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Pharmacology > Week 7 contraception > Flashcards

Week 7 contraception Flashcards

1
Q

Mechanisms 1
Prevent a) ______ from entering the vagina/cervix

b) What are the methods?

A

a) sperm

b) barrier methods
male sterilization

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2
Q

Mechanisms 2
Prevent b) _____ from entering the area if fertilization

What are the methods?

A

a) egg

b) hormonal, female sterilization

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3
Q

Fertility awareness 3
受胎能力
What are they?

A

Calendar method
Cervical mucus viscosity
Basal body temperature

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4
Q

Hormonal contraception

Manipulates a____ and b_____ to convince the body that it is already pregnant

A

a) estrogen
b) progestin

Ovulation does not occur

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5
Q

What is the main component that prevents ovaluation?

A

progestin

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6
Q

Combination oral contraceptives
COCs

When does it introduce?
First COCs are in higher or lower doses than today?

A

a) 1960
b) higher

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7
Q

Estrogen content

Ultra low
Low
High

A

< 20 mcg
30-35mcg
> 35mcg

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8
Q

Types of COCs

21 active pills
7 inactive pills

A

Monophasic COC
E: Ethinyl estradiol
P: Progestin (nonspecific)
all 21 pills are identical in progestin

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9
Q

Types of COCs

Day 1- 10 active pills are a different dose of progestin
11-21 active pills
7 inactive pills

A

Biphasic COCs
E: Ethinyl estradiol
P: Progestin (nonspecific)

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10
Q

Types of COCs

Week1, week2 week 3 active pills
have different dosage
7 inactive pills

A

Triphasic COCs
E: Ethinyl estradiol
P: Progestin (nonspecific)

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11
Q

Hormonal contraceptive

Effectiveness
a) Perfect use
b) Typical use

Fail reason

A

a) 0.3%
b) 8%

Missed pills (50% of 1st-time users missed >3pills during their 3rd cycle)

Stop taking pills without back-up method

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12
Q

Hormonal contraceptive

advantages

A

Highly effectiveness
Rapid reversibility
Improve acne
less cramping and pain

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13
Q

Hormonal contraceptive

Disadvantage

A

Daily administration
Prescription required
Not protect from SDIs

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14
Q

COCs health complications

What is the most concerning complication?

A

VTE
Venous thromboembolism

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15
Q

FDA contraindication of CDCs

A

1) VTE risks pt
2) Cancer that responds hormones
3) Liver issues
4) Suspected pregnant
Hypersensitivity

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16
Q

What is the first day start?

A

Pills are taken on the first day of period=when bleeding

-No back -up needed

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17
Q

What is Sunday start?

A

Pills are taken on the first Sunday of period
-Period free weekends
-Requires to backup if period starts on Monday or Tuesday
Used back up until COCs is used for 7days

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18
Q

COCs
drug interactions

A

Anticonvulsants
Antibiotics
-Only rifampin(TB)
Antiretrovirals
-Covid, HIV
St. John’s worth
-Herbal OTC

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19
Q

COCs
Missed 1 to 2pills

A

Take 1 active pills ASAP then continue taking daily pills
Emergency contraception in the first week and had sex

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20
Q

COCs
Missed > 3 pills during first 2 weeks
of pack

A

Take 1 active pill ASAP then continue taking daily pills
back-up until taking 7 active pills in a row

Ovulation starts day 14
Prevent ovulation

21
Q

COCs
Missed>3 pills during the 3 rd week of the pack

A

Just finish the active pills
Start a new pack the next day without using any placebo pills

22
Q

COCs
Side effects
Unscheduled vaginal bleeding

A

DO NOT change pill until 3 month
By the 3rd pack of pills, 70-90% have no further bleeding

23
Q

COCs
Side effects
Headaches

A

New onset or worsening should be evaluated
One of the VTE risks is stroke.
Stroke’s symptoms is a headache

We need to make sure the headache is just ADR or stroke sing

24
Q

Unique COCs
Yasmin what’s a cycle?
Yaz what’s a cycle?

A

a) 7 placebo pills cycle
longer period
b) 4 placebo pills cycle
shorter than Yasmin

25
Q

Yasmin+ Yaz
Contains?

A

E: Ethinyl Estradiol
P: Drosperinone
Progestin with ant mineralocorticoid activity

Claims less water weight gain that other COCs

26
Q

Unique COCs
Nextstellis
Contains?

