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Womens Health 2 Flashcards

1
Q

When must the copper IUD be placed to act as an emergency contraceptive?

A

Must be inserted within 5 days of the first act of unprotected sex.

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2
Q

Copper IUD MOA

A

Makes the uterine environment in hospitable

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3
Q

Copper IUD SE

A

Heavy menstrual bleeding, spotty menstruation
Ectopic pregnancy, uterine perforation, intrauterine system migration (expulsion)
Anemia
Back pain

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4
Q

Copper IUD contraindications

A

Endometriosis
Pelvic inflammatory disorder
Uterine of cervical malignancy
Intrauterine device already in place
Known pregnancy

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5
Q

When should Ulipristal (Ella) be used for emergency contraception?

A

w/in 5 days

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6
Q

Ulipristal (Ella) MOA

A

Prevents progestin from binding to the progesterone receptor - delaying ovulation and impairing implantation

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7
Q

Ulipristal (Ella) SE

A

Altered menses, acne, alopecia, dysmenorrhea

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8
Q

Ulipristal (Ella) contraindication

A

Pregnancy - not effective

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9
Q

What is the most effective emergency OC?

A

Ulipristal (Ella)

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10
Q

When must the progestin only pills be taken to prevent pregnancy?

A

W/in 3 days

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11
Q

What is the difference between the progesterone only ECs?

A

1 tablet, containing 1.5mg of levonorgestrel (Plan B One-step) or
2 tablets, each containing 0.75mg of levonorgestrel (Second pill taken 12 hours after the first)

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12
Q

Progestin only EC MOA

A

Thickens the cervical mucus, which inhibits sperm passage through the uterus and sperm survival and prevents implantation

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13
Q

Progestin only EC SE

A

Hypermenorrhea, altered menses, acne, alopecia, nausea

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14
Q

Progestin only EC contraindications

A

Pregnancy

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15
Q

Age restrictions for progestin only EC

A
  • “Plan B One-step” available without age restriction
  • “Plan B” 2 step available to those 17 years and older
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16
Q

Progestin only EC clot risk?

A

None

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17
Q

What is the Yuzpe method?

A

When a woman uses everyday birth control pills as Emergency Contraception - combines large doses of estrogen and progestin

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18
Q

What is the dose goal for Combined progestin-estrogen EC pills?

A

100 mcg of ethinyl estradiol and 0.5 mg of levonorgestrel (or the equivalent) - repeated 12 hrs later

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19
Q

When should the Combined progestin-estrogen EC pills be taken to work?

A

within 5 days of the first act of unprotected sex

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20
Q

Combined progestin-estrogen EC pills SE

A

Nausea*, thrombosis, altered menses, uterine cramps

21
Q

Combined progestin-estrogen EC pills contraindications

A

Cigarette smoking/HTN (patient over 35 years)
Liver disease
Heart disease
Thromboembolic disease
Breast cancer
Breast feeding
Pregnancy
Major surgery with prolonged immobilization

22
Q

What is the Least effective form of oral EC?

A

Combined progestin-estrogen EC pills

23
Q

When is the Combined progestin-estrogen EC pills method used?

A

Generally recommended only if the woman wishes to use pills she already has readily available.

24
Q

What is the most effective tx for menopause sxs?

A

estrogen replacement therapy

25
How should hormone replacement tx be prescribed?
the lowest effective dose for the shortest duration necessary to control menopausal symptoms.
26
In which cases can estrogen-only therapy be used and why?
Estrogen-only replacement therapy (ERT) is used solely for patients without a uterus - increases risk of uterine CA
27
USPTF recommendations regarding HRT
Recommends against the routine use of combined estrogen and progestin for the prevention of chronic conditions
28
Estrogen Replacement Therapy use
Reduce menopause symptoms of hot flashes and vaginal dryness Prevent bone loss and osteoporosis in people at high risk Treat certain cancers in men and women
29
Estrogen routes available
Oral, transdermal, topical gels and lotions, and vaginal rings
30
Conjugated Estrogen (Premarin) use
To reduce moderate to severe hot flashes To treat moderate to severe dryness itching, and burning in and around the vagina To help prevent and treat osteoporosis
31
Conjugated Estrogen (Premarin) MOA
In essence, these hormones reduce elevated levels of gonadotropins, LH, and FSH in postmenopausal women.
32
Conjugated Estrogen (Premarin) SE
Thromboembolism, MI, edema, stroke, HTN, breast tenderness
33
What drink can increase estrogen levels?
Grapefruit juice
34
Conjugated Estrogen (Premarin) contraindications
Pregnancy Undiagnosed vaginal bleeding Breast cancer Recent or current thromboembolism Estrogen or progesterone dependent cancer Liver disease Thromboembolic disease
35
Medroxyprogesterone (Provera) MOA
Progestin inhibits pituitary gonadotropin release, preventing follicular maturation
36
Medroxyprogesterone (Provera) use
To decrease endometrial hyperplasia in postmenopausal women receiving concurrent estrogen therapy Treatment of secondary amenorrhea and abnormal uterine bleeding (AUB) caused by hormonal imbalance As an emergency contraceptive
37
Medroxyprogesterone (Provera) SE
Alopecia, acne, oily scalp, melasma Depression, decreased libido
38
Medroxyprogesterone (Provera) interactions
Use as a contraceptive may be rendered ineffective in the presence of phenobarbital, phenytoin, rifampin.
39
Medroxyprogesterone (Provera) contraindications
Pregnancy Undiagnosed vaginal bleeding Breast cancer Recent or current thromboembolism Estrogen or progesterone dependent cancer Liver disease Thromboembolic disease
40
Combination Estrogen/Progestin Products for HRT
Various choices
41
Which iron supplement is preferred to tx iron deficiency anemia?
ferrous sulfate, 325 mg daily is recommended
42
Why should pts on PPIs or H2 blockers be difficult to tx iron def. anemia?
The use of acid-neutralizing medications can impair the response to oral iron
43
When should PCOS be suspected?
Polycystic ovary syndrome (PCOS) should be suspected when there are 2 of the 3 symptoms: - Oligomenorrhea and/or anovulation - Clinical and/or biochemical signs of hyperandrogenism - Evidence of polycystic ovaries
44
Goals of PCOS tx
Lessening of hyperandrogenic features Management of underlying metabolic abnormalities and reduction of risk factors Prevention of endometrial hyperplasia and carcinoma Contraception for those not pursuing pregnancy Ovulation induction for those pursuing pregnancy
45
1st and 2nd line meds to lessen hyperandrogenic features
combined oral contraceptives and antiandrogens
46
Antiandrogens used on PCOS
Spironolactone Finasteride Dutasteride
47
Finasteride and dutasteride should not be used in these cases to tx PCOS?
*Do not use if trying to become pregnant. Must be on birth control. Finasteride and dutasteride are pregnancy category X*
48
Which meds will tx underlying metabolic abnormalities of PCOS?
Metformin and statins
49
In PCOS pts who want to induce ovulation, which meds are used?
Letrozole Clomiphene

Pharm 2 (8 decks)

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