Med List #2: Female Contraception, Anxiety, and Muscle Spasms

Question 1

Contraceptives

Answer 1

ethinyl estradiol/norgestimate; ethinyl estradiol/norethindrone/ferrous fumarate; ethinyl estradiol/drospirenone; ethinyl estradiol/norelgestromin; ethinyl estradiol/etonogestrel; medroxyprogesterone; levonorgestrel

Question 2

Anxiety

Answer 2

clonazepam; alprazolam

Question 3

Muscle Spasms

Answer 3

cyclobenzaprine

Question 4

ethinyl estradiol/norgestimate: Brand Name

Answer 4

Ortho Tri-Cyclen; Tri-Sprintec; Tri-ViLibra

Question 5

ethinyl estradiol/norgestimate: Common Strengths

Answer 5

Three Phases: 0.035mg/0.18mg ; 0.035mg/0.215mg ; 0.035mg/0.25mg

Question 6

ethinyl estradiol/norgestimate: Common Frequency

Answer 6

One first phase tab daily for 7 days; then one second phase tab daily for 7 days; then one third phase tab daily for 7 days; then one inactive tab daily for 7 days

Question 7

ethinyl estradiol/norgestimate: Indications/Use

Answer 7

• Oral contraception
• Acne

Claim to Fame: Tri-phasics mimic natural menstrual cycle

Question 8

Contraceptive: Counseling Tips and Important Info - Side effects for ALL estrogen/progestin medications

Answer 8

• Water retention (bloating, weight gain, breast tenderness)
• Upset stomach/nausea
• Headache

Question 9

Contraceptive: Counseling Tips and Important Info - Non-FDA approved uses may include

Answer 9

• Regulation of menstrual cycle
• Lessen menstrual flow
• Reduce painful menses

Question 10

Contraceptive: Counseling Tips and Important Info - Miss a dose?

Answer 10

Take as soon as possible or with next days’ dose (e.g. miss Monday, take 2 on Tuesday)
If you miss 2 or more days, refer to package directions

Question 11

Contraceptive: Counseling Tips and Important Info - Products containing ethinyl estradiol

Answer 11

Increased cardiovascular risk (DVT, PE, MI).
Not recommended for those:
- +35 y.o.
- smoker
- Hx of stroke/blood clots

Question 12

Contraceptive: Counseling Tips and Important Info - Tips

Answer 12

• If OC not started day 1 of menses, use additional non-drug contraception first week of therapy
• Take same time each day for max effectiveness
• Some anti-convulsants (ex. divalproex, lamotrigine) may decrease effectiveness of hormonal contraceptives and/or increase chance of seizures
• None of the medications on this list protect against HIV/AIDs/STDs

Question 13

ethinyl estradiol/norethindrone/ferrous fumarate: Brand Name

Answer 13

Loestrin Fe, Junel Fe, Microgestin Fe

Question 14

ethinyl estradiol/norethindrone/ferrous fumarate: Common Strengths

Answer 14

0.02mg/1mg/75mg

Question 15

ethinyl estradiol/norethindrone/ferrous fumarate: Common Frequency

Answer 15

Take 1 active tab daily for 21 days; then 1 iron tab daily for 7 days

Question 16

ethinyl estradiol/norethindrone/ferrous fumarate: Indications/Use

Answer 16

• Oral contraception
• Acne

Claim to fame: replaces iron lost during menses

Question 17

ethinyl estradiol/drospirenone: Brand Name

Answer 17

Yaz, Loryna, Jasmiel

Question 18

ethinyl estradiol/drospirenone: Common Strengths

Answer 18

0.02mg/3mg

Question 19

ethinyl estradiol/drospirenone: Common Frequency

Answer 19

Active tab daily for 24 days; then 1 inactive tab daily for 4 days

Question 20

ethinyl estradiol/drospirenone: Indications/Use

Answer 20

• Oral Contraception
• Acne
• Premenstrual Dysphoric Disorder (extreme PMS)

