Womens Health OTC Flashcards
When is EHC used?
Unprotected sex
Contraceptive failure
Advanced supply
When is a referral needed for EHC?
> 5 days unprotected sex
Changes to period
Severe liver dysfunction
Interacting medicines - enzyme inducers, phenytoin, carbamazepine, rifampicin, rifabutin, ritonavir, St. John’s wort, griseofulvin
When is levonelle used?
16+
Within 72 hours
Can take more than once in same cycle
Avoid in severe liver impairment, ectopic pregnancy risk, Crohn’s disease
OK in breastfeeding
Doesn’t reduce efficacy of regular contraception
Significantly interacts with ciclosporin
When is Ella one used?
Women of child bearing age, can be used under 16
Within 120 hours
Can’t take more than once in same cycle
Avoid in severe liver impairment, asthma, steroids
Not recommended in breastfeeding for 1 week
Use condos until next period
What is the advice for EHC?
Take ASAP Second dose if vomiting within 3 hours Use barrier method until next period Ella one reduces contraceptive effectiveness Abnormal bleeding at period see GP Delayed period see Gp Severe abdominal pain see GP
What are the symptoms of cystitis?
Dysuria
Urinary frequency and urgency
Incomplete bladder emptying
Dark, cloudy, strong smelling urine
When do you refer cystitis?
Women under 60, over 70 Men and children Recurrent attacks > 2 episodes in last 6 months Symptoms > 48 hours Severe symptoms Flank pain Systemic symptoms Haematuria Abnormal vaginal discharge Medication ADR
What patient groups are predisposed to ADRs?
Diabetic
Immunocompromised
Pregnant
What is used OTC for cystitis?
Mild symptoms present for < 48 hours for two days only
Potassium citrate (cystopurin) Sodium citrate (cymalon, canesoasis)
When is potassium citrate contraindicated?
Hyperkalaemia
Interacts with ACEi, spironolactone, potassium sparing diuretics
When is sodium citrate contraindicated?
Hypertension Heart disease Pregnancy Kidney disease Self restricted diet
Interacts with lithium
What is the advice for cystitis?
Cranberry juice
Large quantities of water
Urinate after sex
Front to back
Wait 20 seconds to strain out residual urine by leaning backwards
Avoid spermicides, perfumed soaps, douches
Wear cotton underwear and avoid tight jeans and trousers
What are the symptoms of menorrhagia?
Heavy menstrual bleeding
When is menorrhagia referred?
Intermenstrual bleeding Postcoital bleeding or pain < 18 or over 45 OTC failure Renal failure Medication ADR Familial endometrial cancer Active VTE Pregnancy Obesity Diabetes COC PCOS
What is used otc for menorrhagia?
Tranexamic acid
18-45
Once heavy bleeding starts take two 500mg tabs TDS max four days
