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14. Contraception > Drugs > Flashcards

Drugs Flashcards

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1
Q

Ovulation test is checking for

A
  • Check for LH level
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2
Q

What test is used for pregnancy test

A
  • Test for Beta-HCG level
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3
Q

Estrogen

  • Strength range
  • MOA
A
  • 20-50 mcg of estrogen
  • Inhibit ovulation by suppressing hypothalamic release of FSH and LH
  • Inhibits fertilized ovum implantation
  • Accelerate ovum transport, decreasing fertilizing time
  • Cycle control
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4
Q

MOA of progestins

A
  • Cycle control
  • Thickens cervical mucus that slows sperm transport and ability to penetrate ovum
  • Causes endometrial transformation
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5
Q

Seasonale/Seasonique

  • How many days
  • How many day contain hormones

=> What is seasonique different from seasonale

A

Seasonale

  • D: take 1 tab QD x 91 days
  • Start on 1st sunday after onset of menstruation
  • Contain 84 days of hormones and 7 days inactive

Seasonique

  • Provide low dose of estrogen for last 7 days instead of placebo
  • Worth try for women who get menstrual migraines => additional estrogen prevent migraines
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6
Q

Lybrel

  • Special
  • Similar to which O.C
A
  • Lybrel is a non-cyclic oral contraceptive product that is given QD, w/o a hormone-free interval for a year or longer
    => This means no scheduled periods & possibly a lower incidence of PMS, HA, and anemia
    => No regular menstrual cycle but spotting may occur
    => Up to 50% of the women have 7 or more days of bleeding or spotting during the 1st three months. It will decreases with continue use
  • Is very similar to Alesse w/o placebo
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7
Q

Yasmin/Yaz

  • Contain what
  • Equal to what?
  • A good choice for?
  • SEs
A
  • Progestin = drospirenone
  • Drospirenone (increase risk of clot): is the progestin found in Yasmin and Yaz
  • Equal to 25 mg of spironolactone w/ anti-mineral corticoid (anti-aldosterone) and anti-androgenic effects
  • It’s a good choice for polycystic ovary syndrome (PCOS), PMS, mood swings, acne, or excess hair growth
  • Less water retention
  • Risk of hyperK
  • Higher thrombosis risk
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8
Q

Yasmin/Yaz = Drospirenone

  • active days
  • Avoid which medicines
A

Yasmin

  • EE 30 mcg + 3 mg Drospirenone
  • 21 days active; 7 days placebo

Yaz

  • 20 mcg EE + 3 mg Drospirenone
  • 24 days active; 4 days placebo
  • Has shorter days of placebo

Avoid
- K+ spraring diuretics, ACEI, ARB, heparin, and NSAIDs

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9
Q

Levomefolate Ca++

A

Metafolin

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10
Q

Beyaz

  • What special about this med
  • What is the regiments
A
  • Drospirenone - ethinyl estradiol - levomefolate calcium
  • O.C that raises folate levels
  • Is a 24/4 day regimen consisting of:
    => 24 days of
    Drospirenone 3mg
    Ethinyl estradiol 20 mcg
    Levomefolate Ca++ (Metafolin) 451 mcg
    => 4 days of
    Metafolin only
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11
Q

Safyral

  • Generics
  • What special about this med
  • What is the regimen
  • What is the different b/w Beyaz and Safyral
A
  • Drospirenone - ethinyl estradiol - levomefolate calcium
  • O.C that raises folate levels
  • Is a 21/7 day regimen consisting of:
    => 21 days of
    Drospirenone 3mg
    Ethinyl estradiol 30 mcg
    Levomefolate Ca++ (Metafolin) 451 mcg
    => 7 days of
    Metafolin only
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12
Q

Lo Minastrin (has chewable tab)

A
  • Form: chewable tabe
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13
Q

Quartette

A

4 phases Extended cycle PO OC

  • 91 total pills: 84 active 7 inactive
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14
Q

Natazia

  • How many phases
  • Back up
  • FDA also approved for?
A
  • Estradiol valerate and dienogest
  • 4 phases
  • Back up form for contraceptive for the first 9 days of the 1st cycle (not 7)
  • FDA approved for heavy menstrual bleeding
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15
Q

