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Ambulatory Care of Women > Contraception > Flashcards

Contraception Flashcards

(74 cards)

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1
Q

How many pregnancies are unplanned?

A

50%

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2
Q

Most effective contraceptive methods?

A

IUC, implant, vasectomy, female sterilization

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3
Q

Highest rates of complications in abortions?

A

Greater than 20 weeks.

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4
Q

Acronym BRAIDED for informed consent

A

Benefetis, risks, alternatives, inquiry, decision to stop, explanation of method, documentation

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5
Q

What does progesterone do?

A

Provides most benefit. Thickens cervical mucous, blocks LH surge, inhibits capacitation of sperm, decreased tubal motility, and atrophy of endometrium

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6
Q

What does estrogen do?

A

Control cycle, decrease FSH, stabilize endometrium, prevents metrorrhagia

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7
Q

Dose of estradiol?

A

20-50 mcgs/day
20 mcg in patch
15 mcg in ring

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8
Q

What does mestranol do?

A

Metabolized by liver into EE

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9
Q

Perfect and typical rates of failure for contraceptive pills?

A

Perfect=.3

typical =8

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10
Q

Biphasic COC?

A

Mircette

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11
Q

Triphasic COC?

A

Estrostrep, ortho-novum 77, orthotricyclen

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12
Q

Four phasic COC?

A

Natazia

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13
Q

What’s a 365 day active COC?

A

Lybrel. 90 mcg levonorestrel, 20 mcg of EE

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14
Q

Disadvantages of COC?

A

Gallbladder issues. No protection against STIs, daily administration, MI, Stroke, VTE, hypertension, may accelerate development of stones with women who have gallbladder problems

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15
Q

Absolute contraindications to open with COCs?

A

> 35 and smokers, estrogen sensitivites, liver problmes, migraines with aura, uncontrolled hypertension, DM
with vascular involvement, stroke or MI, propensity for blood clots, polycythemia, undiagnosed abnormal vaginal bleeding

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16
Q

Initial exam for initiating OCPs?

A

vitals, breast exam, pelvic, pap 21 y.o. or greater, GC/ chlamydia, urine screen for STIs

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17
Q

How often should you prescribe birth control?

A

1 year

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18
Q

Which pill should you use for COC?

A

Any pill is fine depending on contraindications

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19
Q

What pill to chose in uncomplicated diabetes?

A

Low EE, progestin, androgen

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20
Q

What pill to chose in sickle cell disease?

A

Not a contraindication

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21
Q

What are contraindications to Yaz (Drosperinone)?

A

Hyperkalemia, renal insufficiency, hepatic dysfunction, adrenal insufficiency

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22
Q

When to Start OC, regardless of menstrual cycle?

A

Take pill and use back up for 7 days

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23
Q

When don’t you need backup when starting OC?

A

First day of menses, or within 5 days after menses begins

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24
Q

About starting on Sundays?

A

Take pill on sunday AFTER menses begins, and use backup for 7 says

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25
What do do if missed 1-2 pills? for EE >30
Take next pill and offer emergency contraception
26
What to do if missed 3 or more pills during first 2 weeks of pack? for EE >30
Condoms for 7 consecutive days of pills. Offer emergency contraceptions
27
What do do if missed 3 or mor pills in 3rd weeks? for EE >30
Finish active pills and start new pack
28
What do you do for scan't bleeding or spotting while on COC?
Increase estrogen
29
What do you dog for acne, oily skin, hirsutism for COC?
Increase progestin
30
What are drugs for acne, oily skin, hirsutism? OCOs
Ortho Tricyclen, estrostep, yasmin, desogen, Ovcon-35
31
What do you do for GI (N/V) complaints while on COCs?
Take at night, decrease estrogen, or do progestin only
32
What do you do for constipation/bloating?
Reduce dose of progestin
33
What do you do for headaches?
Check BP, r/o migraine, stroke, d/c COCs, lower estrogen and progestin
34
What do you do for eyes?
salaine drops, send to ophthalmologist
35
What do you do for mastalgia?
Better bra and reduce estrogen and progesterone
36
Whgat do you do for melanoma, chloasma?
Caused by estrogen stimulating melanocytes, do progestin only pill
37
What drug can act with other potassium sparing drugs to cause hyperkalemia?
Drospireone
38
What will St. John's wart do?
decrease hormone levels of COC
39
Warning signs for COCs? ACHES
``` Abdominal Pain Chest Pain Headaches Eye Problems Severe Leg Pain ```
40
Who shouldn't take Orthoevra (Norelgestromin/EE)?
Patch- women over198 pounds
41
How often do you change Orthoevera?
Every week
42
What are those on Orthoevera at increased risk for?
Blood clots
43
How long do you have to go without that patch that you need to use back up EC for 7 days?
Greater than 2 days
44
How often do you insert nova ring?
every month
45
How long can nuva ring be out for?
3 hours
46
Risk of pregnancy with plan B?
35%
47
What does plan B contain?
1.5 mg levonorgestrel
48
Contraindications to Plan B?
Pregnancy, hypersensitivity, undiagnosed genital bleeding
49
When should you take plan B?
Within 72 hours. 120 hours OK but reduced effectiveness.
50
Ingredient in EllaOne?
Ulipristal acetate 30 mg
51
How soon can you take ellaOne?
5 days. Effectiveness 62-85%
52
What else can you use for emergency contraception?
Paragard, IUD upt o 5 days
53
How long do you use protection after ellaOne?
2 weeks
54
How long do you use progestin for Emergency contraception??
2 days
55
Advantages of progestin only methods for COC?
can use if breastfeeding, scant or menses, decrease dysmenorrhea, decrease cyclic mood changes, headaches, nausea, reversible, low risk of ectopic pregnancy
56
Disadvantages of progestin only COC
irregular menses, weight gain, breast tenderness, increased risk for ovarian cysts, possible increased risk for VTE
57
What to do if you missed one Progestin only COC?
take next pill, if more than 3 hours use back up for 48 hours
58
What to do if you missed 2 or more pills?
use back up. Take 2 pills per day for 2 days
59
Warning signs for progestin only COC? Abdominal pain and regular cycles than delayed peirods
abdominal pain: ectopic pregnancy, ovarian cysts | Regular cycles than delayed periods: r/o pregnancy
60
How often do you give Depo Provera?
every 12 weeks IM
61
What is the fail rate for Depo Provera?
3%
62
What is good about depo Provera for specific populations?
Fewer sickle cell crises | Decreased endometriosis and fibroids
63
What can occur with DepoProvera?
Amenorrhea
64
Major important side effects or warnings for DepoProvera?
Osteopenia
65
Cumulative index with pregnancies for implant?
.38
66
What medications shouldn't you take with Implanon?
HIV drugs, St. John's Wart
67
Main reason why people discontinue implanon?
bleeding irregularities
68
3 necessities for sterilization?
21 years of age Mentally comptenet Waiting 30 days after signing
69
Advantages of female sterilization and disadvantages?
Decrease ovarian cancer and increase ectopic pregnancies
70
Rate of conception if no method for birth control is used?
85%
71
How does estrogen contribute to clotting?
decreases antithrombin III
72
How does progestin inhibit androgens?
decreases LH
73
How long do you leave caps and sponges and spermacide in after intercourse?
6 hours
74
How long is egg and sperm viable for
egg- 24 hours | Sperm 72 hours

Ambulatory Care of Women (8 decks)

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