Contraceptives Flashcards
IV treatment if needed to be hospitalized. name the patch that contain progestin and estrogen?
The patch (Ortho Evra®) and ring (NuvaRing®) are also highly effective forms of contraception containing estrogen and progestin with reported rates of 99% efficacy when used as directed.
List the natural method contraceptives?
cervical mucus, basal body temperature (BBT), and symptothermal and LAMs.
………………was recognized as a means to prevent pregnancy and was used by Alaska Natives, Native Americans, and ancient Egyptians
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Breastfeeding
what is cervical mucus method?
The cervical mucus method is based on detecting signs and symptoms of ovulation through consistent consistent observation of the cervical mucus, which is produced by cells in the cervix.
. Then mucus is present for a few days, in which the woman should feel vaginal wetness. After this
During ovulation, cervical mucus nourishes sperm, facilitates their passage into the intrauterine cavity, and probably helps select sperm of the highest quality. However, the peak day is only obvious the day after it occurs, when the mucus becomes less slippery and stretchy. After this day, the mucus starts to lose its slippery, stretchy, wet quality,
How is the cervical mucus after menstruation?
Immediately after the menstrual period, cervical mucus is scant and the woman should notice vaginal dryness for a few days
How is cervical mucus during ovulation?
After few days of menstruation, the mucus becomes clear (as differentiated from milky white, translucent, or creamy color) and slippery or stretchy, similar to raw egg white. The woman should notice increased wetness or a slippery sensation. The peak day of wetness signals ovulation.
What happen during ovulation?
During ovulation, cervical mucus nourishes sperm, facilitates their passage into the intrauterine cavity, and probably helps select sperm of the highest quality.
What is the other name of cervical mucus that occur during ovulation?
These characteristics are referred to as spinnbarkheit.
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How does Basal body temperature work?
The BBT method is based on the temperature change triggered by the progesterone rise that occurs when the ovum leaves the ovary.
During ovulation, the temperature ,,,,,,,,,,,, preovulatory BBT.
To use this method, the woman takes her temperature at the same time every day using a digital basal thermometer; before she eats, drinks, smokes, and/or participates in any physical activity. Then she documents her daily temperature on a chart, noting any variations.
During ovulation, the temperature typically rises up to 1° above the preovulatory BBT. To prevent conception, the woman should abstain from intercourse until after 3 days of temperature rise.
What is symptotherma method? what are primary and secondary sign of ovulation?
The symptothermal method relies on identifying the primary signs of fertility: changes in cervical mucus; BBT; and the position, consistency, and opening of the cervix.
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The symptothermal method also uses observation for secondary signs of fertility: cyclical breast, skin, hair, mood, and energy changes; vaginal aching; spotting; pelvic pain or aching; and mittelschmerz (normal, lower abdominal or pelvic pain some women experience during ovulation). By charting primary and secondary signs, the woman detects
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How is the cervix during ovulation phase?
To receive sperm, as ovulation approaches, the cervix becomes softer and changes position to midline and the cervical opening (os) dilates slightly.
After ovulation, it reverts to its preovulatory state.
While squatting or standing with one foot on a stool or chair, the woman may place a finger in her vagina and feel for position, softness, or firmnes
What is lactation amenorrhea method?
How lactation amenorhea pattern is determined
infant sucking patten
mother’s employement
socio-cultural belief
What is electronic hormonal fertility monitoring?
The electronic hormoning monitor can detect the level of LH and estrogen in urine, identifying peak fertility days.
What is the effectiveness of Combined oral contraceptives?
99.7%
Advantages of Combined oral contraceptives?
Furthermore, COCs are easy to take, are well tolerated, maintain efficacy when an occasional dose is forgotten, and result in lighter menses. However,
Disadvantages of Combined oral contraceptives?
Protection for sexually transmitted infections (STIs, to include HIV), and for that reason, many women require the addition of a barrier method (e.g., condoms).
What are the first component of COC?
The first component, estrogen, provides some contraceptive effect by suppressing the release of follicle-stimulating hormone (FSH) but more importantly stabilizes the endometrium in order to maintain bleeding regularity
What are the name of the estrogen found in COC?
ethinyl estradiol and less commonly mestranol are the synthetic estrogens used in COCs.
What is the dose of estrogen in the COC?
the amount of estrogen contained in COCs has been decreased to less than 35 mg, thereby significantly improving both safety and tolerability
What is the second component found in COC?
COCs is a synthetic progesterone, which is classified by “generation.”
How does progesterone work in COC?
Progesterone provides the vast majority of the contraceptive effect by suppressing both the FSH and LH. The result of these altered hormonal conditions is suppression of ovulation, thickening of cervical mucus, and the creation of hormonal conditions within the uterus that are unfavorable for implantation
Side effect of Progestin?
A side effect of the progestin component is androgenization, which can cause acne, hirsutism, and weight gain.
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How many pills does monophasic preparation have?
Most monophasic preparations contain a pill that is taken for 21 days followed by 7 days of inert pills (placebo) that exist only as a daily placeholder until the next round of active pills begins.
How many types of COC are found?
Monophasic, biphasic, triphasic, quadriphasic.
what are the absolute contraindication for COC?
