Flashcards in 00 Contraception Deck (42):
1
What is the Follicular Phase?
Days 1-14: FSH dominant w/ LH surge on day 14 for ovulation. LH initiates estrogen production
2
What is the Luteal Phase?
Days 14-28: Ruptured follicle = corpus luteum (secretes progesterone, estradiol and androgens). E and P peak at mid-luteal phase; FASH and LH levels decline
3
What is Ethinyl Estradiol?
Estrogen. Almost always fixed dose EXCEPT: Mircette, Estrostep Fe
4
What are the different concentrations of Estrogen?
Usually 20-35mcg. Low: 10-30, High: 50 (Ovcon 50)
5
What side effects can too much estrogen cause?
Nausea, Breast tenderness, Increase in BP, Melasma (patch pigmentation spots), HA
6
Which hormone causes withdrawal bleeding?
Progestin discontinuation after 3rd week (i.e. placebo week)
7
Which generation Progestin has increased risk for spotting?
1st gen
8
Which generation Progestin has the highest potency?
2nd and 3rd gen
9
Which generation Progestin causes more Androgenic activity?
2nd gen
10
Which generation Progestin has higher risk of thrombosis?
3rd gen
11
Which generation Progestin are spironolactone derivatives?
4th gen
12
What side effects can too much Progestin cause?
Breast tenderness, HA, Fatigue, Mood changes
13
What does too much Androgen cause?
Increased appetite (leading to weight gain). Acne. Oily skin. Hirsutism. Increased LDL/decreased HDL
14
How do Biphasic combination pills usually work?
Usually increased progestin at the end of the month
15
How do Triphasic combination pills usually work?
Doses of estrogen or progestin change weekly
16
In Triphasic combination pills, what is the main hormone changing?
Progestin
17
What is unique about Estrostep Fe?
Its the only triphasic pill where the Estrogen component is the one changing
18
What are the 4 products FDA approved for Acne?
Ortho Tri Cyclen, Estrostep Fe, Yaz, Beyaz
19
What i s unique about Mircette?
Contains estrogen 10mcg x5 days during placebo to help with menstal migraines (not a 7 day placebo, don't skip these pills)
20
Why is Lo Loestrin Fe (and Lo Minastrin Fe) not recommended 1st line?
Very low Estrogen (10mcg), causing lots of BTB. Reserved for patients who have issues with estrogen SEs
21
What is important to know about Yasmin and Yaz?
Spironolactone derivatives. 3mg drospirenone = 20-25mg spironolactone. Monitor potassium levels
22
What is important to know about Beyaz?
Contains folic acid derivative. Caution with antifolate drugs (i.e., MTX)
23
What is important to know about Safyral?
Contains folic acid derivative. Caution with antifolate drugs (i.e., MTX)
24
What is unique about Seasonale?
Combination pill x84 days with 7 days placebo. Only 4 periods/year
25
How is Seasonique different than Seasonale?
Both combination the same x84 days, but Seasonique has EE 10mcg x7 days afterwards to decrease BTB while Seasonale is placebo x7 days
26
How does Estradiol Valerate compare to EE?
EV may be better tolerated and less impact on lipid and clotting parameters
27
What is Dienogest?
Resembles Drospirenone, No anti-mineralocorticoid activity (no K sparing --> no K monitoring)
28
What is unique about Natazia?
Estradiol valerate (EV)/Dienogest. 4 phasic, need back up method x9 days once started
29
What is "Day 1 Start"?
Day 1 of menstruation. No BUM needed, protection immediate
30
What is "Sunday Start"?
Sunday after menses starts, BUM x7 days
31
What is "Anytime Start"?
Jump start. Protection requires 7 days of active pills
32
Why is it important to note when BTB takes place?
First 10 days, may need to increase estrogen dose. Last 11 days, may need to increase progestin dose
33
Whats important to know if you see Norethindrone 0.35mg?
ALWAYS going to be a Progestin only pill if you see this strength
34
What are Mini Pills?
Progestin only (Micronor, Errin, Camila, Jolivette)
35
What should you remember if you see someone on Lipitor?
Combo may increase OC levels by 20-30%, Consider lower dose of OC
36
What should you remember i you see someone on an Anticonvulsant?
Increased OC metabolism, leads to decreased OC action. Recommend OC with 50mcg EE
37
What is Ortho Evra?
Combination patch, applied once weekly
38
What is Depo-Provera?
Injectable given Q3 months, may result in osteoporosis (significant decrease in BMD)
39
What is Mirena?
IUD, lasts 5 years
40
What is Implanon?
Subdermal rods effective for 3 years
41
What is Ella?
Ulipistal Acetate: RX ONLY. Emergency contraceptive more effective at days 3-5
42