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Pharmacy Practice III > Prevention of Pregnancy and STIs > Flashcards

Prevention of Pregnancy and STIs Flashcards

1
Q

What is conception?

A
  • Viable egg released during ovulation to be available for fertilization
  • Conception occurs during a 6-day window (5 days before ovulation + ovulation day)
    • Peak occurs that day before ovulation
    • Sperm penetrate cervix to reach cervix to reach egg (live 3-5 days, up to 7 days in tract)
    • Fertilized egg is implanted into uterine lining
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2
Q

What are the ways to prevent pregnancy?

A

Suppress ovulation

Prevent fertilizations

Prevent implantation

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3
Q

What is the fertility window?

A

During a typical 28 day cycle, probability increases by day 7, peaks at day 12 or 13 before declining

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4
Q

How do you get STIs?

A

Genital tissues, mucus membranes, bodily fluids

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5
Q

True/False: patients with uterus are less prone to reproductive consequences

A

False

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6
Q

What are reproductive consequences that are associated with STIs?

A

Pelvic inflammatory disease, chromic pelvic pain, ectopic pregnancy, epididymitis, malignancy, infertility

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7
Q

What are perinatal consequences associated with STIs?

A

Morbidity/mortality, low birth weight, premature birth, transmission

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8
Q

How are STIs transmittable?

A

Secretions

Infected skin or mucosal surfaces

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9
Q

Which STIs are spread through infected secretions?

A

HIV, Gonorrhea, Chlamydia, Trichomoniasis, Bacterial Vaginosis (BV), Hepatitis B

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10
Q

Which STIs are spread through infected skin or mucosal surfaces?

A

HSV, Syphilis, Chancroid, HPV

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11
Q

How do you minimize the risk of STI?

A

Vaccines and contraception

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12
Q

Which STIs are treated with vaccines?

A

HPV, Hepatitis B

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13
Q

Which contraception’s are used to treat STIs?

A

Condoms, spermicides, sponge (self-care)
Fertility Awareness-Based Methods (self care)
EC (self care)
Hormonal contraception (CQA furnishing by pharmacist)

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14
Q

What is the most common STI in the US?

A

HPV

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15
Q

When is there the highest risk of HIV infection?

A

During the first few years after sexual activity begins

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16
Q

What is a major cause of genital warts and cervical cancer?

A

HPV

17
Q

Which subtypes of HPV cause cervical cell changes, warts, and laryngeal papilloma?

A

Subtypes 6 and 11

18
Q

Which subtypes are responsible for 70% of cervical cancers?

A

subtypes 16 and 18

19
Q

Which vaccine is used to treat HPV?

A

Gardasil-9

20
Q

Which HPV subtypes is Gardasil-9 protective against?

A

6, 11, 16, 18

21
Q

What are the doing regimens for the different age groups taking Gardasil-9?

A

11-12 yo should receive vaccine (as young as 9); catch-up through 26

- <15yo: 2 doses at 0 and 6-12 months
- ≥15 yo: 3 doses at 0, 1 - 2 months, and 6 months
22
Q

When is it best to take Gardasil-9?

A

prior to HPV exposure (but previous sexual intercourse does not preclude vaccination with expected benefit)

23
Q

What adverse effects are associated with Gardasil-9?

A

injection site irritation, malaise, syncope

24
Q

About 79% of new Hepatitis B infections are associated with _____ & _____

A

High-risk sexual behaviors and injection drug use

25
Q

What is the dosing regimen for the inactivated hepatitis B vaccine?

A

Recombivax/Engerix: 3 doses at 0, 1, and 6 months

Heplisav-B: 2 doses at 0 and 1 month

26
Q

Which candidates who are not previously vaccinated meet the criteria for the inactivated Hepatitis B vaccine?

A

Sexual exposure to partners of Hep-B infected persons

Not in long-term mutually monogamous sexual relationships

In need of evaluations/treatment for STI

Men who have sex with men (MSM)

27
Q

True/False: No method of contraception (other than abstinence) is 100% effective

A

True

28
Q

What is the difference between perfect and typical effectiveness?

A

Perfect (method-related failure): Theoretical and difficult to measure + assumes accurate/ consistent use every time

Typical (use/user-related failure): More realistic; accounts for pregnancies due to inconsistent or incorrect use

29
Q

What are the most effective methods of avoiding STIs?

A

abstaining from risky sexual activity

being involved in long-term mutually monogamous relationships with uninfected partners

Preventive strategies + contraceptives

30
Q

What are the advantages/disadvantages of vaginal spermicides?

A

Advantages

  • Cheap
  • Various dosage forms

Disadvantages

  • No protection against STI transmission
  • High failure rate when used alone
  • Not recommended patients with vaginal anatomic abnormalities
31
Q

What are the advantages/disadvantages of contraceptive sponge (Today Sponge)?

A

Advantages

  • Serves as a mechanical barrier
  • Cheap

Disadvantages

  • No STI protection
  • Failure rates higher in patients who have given birth previously
  • Vaginal dryness; Toxic shock syndrome (rare)
32
Q

What are the advantages/disadvantages of emergency contraceptive (EC)?

A

Advantages
- Can use up to 3 - 5 days after unprotected sex

Disadvantages

  • Not as effective with BMI >26
  • Expensive
  • AEs: N/V
33
Q

Explain Fertility Awareness-Based (FAB) Methods

A

Techniques to determine fertile phase of menstruation cycle

Intercourse should be avoided or another contraception method used

34
Q

Explain the Calendar Method

A

o Uses monthly menstrual cycle length to calculate fertile window
o Factors in viability of ovum (up to 24 hours) and sperm (3-5 days)

35
Q

Explain the Cervical Mucus Methods

A

o Rely on detection of changes in cervical mucus during menstrual cycle
o Patients should avoid intercourse during first cycle
o Vaginal foams, gels, creams, and douches will interfere with cervical mucus
o Billings Ovulation Method
Daily observation/charting of mucus character and quantity
o TwoDay Method
If mucus that day or the day before, likely fertile

36
Q

Explain the appropriate use of EC

A

Regimen: 1.5 mg LNG po x 1 within 72 hours of unprotected sex or contraceptive failure (effective up to 120 hours but declines with time)
- If within 120hrs, can offer non-rx EC products OR refer to PCP for UPA or copper IUD
- my not be as effective as in patients with BMI >26
- Refer to PCP after 120hrs
AEs: N/V
- if vomit within 1-2hrs after taking, repeat dose
$40-50 for single use
EC training in 2 weeks

37
Q

In California, what type of hormonal contraception may a pharmacist furnish?

A

Oral tablets (combo hormonal contraception)
Transdermal patch
Vaginal ring
Depot injection

38
Q

What is the pharmacists role in terms of necessary requirements for furnishing oral contraceptives in California?

A

Patients fills out self-screening tool and pharmacist reviews it
Check and record PT’s seated BP if desiring oral tablets
Counsel on how to use contraceptives

Pharmacy Practice III (7 decks)

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