Claim to fame: Only 4 inactive days = shorter menstrual periods

Question 21

ethinyl estradiol/drospirenone: Counseling Tips and Important Info

Answer 21

Drospirenone lessens the water retention/weight gain SE of estrogen

Question 22

ethinyl estradiol/norelgestromin: Brand Name

Answer 22

Xulane

Question 23

ethinyl estradiol/norelgestromin: Common Strengths

Answer 23

0.53mg/4.86mg

Question 24

ethinyl estradiol/norelgestromin: Common Frequency

Answer 24

Apply 1 new patch each week for 3 weeks; then week 4 is patch free

Question 25

ethinyl estradiol/norelgestromin: Indications/Use

Answer 25

Contraception

Question 26

ethinyl estradiol/norelgestromin: Counseling Tips and Important Info

Answer 26

- Same SE profile as OC but more common - Adhesive may cause skin rash/rotate sites - Do not cut patch - Apply to butt, upper torso, stomach, or upper arm

Question 27

ethinyl estradiol/etonogestrel: Brand Name

Answer 27

NuvaRing

Question 28

ethinyl estradiol/etonogestrel: Common Strengths

Answer 28

0.015mg/0.12mg/24 hrs ER

Question 29

ethinyl estradiol/etonogestrel: Common Frequency

Answer 29

Insert 1 ring into vagina on or before day 5 of cycle and leave in for 3 weeks; then remove on week 4 and discard

Question 30

ethinyl estradiol/etonogestrel: Indications/Use

Answer 30

Contraception

Question 31

ethinyl estradiol/etonogestrel: Counseling Tips and Important Info

Answer 31

- If ring falls out, rinse with cool water and re-insert within 3 hours - Don't remove for intercourse - Ring is a drug delivery device; not a barrier

Question 32

medroxyprogesterone: Brand Name

Answer 32

Depo-Provera

Question 33

medroxyprogesterone: Common Strengths

Answer 33

150mg/mL

Question 34

medroxyprogesterone: Common Frequency

Answer 34

150 mg deep IM inj in gluteal or deltoid muscle every 3 months

Question 35

medroxyprogesterone: Indications/Use

Answer 35

- Contraception - Endometriosis pain, abnormal uterine bleeding, amenorrhea Claim to fame: No estrogen

Question 36

medroxyprogesterone: Counseling Tips and Important Info

Answer 36

- Nervousness - Admin by healthcare professional - Don't use >2 years due to potential bone loss - Spotting or absent menses may result

Question 37

levonorgestrel (OTC): Brand Name

Answer 37

Plan B One-Step, EContra One-Step

Question 38

levonorgestrel (OTC): Common Strengths

Answer 38

1.5mg

Question 39

levonorgestrel (OTC): Common Frequency

Answer 39

Take 1 tab PO ASAP within 72 hours of unprotected sex

Question 40

levonorgestrel (OTC): Indications/Use

Answer 40

Emergency post-coital contraception

Question 41

levonorgestrel (OTC): Counseling Tips and Important Info

Answer 41

- Fatigue - No evidence of interaction w/ antibiotics - Will not terminate an existing pregnancy

Question 42

clonazepam: Brand Name

Answer 42

Klonopin

Question 43

clonazepam: Common Strengths

Answer 43

0.5mg, 1mg, 2mg

Question 44

clonazepam: Common Frequency

Answer 44

QD, BID, TID, QID

Question 45

clonazepam: Indications/Use

Answer 45

- Panic disorder - Seizure disorders - Off label use: Anxiety

Question 46

clonazepam: Counseling Tips and Important Info

Answer 46

- Drowsiness - Fatigue - Ataxia (clumsy voluntary movement) - Behavioral problems

Question 47

alprazolam: Brand Name

Answer 47

Xanax

Question 48

alprazolam: Common Strengths

Answer 48

0.25mg, 0.5mg, 1mg, 2mg

Question 49

alprazolam: Common Frequency

Answer 49

BID, TID, or PRN

Question 50

alprazolam: Indications/Use

Answer 50

- Panic disorder - Anxiety

Question 51

alprazolam: Counseling Tips and Important Info

Answer 51

- Confusion - Drowsiness - Excessive drowsiness w/ alcohol - avoid - Do not stop drug suddenly if taking routinely

Question 52

cyclobenzaprine: Brand Name

Answer 52

Flexeril

Question 53

cyclobenzaprine: Common Strengths

Answer 53

5mg, 10mg

Question 54

cyclobenzaprine: Common Frequency

Answer 54

QD, TID, or PRN

Question 55

cyclobenzaprine: Indications/Use

Answer 55

Muscle spasm

Question 56

cyclobenzaprine: Counseling Tips and Important Info

Answer 56

- Dry mouth (xerostomia) - Dizziness - Drowsiness