Absolute CI for O.C from package insert

A
  • Thrombo-embolic disorder or hx
  • Hx of breast/uterus or any estrogen dependent neoplasia
  • Undiagnosed vaginal bleeding
  • Liver issues: cholestatic jaundice of pregnancy or hx of jaundice, hepatic adenomas/carcinoma
  • Pregnancy
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16
Q

CI from the WHO

A
  • Lactation < 6 wks postpartum
  • Age > 35 y.o & smoke > 15 cigarettes/day
  • HTN
  • Migraines
  • DM with end organ disease
  • Chest pain
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17
Q

What are the routine PE before starting OC

A
  • BP
  • Breast examination
  • Pelvic examination
  • Pap smear
  • Liver fxn
  • Family hx clotting
  • Social hx: smoking, hyper-coagulation
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18
Q

Counseling on OC

  • Start day
  • Contact MD
A
  • Start on Day 1: Start 1st day of menstrual bleeding
    => prevents ovulation in the 1st cycle => eliminating the use of alternative
  • Sunday starter: start on 1st sunday after menstrual bleeding begins
    => Prevents menstrual periods on weekend
    => Back up method is necessary for 1st 7 days
- Contact MD if experience ACHES
  => Abdominal pain
  => Chest pain, cough, SOB
  => HA, dizziness, numbness
  => Eye problems - vision loss/burning
  => Severe leg pain (Calf or thigh)
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19
Q

Minipils

A

=> Progestin only

  • Micronor
  • Nor-QD
  • Aygestin
  • Camila
  • Errin
  • Jolivette
  • Nora-BE

=> Norethindrone = 0.35mg

=> Mini = Micro but more breakthrough bleeding

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20
Q

Minipils - Progestin

  • How to take it
  • Backup method
  • If late for > 3H taking it:
A
  • Imp to take at the same time everyday
  • Use backup for entire first month of mini-pill
  • Use back up for 2 days if > 3H late on dose
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21
Q 
Minipils - Progestin
- #s of active pills
- Contain
  => the downside
- Good for
A
  • All 28 pills: active. No inactive
  • Not as effective as COC’s but lots safer

Contain

  • Less progestin than COC’s => fewer SEs
  • More breakthrough bleeding and spotting
  • Some stop having periods for several months at a time

Good for

  • Cannot tolerate estrogen: hx of CHD or emboli
  • During lactation: estrogen decr milk production & postpartrum women are in hyper-coagulate state
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22
Q

Depo-Provera

  • Candidates for use:
  • Avoid in whom?
A
  • Medroxyprogesterone acetate
    150mg/mL vial injection Q3M

Candidates for use:

  • Indicated for contraception/endometriosis
  • Contraception of > 1 year duration is desired
  • Pts in whom estrogen should be avoided
  • Non-compliant w/ COC
  • Breast feeding is desired
  • Hx of sz
  • Amenorrhea (no bleeding) is desired
  • AVOID in ppl w/ hx of depression of HA w/ aura

=> pure progesterone => cause hungry and depression
=> take > 1 yr to get pregnant

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23
Q

DepO-Provera

  • ADEs
A
  • Irregular bleeding and spotting for up to 7 days during 1st few months
  • Amenorrhea
  • Weight gain
  • Delayed fertility upon d/c (9mo - 1yr)
  • HA, depression in some pts
  • Risk of bone loss with prolonged administration, may be irreversible
  • O: bone
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24
Q

