill even if have to take 2 in one day and omit earlier missed pills. Then continue as normal.
Use condoms/other contraception for 7 days
If 2 pills missed of COCP in week 2?
Take the last pill even if have to take 2 in one day and omit earlier missed pills. Then continue as normal.
Use condoms/other contraception for 7 days
Emergency contraception not needed
If 2 pills missed of COCP in week 3?
Take the last pill even if have to take 2 in one day and omit earlier missed pills. Then continue as normal.
Use condoms/other contraception for 7 days
Emergency contraception not needed
should finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval
What is used as emergency contraception?
Levonorgestrel (a progesterone) - 1.5mg single dose
EllaOne/Ulipristal (progesterone receptor modulator) - 30mg single dose
Copper IUD
When can levonorgestrel (levonelle) be used as emergency contraception?
Within 72 hours of UPSI
Dose must be repeated if she vomits within 2 hours of taking
When can EllaOne/Ulipristal be used as emergency contraception?
120 hours after UPSI
Who should not receive Ulipristal?
Caution in severe asthmatics
How does Ulipristal work as emergency contraception?
Inhibits ovulation by inhibiting LH secretion / no LH surge (progesterone receptor modulator)
Does Ulipristal effect regular hormonal contraception?
Yes - reduce the effectiveness of other hormonal contraception:
- COCP should be started/restarted 5 days after taking
- POP should be restarted 7 days later
When can an IUD be used as emergency contraception?
Within 5 days of UPSI OR up to 5 days after ovulation
Pharmacological mx of ectopic pregnancy
Methotrexate
What drugs are used in the management of urge incontinence?
Antimuscarinics: Oxybutynin, Tolterodine & Darifenacin
B3 agonist: Mirabegron
What drug is used for symptomatic relief in obstetric cholestasis?
Ursodeoxycholic acid
Which antibiotic is used for the treatment of group b strep?
Benzylpenicillin
What SSRI can be used in postnatal depression?
Paroxetine (Fluoxetine has too long a half life)
What is the name of the contraceptive patch?
Evra patch
How is the contraceptive patch taken/used?
4 weeks - wear for 3 weeks and have 1 week off (need to change the patch weekly for those first 3 weeks)
Delay in changing the contraceptive patch at the end of week 1 or 2?
If <48 hours change immediately and no other precautions needed
If >48 hours change immediately and use barrier contraception for the next 7 days.
Consider emergency contraception if the lady has had UPSI during this patch free interval or in the past 5 days
Delay in removal of the contraceptive patch at the end of week 3?
Remove ASAP and apply new patch on the usual cycle start day
If forget to reapply patch at the end of patch free week (week 4)?
Use barrier contraception for the next 7 days
What antibiotic is used for mastitis and how long for?
10-14 days of Flucloxacillin
Time until contraceptives are effective?
IUD - instant
POP - 2 days
COCP, injection, implant, IUS - 7 days
What contraception can be used in a patient with breast cancer?
Copper IUD
ALL hormonal contraceptives are contraindicated in breast cancer
What medication is safe to use in pregnancy for thrush/candidiasis?
And why can’t fluconazole be used?
Clotrimazole Pessary
Fluconazole is contraindicated in pregnancy due to risk of congenital abnormalities