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pharm 2 2 > Contraceptives > Flashcards

Contraceptives Flashcards

(56 cards)

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1
Q

What does FSH do?

A

Promotes growth of follicle to prepare for ovulation

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2
Q

What does LH do?

A

Promotes ovulation & oocyte maturation

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3
Q

What are the phases?

A

Follicular (1-13)
Ovulation (day 14)
Luteal

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4
Q

How does estrogen work?

A

Suppress FSH release from the pituitary and maintains stability of endometrium

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5
Q

What are the 2 forms of estrogen?

A
  • Ethinyl estradiol (almost all)

- Mestranol (rare, prodrug)

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6
Q

What are the MOA of estrogens?

A
  • Inhibit ovulation
  • Inhibit implantation
  • Accelerated ovum transport
  • Induction of luteolysis
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7
Q

A/E of estrogens

A
  • VTE
  • Mi
  • Stroke
  • HTN
  • Migraine
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8
Q

Why use progestin?

A

Provides majority of contraceptive effects

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9
Q

How does progestin work?

A
  • inhibits ovulation by mod of FSH & LH
  • inhibit implantation, suppress endometrium
  • produces thick cervical mucus
  • slows ovum transport
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10
Q

Adverse effects of progestin?

A
  • Androgenic a/e (acne, hirtuism, weight gain)
  • Potential VTE risk with 4th generation
  • worsening of lipid profile
  • diuretic effect, may increase K
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11
Q

What do you start your patient on for OCP?

A

Monophasic, 21 days of the same dose

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12
Q

Why use multiphasic OCP?

A

Minimizes adverse effects

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13
Q

Contraindications of OCP for patients with migraines?

A
  • migraines with aura (any age)

- migraines >35

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14
Q

Smoking and OCP contraindications?

A

No if >35 and heavy smoker

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15
Q

Precaution with pregnancy and OCP?

A

Breast feeding women 6weeks – 6 months postpartum

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16
Q

Who should get progestin-only ?

A

Does NOT contain active pills

Give to lactating women or if they have contraindication to combined OCP

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17
Q

Progestin only is great for who?

A

Patient with light menses

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18
Q

Progestin only disadvantages?

A
  • Must take at same time every day
  • Weight gain
  • More breakthrough bleeding
  • Increased risk of ectopic pregnancy
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19
Q

Disadvantages of OCP?

A
  • Depend on user consistency

- No protection against STI

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20
Q

Continue OCP for how long before adjusting based on adverse effects?

A

3 months

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21
Q

Symptoms of serious a/e of OCP?

A
  • Abdominal pain
  • Chest pain
  • Headache
  • Eye problems
  • Severe leg pain
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22
Q

Use back up for how long after starting OCP

A

One month

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23
Q

What is a transdermal contraceptive?

Study These Flashcards
A

Combined estrogen and progestin (so same CI as before)

24
Q

How is transdermal different?

Study These Flashcards
A

60% more estrogen due to eliminating first pass metabolism (liver processing)

25
How often do you change the patch? What if you forget to take off your patch?
Repleace every 3 weeks (leave off for a week) with 48 hour forgivness
26
What if patch detaches?
For more than 24 hours, restart new cycle. If not, just reapply
27
A/E of patch?
Application site reactions
28
BBW of patch?
Possible increase in thromboembolism due to increased estrogen exposure
29
Who can NOT use the patch?
Women > 198 pounds (90 kg)
30
What Is the nuva ring?
Estrogen and progestin in a flexible Rx ring
31
How do you use the ring?
Insert on or before 5th day of first cycle of use. Leave in 3 weeks, take out for 1 week
32
When do you use backup with the ring?
If expelled for > 3 hours, use for a week
33
Advantage of ring?
- Increased compliance - Improved cycle control (less breakthrough bleeding) - Precise placement not necessary
34
A/E unique to the ring?
- Vaginal irritation - Leukorrhea - Increased wetness - Foreign body sensation
35
What is in the injectable form of BC?
Progestin only (Depo-provera)
36
When do you use injectable?
Give within 5 days of onset of bleeding
37
How long does injectable work?
Inhibits ovulation for 3 months
38
What about injectable with post partum women?
Not until 6 weeks postpartum if breast feeding
39
Non-contraceptive benefits of injectable?
- Decreased sickle cell pain crises - Fewer seizures in women with history - Approved for endometriosis associated pain
40
Disadvantages of injectable?
- Not readily reversible - 10-18 months until return to fertility - Ammenorhea & breakthrough bleeding
41
BBW of injectable?
Decreased bone marrow density
42
How does the subdermal contraceptive work?
Progestin only implant (implanon)
43
How long does subdermal work?
3 years
44
Subdermal decreased efficacy in whom?
> 130% of ideal body weight
45
When does fertility return with subdermal?
30 days after removal
46
No subdermal in who?
- Pregnant - History of active liver disease - History of thromboembolic events - History breast cancer
47
What are the types of IUD?
- Paragard (copper only) | - Mirena (5 years) or Skyla (3 yrs) (progestin only)
48
How do IUDs work?
- Low grade intrauterine inflammation - Increased prostaglandin formation - Endometrial suppression - Interference with egg implantation
49
Return to fertility with IUD?
IMMEDIATE
50
Who is great candidate for IUD
Heavy menstrual bleeding
51
Disadvantages of IUD?
Increased risk of infection Uterine perforation Spotting NO for uterine fibroids and PID
52
How does emergency contraceptives work?
Levonorgestrel (plan B) - Inhibits / delays ovulation - May interfere with sperm transport - May interfere with corupus luteum function
53
How long do you have to take emergency contraceptive?
5 days after
54
What happens to your period if you take emergency contraceptive?
- 1 week late or early, so take pregnancy test if period doesn’t begin within 3 weeks
55
What is ulipristal?
- 1 week late or early, so take pregnancy test if period doesn’t begin within 3 weeks
56
OCP and antibiotics?
RX emergency contraception Selective progesterone receptor modulator (agonist & antagonist) that delays ovulation

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