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Pharm 2 > Womens Health 2 > Flashcards

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
Q

How should hormone replacement tx be prescribed?

A

the lowest effective dose for the shortest duration necessary to control menopausal symptoms.

26
Q

In which cases can estrogen-only therapy be used and why?

A

Estrogen-only replacement therapy (ERT) is used solely for patients without a uterus - increases risk of uterine CA

27
Q

USPTF recommendations regarding HRT

A

Recommends against the routine use of combined estrogen and progestin for the prevention of chronic conditions

28
Q

Estrogen Replacement Therapy use

A

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
Q

Estrogen routes available

A

Oral, transdermal, topical gels and lotions, and vaginal rings

30
Q

Conjugated Estrogen (Premarin) use

A

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
Q

Conjugated Estrogen (Premarin) MOA

A

In essence, these hormones reduce elevated levels of gonadotropins, LH, and FSH in postmenopausal women.

32
Q

Conjugated Estrogen (Premarin) SE

A

Thromboembolism, MI, edema, stroke, HTN, breast tenderness

33
Q

What drink can increase estrogen levels?

A

Grapefruit juice

34
Q

Conjugated Estrogen (Premarin) contraindications

A

Pregnancy
Undiagnosed vaginal bleeding
Breast cancer
Recent or current thromboembolism
Estrogen or progesterone dependent cancer
Liver disease
Thromboembolic disease

35
Q

Medroxyprogesterone (Provera) MOA

A

Progestin inhibits pituitary gonadotropin release, preventing follicular maturation

36
Q

Medroxyprogesterone (Provera) use

A

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
Q

Medroxyprogesterone (Provera) SE

A

Alopecia, acne, oily scalp, melasma
Depression, decreased libido

38
Q

Medroxyprogesterone (Provera) interactions

A

Use as a contraceptive may be rendered ineffective in the presence of phenobarbital, phenytoin, rifampin.

39
Q

Medroxyprogesterone (Provera) contraindications

A

Pregnancy
Undiagnosed vaginal bleeding
Breast cancer
Recent or current thromboembolism
Estrogen or progesterone dependent cancer
Liver disease
Thromboembolic disease

40
Q

Combination Estrogen/Progestin Products for HRT

A

Various choices

41
Q

Which iron supplement is preferred to tx iron deficiency anemia?

A

ferrous sulfate, 325 mg daily is recommended

42
Q

Why should pts on PPIs or H2 blockers be difficult to tx iron def. anemia?

A

The use of acid-neutralizing medications can impair the response to oral iron

43
Q

When should PCOS be suspected?

A

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
Q

Goals of PCOS tx

A

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
Q

1st and 2nd line meds to lessen hyperandrogenic features

A

combined oral contraceptives and antiandrogens

46
Q

Antiandrogens used on PCOS

A

Spironolactone
Finasteride
Dutasteride

47
Q

Finasteride and dutasteride should not be used in these cases to tx PCOS?

A

Do not use if trying to become pregnant. Must be on birth control. Finasteride and dutasteride are pregnancy category X

48
Q

Which meds will tx underlying metabolic abnormalities of PCOS?

A

Metformin and statins

49
Q

In PCOS pts who want to induce ovulation, which meds are used?

A

Letrozole
Clomiphene

Pharm 2 (8 decks)

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