Contraceptives

Question 1

Primary MOA of hormonal contraceptives

Answer 1

inhibition of ovulation

Question 2

hormonal components of contraceptive

Answer 2

estrogen (synthetic)
– ethinyl estradiol (EE)
progestins (synthetic progesterone analogs) –
levonorgestrel (LNG)

Question 3

common oral OCPs

Answer 3

monophonic products
biphasic products
triphasic products
quadriphonic products
Progestin only (mini pill)

Question 4

non contraceptive benefits of HC’s

Answer 4

increased hemoglobin (some OC’s contain Fe2+)
reduced risk of fetal neural tube defects (some contain folate)
decreased vasomotor symptoms (‘hot flashes”) in postmenopausal women
increased BMD in perimenopausal women

Question 5

adverse effects of OCPs

Answer 5

venous thromboembolism (VTE)
CA
CV effects

Question 6

greatest risk factors for VTE with OCPs

Answer 6

obesity, smokers, HTN, diabetics, recent post-op & previous DVT.

Use progestin only Has in these patients

Question 7

least risk for VTE is with progestin:

Answer 7

levonorgestrel

Question 8

CA with OCPs is mostly associated w/ ____

Answer 8

unopposed estrogen

Question 9

lower EE increases risk of ___

Answer 9

failure (pregnancy)

Question 10

HC users with HTN have a higher risk of ___ or ___

Answer 10

MI; stroke

Question 11

E2 HCs are not recommended for ____, ___ or ___

Answer 11

smokers >35, women w/ HTN, migraines

Question 12

less serious S/E of HC can be minimized/avoided by adjusting ___

Answer 12

E2 and or progestin content

Question 13

transdermal patch that is no longer available

Answer 13

Evra (ortho)

Question 14

transdermal patch. delivers __/__

Answer 14

EE/norelgestromin

Question 15

administration of transdermal patch

Answer 15

apply 1 patch weekly x 3 weeks, then 1 week with no patch.

Question 16

transdermal patch is less effective in women ___

Answer 16

> 90kg

Question 17

vaginal ring: __/__

Answer 17

EE/etonogestrel

Question 18

administration of vaginal ring

Answer 18

left in place x 3 wks

then 1 wk ring free interval

Question 19

vaginal ring return to fertility after removal

Answer 19

rapid

Question 20

with vaginal ring, users report less ___, ___,___ and ___

Answer 20

nausea
acne
irritability
depression

Question 21

Injectable hormonal contraception dosage

Answer 21

Depo provera (DMPA) -- IM q3mo
depo-subQ provera: SC q3mo

Question 22

injectable hormonal contraception have improved. ___

Answer 22

adherence over OC’s

Question 23

side effects of injectables

Answer 23

decreased BMD

Question 24

labeling recommends to discontinue injectables after ___

Answer 24

2 yrs o f u se

Question 25

__ may be delayed after use of injectable hormonal contraception

Answer 25

fertility

Question 26

DMPA:

Answer 26

dopo medroxyprogeserone acetate

Question 27

long acting reversible contraception

Answer 27

subdermal implant | intrauterine device

Question 28

IUD:

Answer 28

``` non hormonal (copper) hormonal ```

Question 29

subdermal implant duration of use

Answer 29

3 year duration of use

Question 30

subdermal implant contains ___ for x ray visualization

Answer 30

barium

Question 31

Subdermal implant is not affected by ___

Answer 31

BMI

Question 32

subdermal implant is safe immediately ___ or ___

Answer 32

postpartum or abortion

Question 33

copper IUD duration of use

Answer 33

10 years

Question 34

most effective form of emergency contraception

Answer 34

copper IUD

Question 35

main s/e of copper IUD

Answer 35

increased menstrual bleeding

Question 36

hormonal IUDs duration of use

Answer 36

3-5 years

Question 37

unlike Cu-IUD, hormonal IUDs tend to decrease ___

Answer 37

menstrual bleeding

Question 38

IUD can be unsuccessful in up to ___%

Answer 38

18%

Question 39

risk o expulsion of IUD immediacy post placental delivery

Answer 39

3-27%

Question 40

risk of expulsion of IUD 10min-48h post placenta delivery

Answer 40

11-27%

Question 41

risk of expulsion of IUD 4-8 wks post partum

Answer 41

0-6%

Question 42

IUD has risk of ___

Answer 42

uterine perforation

Question 43

emergency contraception pills:

Answer 43

``` progestin ECPs (available OTC, no age restriction) Antiprogestin ECPs (rx only) ```

Question 44

progestin ECP uses

Answer 44

levonorgestrel

Question 45

atiprogestin ECP uses

Answer 45

ulipristal acetate

Question 46

antiprogestin is more effective than ___

Answer 46

progestin ECP

Question 47

antiprogestin may be taken up. to ____ post intercourse

Answer 47

5 days

Question 48

___ is prudent in EPC use

Answer 48

prompt use

Question 49

copper IUD is the more effective than ___

Answer 49

ECPs.

Question 50

copper IUD may be inserted up to ___ post intercourse

Answer 50

10 days

Question 51

abortifacients

Answer 51

mifepristone RU-486

Question 52

mifepristone is given with other ___

Answer 52

prostaglandins (PO misoprostol)

Question 53

success rates with aborticfacents

Answer 53

>90% with pregnancies <49 days

Question 54

EE is metabolized mainly by __

Answer 54

CYP3A4

Question 55

3A4 inducers increase ____

Answer 55

Has metabolism, increasing risk of pregnancy

Question 56

3a4 inducers:

Answer 56

anticonvulsants antiretrovirals (HIV meds) St John's wort