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Patient > Contraception II > Flashcards

Contraception II Flashcards

1
Q

when starting COC when is it effective immediately?

A

day 1 of natural cycle

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2
Q

if you start COC on day 1-5 do you need additional precautions?

A

no

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3
Q

when is starting COC classed as quick starting

A

> day 6

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4
Q

if quick starting COC (6th day and after of cycle) for how long must you use additional precaution?

A

7 days

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5
Q

how many days into period can you start POP without needing additional precautions

A

1-5

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6
Q

if quick starting POP (6th day or later) how long must you use additional precaution for?

A

2 days

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7
Q

POP pill examples?

A

noriday
cerazette
mironor

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8
Q

Kylie would like to start taking Cerazette for the first time. It is day 12 of her 30-day menstrual cycle and shell have her first pill today. Does she need to take additional precautions?

A

yes for 2 days as its a POP

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9
Q

Kendall has been taking Microgynon 30 ED. She started the pill on day 8 of her cycle. Does she need to take additional precautions?

A

yes as not within first 5 days

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10
Q

examples of COC

A

zoely
qlaira
logynon
microgynon

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11
Q

for zoely COC what day can you start it, if after this how long must you add additional precautions?

A

1-2

7 days

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12
Q

for qlaira COC what day can you start it, if after this how long must you add additional precautions?

A

1-2

9 days

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13
Q

for combined TDS and vaginal ring what day can you start it, if after this how long must you add additional precautions?

A

1-5

7 days

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14
Q

for POP traditional/ desogestrel what day can you start it, if after this how long must you add additional precautions?

A

1-5

2 days

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15
Q

for POP injectable and implant what day can you start it, if after this how long must you add additional precautions?

A

1-5

7 days

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16
Q

for levonorgestrel intrauterine system what day can you start it, if after this how long must you add additional precautions?

A

1-7

7 days

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17
Q

for Cu IUD what day can you start it, if after this how long must you add additional precautions?

A

any start day

0 days

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18
Q

changing from COC to POC:

what advice do you give for it to be effective immediately ?

A

tell them to not have HFI

on start day of HFI start the POP and it will be effective immediately

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19
Q

changing from COC to POC:

if the person has already started their HFI what advice do you give?

A

(finish the white pills if ED or HFI)

then start the POP but use additional precautions for 2 days

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20
Q

POP to COC:

advice?

A

need additional precautions for 7 days

21
Q

POP to COC:

exceptions to 7 day precautions

A

if POP to Qlaira COC:
additional precautions for 9 days as its triphasic

POP to Zoely: additional precautions for 7 days

22
Q

why do you need 9 days precautions when POP to Qlaira?

A

as its triphasic

23
Q

when changing to any non-monophasic pills what must you advise

A

go straight to day 1 as there’s different concentrations each pill

24
Q

if you’ve missed COC can you take two within one hour- to stop it being a missed pill?

A

yes this isn’t a problem and keeps it within the 24 hours

25
Q

when is EHC indicated for COCs?

A

if 2 or more missed within 24 hours

26
Q

exceptions to when EHC is needed in COCs?

A

Zoely (monophonic)
Qlaira (triphasic)

EHC is indicated if 1 or more is missed in 12 hours

27
Q

when is a POP classed as a missed pill?

A

micronor and noriday: >3 hours late

Cerazette and Cerrelle: >12 hours late

28
Q

what to do if you miss your POP?

A

continue pills with 2 days precautions

29
Q

when is EHC indicated in POP?

A

If 1 or more pills are missed within >3/ 12 hours)

30
Q

non hormonal EHC?

A

Cu-IUD

31
Q

hormone EHC?

A

Levonelle 1.5mg or EllaOne 30mg

32
Q

Kourtney takes Logynon ED. She missed her pills only on day 1, 14 and 24 and had sexual intercourse on day 25. Does she need EHC?

A

NO
Missing day 1 elongates pill free period. However built cover as didn’t stop for 7 days.
Missing 1 on day 14 but to be compromised she needs to have missed 2. So not compromised
24- this is a placebo pill so should be fine as doesn’t make any difference

33
Q

Kourtney takes Logynon ED. She missed her pills only on day 1, 14 and 24 and had sexual intercourse on day 19. Does she need EHC?

A

YES

Sexual intercourse on 19, not waited 7 days so she could get pregnant

34
Q

Kourtney takes Logynon ED. She missed her pills only on day 13, 14 and 24 and had sexual intercourse on day 25. Does she need EHC?

A

NO- cover rebuilt

35
Q

Khloe takes Noriday (POP) she missed 1 pill on day 6 and had sex on day 9. Does she need EHC?

A

NO
Missing 1 pill makes her compromised
But has taken 2 days so she has brought her cover back up to normal

36
Q

Kris takes Logynon ED. She missed her pills on day 14, 15 and 22 and has sex on day 17. Does she need EHC?

A

YES- cover not rebuilt

22 is placebo so doesn’t effect

37
Q

what types of drugs makes contraception ineffective?

A

anti epileptics
antiretro virals
antibiotics- only if enzyme inducing
st Johns wort and griseofulvin

38
Q

why do anti-epileptics make contraception ineffective?

A

enzyme inducers

39
Q

TF: once the enzyme inducing drug has been stopped contraception will be effective immediately

A

FALSE

28 days after taking enzyme inducing medicine it won’t work as effectively

40
Q

what can be recommended if a patient is on enzyme inducing drugs?

A

Parenteral POCs

IUS

41
Q

TF: antibacterials with no enzyme inducing activity won’t have an effect on contraceptive cover?

A

true- UNLESS vomiting and diarrhoea occur

42
Q

can women be reassured that the contraception efficacy of both IUDs and injectables aren’t affected by drug interactions?

A

yes

43
Q

will the implant be effected by enzyme inducing drugs?

A

yes- efficacy may be reduced

44
Q

Kendall, 24 had a baby 3 months ago and requires regular long term contraception. Her PMR shows she takes Carbemazepine MR 400mg for epilepsy. Is the Mirena IUS suitable for her or not?

A

Mirena- LARCs- slowly releases Levongesterol.
Yes as it doesn’t get effected by Carbemazepine.
Hormone isn’t systemic- acts locally

45
Q

Khloe uses Depo- Provera (POC) and presents a Rx for Rifamipicin 300mg capsules BD 6/12. Will taking this antibiotic compromise her contraceptive cover?

A

DMPA

This is fine with enzyme inducers. Cant recommend orals, patches or implant but the DMPA is fine

46
Q

kylie uses Nexplanon implant (POC) she presents a Rx for Rifampicin. Will taking this compromise her contraceptive cover.

A

YES as its known to be effected by enzyme inducing medication

47
Q

Kim has never used contraception before. She takes Ventolin for asthma and has a family history of uterine cancer. She takes Sumatriptan for migraines which occur 1-2 times monthly. Her migraine symptoms include headache, ringing in the ears and zig-zagging lights in her field of vision. Dr Johnson is asking if Logynon ED is suitable for use.

A

Migraine with aura!!
She fits category 4. This means Logynon is unsuitable as it is a COC which means has oestrogen
Cant give this

48
Q

what can taking valproate in pregnancy cause?

A

congenital malformation and neurodevelopment disorders

49
Q

what type of contraceptive is needed if on this medication?

A

LARC or any with a failure rate of <1%

all female patients of child bearing age regardless of sexual activity

Patient (19 decks)

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