Depo-Provera

  • Advantage
  • Ok to use w/ what type of drugs
A

Advantage

  • NO estrogen SEs
  • No increase risk of blood clot
  • Decr sz frequency
  • Decr risk of endometrial cancer
  • Incr Hgb and RBC survival in pt w/ sickle cell disease
  • Incr protein in breast milk
  • Ok w/ anticonvulsants drugs
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25
Implanon - Generic - Formula - Indication - DDI - ADEs
Etonogestrel - Subdermal etonogestrel rod implant => Release over 3 years - I: when long term contraceptive is desired - Inserted/removed by minor procedure - DDI: Inducers decr drug ADES - Risk of thromboembolism - Implantation site tenderness
26
``` Ortho-Evra Patch - Formula - Dosage - When to start waring patch - What if the patch falls off Backup? ```
- F: Patch is a square Band-Aid 2x2 Worn on the skin. NEVER wear on breast - D: once a week: 3 weeks on 1 week off - Released ~ 60% more estrogen into bloodstream than average O.C => risk of clot is high Start wearing patch - Usually start on 1st day of menstrual cycle or 1st sunday after period Patch falls off - 24H start a new 4-wk cycle w/ a NEW PATCH CHANGE DATE. Use BACK UP for at least the next week (1 wk)
27
Nuvaring Vaginal Ring - Frequency - Storage
- D: use for 21 days QM (3 weeks on 1 week off) - Storage => REFRIGERATE: until expiration date => RT: exp 4 months
28
Copper Intrauterine Device (IUD) - Prevention how many years
ParaGard - Prevention up to 10 yrs
29
Levonorgestrel IUD - Insert how long?
Mirena - Up to 5 yrs Skyla - Up to 3 years
30
IUD - Early danger signs
Sign of danger: PAINS - P: Period late; pregnancy - A: abdominal pain - I: infection exposure/abdominal vaginal discharge - N: not feeling well, fever, chills - S: string missing
31
IUD | - SEs
- PID: Pelvic inflammatory Disease - Ectopic pregnancy - Excessive uterine bleeding, or spotting, pain - If become pregnant: 50% chance of spontaneous abortion (miscarriage) if IUD left in place & 25% chance of miscarriage if remove IUD
32
Diaphragms - Brands
Ortho-White Diaphragm - I: for W w/ firm vaginal muscle tone or W who desire a THIN delicate rim w/ gentle spring strength for more comfort Koromex - For W w/ average virginal muscle tone & for W who can tolerate the STURDY rim and firm spring strength All-Flex Milex Wide-seal arching
33
Diaphragms Instructions
- Leaves in 6H after sex, but take out ASAP afterward - Never in for > 24H - Can be inserted up to 6H prior to intercourse - Do not use during menses - Toxic shock syndrome: fever vomiting, aches - Wash with mild soap & warm water, dry w/ towel and store in plastic containers - DO NOT use petroleum products (Vaseline => break diaphragm). Use water base gel (KY-gel) - If gain/loses 10-20lbs, refit diaphragm may needed
34
Breakthrough bleeding - Occur in early cycle day 1-10 - Occur after 10 days - Occur in middle of cycle
In early cycle: day 1-10 - Estrogen deficiency => higher estrogen dose for EARLY bleeders - EARLY-Estrogen - Earli est After 10 days - Progestin deficiency - Use more progestins for LATE bleeder Mid cycle bleeder - More estrogen and progestin
35
Spermicide - MOA
Nonoxynol-9 - MOA: cause the sperm to be immobilized
36
Emergency Contraception - ADEs
ADEs - N/V - Give anti-emetic 1H prior to 1st dose - If pt throw up w/in 1H, MUST start over again
37
EC products
Plan B One-Step, My Way One dose, and generic versions - Sold OTC - In family planning aisle - NO restriction and regardless of age Next Choice One Dose - W & M age > 17 or older can buy w/o Rx - Age 16 or less: Need Rx
38
Ulipristal - Class - MOA - Dosage
Ella => RX only - MOA: to delay/inhibit ovulation & may prevent implantation. Doesnt interfere w/ pregnancy - D: 1 tab (30 mg) PO ASAP w/in 120 H (5 days) after unprotected intercourse (w/ or w/o foods)
39
* Prempro | - Indication
Estradiol + medroxyprogesterone - I: Hormone replacement therapy (HRT)
40
* Premphase | - Indication:
Estradiol + medroxyprogesterone - I: Hormone replacement therapy (HRT)