(a) women who are breastfeeding and less than 6 weeks postpartum;
(b) those who are older than 35 years and smoke greater than or equal to 15 cigarettes per day;
(c) women with a systolic blood pressure greater than or equal to 160 mmHg;
(d) those with vascular disease;
(e) those with known heart disease, valvular disease, or stroke;
(f) those with current breast cancer; (
g) those with a history of diabetes with target end-organ damage; and
(h) those with active viral hepatitis, cirrhosis, or liver cancer (
. Thromoboembolism, pulmonary embolism and immobilization due to suergery.
It is considered safe to prescribe COCs to women with normal blood pressures
140 /90 mmhg
Women with poorly controlled hypertension and smokers are better candidates for 1, ,,, 2,,,, 3,,,,,,,
progesterone-only methods, IUDs, or barrier contraception
What type of hormonal contraceptive would be use ful for people who have Thromoboembolism, pulmonary embolism and immobilization due to suergery.
Progestin only
You should not give_________ migraine with aura
COC
You could give_________for migraine without aura
COC
Migraine with aura have more chances of having_______
stroke
Many women who take COCs (particularly triphasic preparations) experience a significant decrease of ________
acne
Most common side effect of COC?
The most common side effects of COCs include breakthrough bleeding (BTB), nausea, and mild headaches.
melasma (patches of pigmented skin discoloration), which usually dissipates slowly when the medication is stopped.
Most serious side effect of COC?
he acronym “ACHES” was developed as a mnemonic to help women remember these potential serious adverse effects.
Any woman who experiences ACHES should immediately stop taking her COCs and notify her provider. ACHES include: Abdominal pain (severe)
Chest pain (severe),
cough, or
shortness of breath
Headaches (severe),
dizziness,
weakness, or numbness
Eye problems (vision loss or blurring) or
speech problems
Severe leg pain (calf or thigh)
What is contraceptive patch?
The contraceptive patch and the contraceptive ring are estrogen/progesterone combination products that have the same mechanism of action as COCs.
Why contraceptive patch is more beneficial?
The patch and the ring are particularly advantageous to women who find the ritual of remembering a daily medication burdensome.
Do contraceptive patch and oral contraceptives share the same side effects, risks, contraindications, and noncontraceptive benefits as combined oral products.
Yes,Both products have a quick return to fertility, as ovulation usually occurs within a few cycles of cessation.
Contraceptive patch consist of a 20 cm2 square adhesive patch combining_________________
0.75 mg of ethinyl estradiol with 6 mg of norelgestromin,
How do you use this contraceptive patch?
Applied on the first Sunday after menses, the patch is worn for a week and then replaced for three consecutive weeks.
On the fourth week, no patch is worn, creating a withdrawal bleed.
Where do you use contraceptive patch?
It is placed on clean skin on any of the following areas: lower abdomen, upper arms, buttocks, and upper torso.
rs.
Contraceptive patch is avoided in which part of the body?
The breasts are to be avoided.
What happen if the patch is partially detached or become completely removed?
patch that partially detaches or becomes completely removed can be reapplied or taped on as long as it has been off for less than 24 hou
For obese patient ( or patient that are more than 198 pounds). What do you suggest?
No contraceptive patch
Suggest IUD or barrier method with hormonal pills.
What are contraceptive ring?
It is also called Nuva-Ring
. It is a soft and flexible 54-mm diameter ring that releases 120 mcg/day of etonogestrel and 15 mcg/day of ethinyl estradiol
what is the effectiveness of contraceptive ring?
It is 91%
When do you use contraceptive ring?
On the first Sunday after menses, the patient compresses the opposite sides of the ring and inserts it into her vagina.
Although the ring can be placed anywhere in the vagina to be effective, it tends to be less apparent to the patient and their partner in the deeper, posterior portion of the vagina.
The patient places the vaginal ring on the Sunday following menses and replaces it once a week for a total of 3 weeks. A ring-free fourth week creates a withdrawal bleed.
If it contraceptive ring falls out?
If it falls out, the patient should rinse it with water and put it back in place.
If the ring is out of the vagina for more than 3 hours during the first 2 weeks , what should you do>
If the ring is out of the vagina for more than 3 hours during the first 2 weeks it should be reinserted and a barrier method should be used for the next 7 days. n.
If the ring is out of place for more than 3 hours during the third week, what should you do?
If the ring is out of place for more than 3 hours during the third week, then a new ring should be inserted and a backup barrier method should be used for 7 days
Who commonly uses POP?
POPs are most commonly used by lactating mothers who are in the immediate postpartum period and do not wish a long-term progesterone-only solution, such as injectable medroxyprogesterone acetate. Efficacy rates may be lower for women who are not lactating.
Effectiveness of progesterone only contraceptives?
91% effective with typical use and 99.7% effective with perfect use
Efficacy rates may be lower for women who uses progesterone only pills and _____________________
who are not lactating
When can you start using POP?
POPs can be started as quickly as 6 weeks postpartum.
A woman who takes POP ( progesteron only pills) who is more than 3 hours late taking her medication __________________
should use a backup barrier method for any intercourse following the next 48-hour period
Which emergency contraceptive does not do abortifacient and not harm existing pregenancy?
EC is not an abortifacient and does not harm an existing pregnancy.
What are the common reason for prescribing Emergecny contracpetive?
Common reasons for prescribing EC include unprotected intercourse, a mistake in or failure of a contraceptive, or sexual assault.
name of the OTC that is used as emergency contraceptive?
levonogesteral
what is levonogesterol?
progesterone only product EC