A

E: Estetrol
P: Drosperinone
A new estrogen
May see less bleeding
May see less risk of VTE
$190!!

27
Q

Unique COCs
Seasonal

A

E: Ethinyl Estradiol
P: Nonspecific

First COC approved for extended cycles
Period every 3 moths
Increased bleeding

28
Q

Unique COCs
Seasonique
loseasonique

A

E: Ethinyl Estradiol
P: Levonorgestrel
Low EE
No placebo so must take it everyday
less bleeding

29
Q

Unique COCs
Lybrel

A

First COC approved for continuous use
No period!!
No placebo so must take it every day

many reports of unscheduled bleeding

30
Q

NuvaRing
What consists?

A

E: Ethinyl estradiol 15mcg
P: Etonorgestrel 120mcg

It doesn’t pass the liver so low dosage is OK

31
Q

NuvaRing
How to use it?
Effectiveness?
ADRs?

A

Inserted into the vagina and left for 21days
Wait 7 days and insert the new one

Perfect use 0.3%
Typical use: 8%

ADR: Same
May less abnormality bleeding

32
Q

NuvaRing
Advantage

A

Slow, steady release of hormones
Rapidly effective and rapidly reversible

33
Q

NuvaRing

a) Ring out less than 3 hr
b) Out more than 3 hr during week 1-2
c) Out more than 3 hr during 3weeks

A

a) Rinse with water and re-insert
b) Rinse with water and re-insert
Backup for 7days
Offer EC if had sex
c) Discard ring and insert new one immediately
Backup for 7days

34
Q

Xulane
What contain?

A

E: Ethinyl estradiol 20mcg
P: Nonrelgestromin 150mcg

35
Q

Xulane
How to use it?

A

Apply patch and leave in place for 1 week
replace another for week 2
replace another for week 3

remove the patch and wait 7 days

Patch can be on abdomen, butt, upper torso, upper outer arm

36
Q

Xulane
Advantages

A

Weekly regimen
Rapidly reversible

37
Q

Xulane
Disadvantage

A

Same ADRs as COCs
Skin reactions
Breast discomfort, engorgement

38
Q

Xulane
If patch detach
a) <24hr
b) >24 hr or unknown

A

a) Try to re-adhere with pressure
If not put the new one
b) Start a new one
Use backup for 7days

39
Q

Minipills
Progestin-only pills
a) contain?
b) the main failure?

A

a) Norethindrone
b) Lower progestin does have a shorter duration action
Late pill-taking can compromise efficacy

40
Q

Minipill
action

A

Inhibits ovulation
Thickens cervical mucus
Reduce ovum transport through fallopian tubes
Altered endometrium

41
Q

Minipills
a) advantage
b) disadvantage

A

a) Lack of estrogen and lower progestin

b) causes bleeding changes
short cycle, irregular periods
Must take at the same time

42
Q

Minipills

If take 3hr late?

A

Consider missed pill
take soon as remember
backup for 48hr

Must take EVERY DAY and SAME TIME

43
Q

Nexplanon

What contains?

A

A single matchstick
68mg etonorgestrel (P)

Inserted under the skin
Effective for at least 3 years
0.05% failure

44
Q

Nexplanon
a) Advantage

b) disadvantage

A

a) Same as other progestin-only methods

c) Clinical dependent
Insertion complications
Obesity tend to fail

45
Q

IUD
ParaGard

A

Copper wire
Inhibits spermatic functioning

46
Q

IUD
Mirena

A

P: levonorgestrel system
Local hormonal effect
-thickens cervical mucus
-inhibits sperm survival
-suppress endometrium

47
Q

IUD
a) advantage
b) disadvantage

A

a) long-lasting
b) irregular bleeding
Cramping, pain
Missing strings
Inc ectopic pregnancy risk
Inc miscarry risk

48
Q

Phexxi

A

pH control gel
used within 1 hour BEFORE of intercourse

Perfect fail 7%
Typical 14%

non-hormone
require prescription
Can’t use women history of UTI

49
Q

Emergency contraception
What is the option 1,2,3?

A

1) Plan B up to 72 hr
2) Ulipristal up to 5days
3) Copper T IUD up to 5days

Pharmacology (34 decks)

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