41
Angeliq - Indication: => Liq= liquid= spironolactone
Hormone replacement therapy (HRT)
42
Activella - Indication
Hormone replacement therapy (HRT)
43
*Climara Pro - Indication: - Form - Frequency
Hormone replacement therapy (HRT) - Form: patch - Frequency: QW
44
Combipatch - Indication - Form - Frequency
Hormone replacement therapy (HRT) - Form: patch - Frequency: Twice per week
45
Estratest - Indication - Contain
Hormone replacement therapy (HRT) - Contain: Methyltestosterone
46
FemHRT - Indication
Hormone replacement therapy (HRT)
47
Prefest - Indication
Hormone replacement therapy (HRT)
48
Estrogen PO - Drugs - Indication
Premarin Estrace Femtrace - I: HRT w/ hysterectomy
49
Estrogen vaginal cream - Drugs - Indications
Premarin cream Estrace - I: HRT w/ hysterectomy
50
Estradiol vaginal ring - Drugs - How long to replace when
Estring Ferming - I: HRT w/ hysterectomy - Replace after 90 days
51
Estradiol Vaginal tab
Vagifem: 1 tab PO QD => then twice weekly - I: HRT w/ hysterectomy
52
Estradial transdermal patch - Indication How often it needs to be changed? - Menostar - Climara: - Fempatch: - Vivelle/Vivelle dot: - Esclim: - Alora: - Minivelle:
- I: HRT w/ hysterectomy - Menostar: QW - Climara: QW - Fempatch: QW - Vivelle/Vivelle dot: BIW - Esclim: BIW - Alora: BIW - Minivelle: BIW
53
Estradiol Spray
Evamist - I: HRT w/ hysterectomy
54
Provera - Contain: - Indication"
Medroxyprogesterone - C: Progesterone alone - I: Postmenopausal vosomotor symptoms, amenorrhea, and dysfunctinal uterine bleeding
55
Prometrium - CI
Micronized progesterone - CI: peanut allergy
56
Endometrin
Progesterone vaginal insert
57
Progesterone Mini Pills
- * Micronor - * NorQD - Camilla - Errin - Jolivette - Nora-BE - Aygestin
58
Mycelex-3 Gynazole - Indication
Butoconazole - Indication: Vaginal Candidiasis
59
Cleocin Clindesse - Indication
Clindamycin - Indication: Vaginal Candidiasis
60
Mycelex-7 Gyne-Lotrimin - Indication:
Clotrimazole - Indication: Vaginal Candidiasis
61
Miconazole - indication
Monistat - Indication: Vaginal Candidiasis
62
Nystatin - Indication
Mycostatin - Indication: Vaginal Candidiasis
63
Terazol - Indication
Terconazole - Indication: vaginal Candidiasis
64
Vagistat -1 Monistat 1 Day - Indication
Tioconazole - indication: Vaginal Candidiasis
65
Boric acid - Indication
- I: Resistant vaginal candidiasis
66
Danocrine - Indication
Danazol - I: endometriosis
67
Synarel - Indication
Nafarelin - I: endometriosis
68
Mifeprex - Indication
Mifepristone - Pregnancy termination
69
Rho Immunoglobulin - Brand - Indication
Rhogam -I: Prevention of hemolytic disease of newborn if mom Rh(-) or baby may be Rh(+)
70
Cervidil Prepidil - Indication
Dinoprostone - I: Cervical ripening
71
Cytotec - Indication
Misoprostol - I: Cervical ripening (Cervix becomes soft and starts opening up)
72
Pitocin - Indication
Oxytocin - Labor induction/augmentation
73
Clomid - Indication
Clomiphene - I: infertility
74
CetroRelix - Indication
Cetrotide - I: infertility
75
Follistim Antagon - Indication
Ganirelix - Infertility
76
Lysteda - Generic - Indication - Dosage
Tranexamic acid - Tx of cyclic heavy menstrual bleeding - D: two 650 mg Tab TIDs (3900mg/d) for a max of 5 das during monthly menstruation
77
Osphena - Indication - MOA - SEs - Frequency and administration - DDI - Preg Cat:
- Ospemifene - I: Painful sexual intercourse due to menopause (Dyspareunia) - SEs: hot flashes and blood clot - D: 60mg PO QD w/ Food - DDI: metabolized by 3A4 and 2C9 - Preg Cat X
78
Estradiol Transdermal Gel
- I: HRT w/ hysterectomy - Divigel - Estrogel - Elestrin
79
Duavee - Indication - Dose
Conjugated estrogen and Bazedoxifene Indication - Vasomotor sx ass w/ menopause - Prevention of Postmenopausal osteoporosis - W needs estrogen for menopausal sx - Dose: 1 tab PO QD
80
COC approved for premenstrual dysphoric disorder
Yaz
81
Yaz is similar to
Beyaz
82
Yazmin is similar to
Safyral

14. Contraception (1 decks)

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