Quiz 2 LARCs/emergency contraception

Question 1

Mirena IUD (Levonorgestrel 52mg) MOA

Answer 1

sterile inflammatory rxcn toxic to sperm and ova, thickens mucus, endometrial decidualizaion and glandular atrophy, inhibiting sperm-egg binding, partial inhibition of follicular development/ovulation

Question 2

Mirena IUD (levonorgestrel 52mg) efficacy and dosing

Answer 2

0.2% failure with perfect and typical use
20ug/day then 10ug/day
up to 5 years, off label for 7 years

Question 3

Mirena IUD (levonorgestrel 52mg) safe in

Answer 3

nulliparous women/teens

immediately postpartum/D&C (^rate of expulsion compared to delayed placement 6-10wks)

Question 4

Mirena IUD (levonorgestrel 52mg) SE
SE mgmt

Answer 4

irregular spotting for first 3-6months, resolves after 6mo, may not have period after 1yr
nsaids, COCs, progestin only pills for spotting/cramps

Question 5

Mirena IUD (levonorgestrel 52mg) can reduce

Answer 5

heavy bleeding in menorrhagia

Question 6

Liletta IUD

Answer 6

releases 18.6ug/day, approved for 3 years-12.6ug/day

Question 7

Kyleena IUD

Answer 7

releases 17.5 ug/day-1st year, then 7.5, 5 years, smaller insertion tube for nulliparous women

Question 8

Skyla IUD

Answer 8

14ug/day, then 5ug/day, 3 years, smaller insertion tube for nulliparous women , more bleeding days than mirena

Question 9

Paraguard copper IUD

Answer 9

copper enhances inflammatory reaction toxic to sperm/ova, 0.6/0.8% failure rate, 10yrs, ^bleeding/cramping

Question 10

Nexplanon (etonogestrel 68mg implant)

Answer 10

thickens cervical mucus and thins endometrial lining
0.05%, 0.3% efficacy
60-70ug/day, 25-50ug/day by 3rd year
irregular period common 6-12 mo, may persist

Question 11

Paraguard Emergency Contraception

Answer 11

insert up to 5 days after intercourse

0.04-0.19% failure

Question 12

Ulipristal 30mg Emergency Contraception

Answer 12

selective progesterone modulator, up to 5 days after, 2% failure rate

Question 13

Levonorgestrel 1.5mg Emergency Contraception (Pan B)

Answer 13

failure rate 1.1-2.4%, most effective w/in 72 hours, declines w time, ineffective >30BMI

Question 14

Estradiol/levonorgestrel (Yuzpe method)

Answer 14

50ug/0.25mg 2 tabs q12h. Any OC can be used as long as estrogen is 100ug/dose
failure rate 3.2%, need antiemetic 1-2hrs before each dose

Question 15

Beyaz, Safyral

Answer 15

contain estrogen, progestin, and levomefolate (folic acid) to reduce neural tube defects risk if pregnancy occurs

Question 16

Natazia

Answer 16

estradiol valerate (estradiol prodrug) and dienogest, 4th gen progestin
does not cause K retention, withdrawal bleeding shorter/lighter than other OCs