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OTC > EHC > Flashcards

EHC Flashcards

1
Q

What is used for emergency hormonal contraception?

A

Levonorgestrel within 72 hours
Ulipristal 120 hours

following unprotected sexual intercourse

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2
Q

Which is more effective and considered first line? is it suitable for women of child bearing age?

A

Ulipristal

Yes

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3
Q

What age group is levonorgestrel and ulipristal given to?

A

> 16 years of age

any age for ulipristal

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4
Q

What is the mode of action of ulipristal?

A

inhibits or delays ovulation via suppression of the LH surge

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5
Q

What is the mode of action of levonorgestrel?

A
  1. Before ovulation - prevents ovulation by delaying or inhibiting the release of the ovum from the ovary
  2. after ovulation - prevents fertilisation by affecting the motility of the fallopian tube and prevents sperm from meeting the ovum
  3. after fertilisation it induces changes in the endometrium that render it unreceptive to the ovum and prevent implantation
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6
Q

What % of expected pregnancies does it prevent if used within 72 hours of unprotected intercourse?

A

85% but effectiveness declines over time

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7
Q

When to refer?

A
  1. If ovulation has already occurred, EHC not thought to be effective therefore need IUD
  2. Hypersensitivity to ingredients
  3. Severe hepatic dysfunction
  4. Severe diarrhoea
  5. Crohns disease
  6. pt with asthma on oral glucocorticoid therapy
  7. Pt on ciclosporin therapy
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8
Q

What is the dose of levo and uli

A

uli - 30mg

levo - 1500micrograms

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9
Q

what interacts with both?

A

metabolised by the liver so drugs which induce liver enzymes will therefore increase metabolism and could reduce the effectiveness of the EHC

primidone, phenytoin, carbamazpine, st johns wort, griseofulvin, rifampcin, rifabutin, ritonavir

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10
Q

What side effects occur with ellaone?

A

headache
Nausea
ab pain
dysmenorrhoea

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11
Q

what side effects occur with levo?

A

nausea
headache
disturbed menstrual cycle
fatigue

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12
Q

Can both be used in BF or P?

A

P: limited info, not known to harmful

BF: yes for levo
BF: avoid for 1 week for ellaone

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13
Q

If pt vomits, what should you recommend?

A

if pts vomits within the first 3 hours of taking the pill, another tablet should be taken

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14
Q

What is the most effective type of contraceptive method?

A

IUD - first line

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15
Q

What questions about pregnancy and late period should be asked?

A

ask pt if already pregnant or symptoms of pregnancy

Details about last period should be asked last period? if late, how many days?

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16
Q

What else should be recommended after using the emergency contraceptive pill?

A

use barrier method until next menstrual period starts

17
Q

if a woman takes ellaOne, does this interfere with normal hormonal contraception?

A

it reduces its contraceptive action
therefore, she can start taking hormonal contraception after using ellaOne BUT use reliable barrier method unti next menstrual period

18
Q

when should pts be referred so that pregnancy is excluded?

A
  1. if menstrual period delayed by more than
  2. 5 days after taking levonelle one step or 7 days after taking ellaone
  3. or abnormal bleeding occurs at the expected date of menstrual periods or pregnancy
19
Q

if pt misses one pill, what does this mean? What should they do?

A

if a pt misses one pill (a missed pill is defined as one that is more than 24 hours late) or starting a new pack 1 day late: no additional or EHC is required. Pt should take the missed pill and continue to take the rest of the pack as usual

20
Q

if pt misses TWO or MORE pills or starting new pack 2 days or more late, should they use EHC?

A

take the last missed pill immediately and continue to take the rest of the pack as usual and use an extra method of contraception for the next 7 days

21
Q

if pills are missed in first week, Pills 1-7, EHC?

A

Yes if unprotected sexual intercourse has occurred in the pill-free interval or in the first week of pill-taking

22
Q

if pills are missed in the second week (pills 8-14), EHC?

A

No EHC - ensure pt takes the rest of the pills and extra protection

23
Q

if pills are missed in the third week (pills 15-21), EHC?

A

omit the pill-free interval by finishing the pills in the current pack or discarding placebo - start new pack the next day

24
Q

if pt is on POP, EHC?

A

12 hours late for cerazette - EHC

old POP 3 hours late - EHC

25
Q

Can levo be repeated in the same cycle?

A

Yes

26
Q

How effective is ulipristal?

A

95% effective

OTC (39 decks)

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