medicines 51 Flashcards
(14 cards)
When starting the combined oral contraceptive (COC), under what condition is additional contraceptive protection (e.g. condoms) not required?
If COC is started on Day 1 to Day 5 of the natural menstrual cycle, no additional contraception is needed.
If started after Day 5, use additional protection (e.g. condoms or abstain) for the first 7 days.
What are the rules regarding missed pills for the combined oral contraceptive?
if one pill is missed
If two pills are missed
Safe window- 24hrs, if taken within 24hrs you are still protected
One pill missed - Take it ASAP & take next pill as normal- even if it means x2 pills in a day
Two pills missed - Take one ASAP & take next pill as normal- even if it means x2 pills in a day
AND barrier/abstinence for 7/7
What happens to the risk of cervical and breast cancer after stopping the COC
RISK OF BREAST & CERVICAL CANCER
returns to normal 10 years after stopping COCPs
What is the guidance around vomiting with the COCP and the POP
Following vomiting, unlikely for pill to have delivered its effects if
COCP- vomiting occurs within 3hrs
POP- vomiting occurs within 2hrs
Important to take another pill straight away!
What is the guidance to take for a missed pill of the progesterone only pill
🟡 Traditional POP (e.g. norethisterone, levonorgestrel):
Missed = more than 3 hours late
Action:
Take the missed pill as soon as remembered, even if it means taking two pills in one day.
Take the next pill at the usual time.
Use condoms or abstain for the next 2 days (48 hours).
Continue the rest of the pack as normal.
🟣 Desogestrel POP (e.g. Cerazette) – 12-hour window:
Missed = more than 12 hours late
Action:
Take the missed pill as soon as remembered, even if this means taking two pills in one day.
Take the next pill at the usual time.
Use additional contraception (e.g. condoms or abstain) for the next 2 days (48 hours).
Continue the rest of the pack as normal.
Which sulphonylurea can be used in pregnancy?
GLIBENCLAMIDE
can be used
unlicensed in 2nd
and 3rd trimester
which two abx can cause cholestatic jaundice
Flucloxacillin
Cholestatic jaundice and hepatitis may occur very rarely, up to two months
after treatment with flucloxacillin has been stopped.
Administration for more than 2 weeks and increasing age are risk factors
Co-Amoxiclav
It can cause hepatic disorders thus is contraindictaed in histories of co-
amoxiclav-associated jaundice or hepatic dysfunction
Which ABX cause blood disorders
Vancomycin
Linezolid
Co-trimoxazole
Trimethoprim
Gentamicin
Which ABX can cause toxic mega colon risk?
Co-amoxiclav - therefore least likely to be used in C.Diff
Which ABX can cause Ocular toxicity ?
Ethambutol - Important to assess eye function before & after treatment
Linezolid - Risk of eye damage when used more than 28 days
Rifamicin can also cause eye disturbances but less common
WHat is the treatment for Trichomoniasis
For men and women (not pregnant or breastfeeding), oral metronidazole 400–500 mg twice a day for 7 days should be prescribed.
For breastfeeding and symptomatic pregnant women, oral metronidazole 400 mg twice a day should be prescribed for 7 days.
Which Vaccine is administered orally in the UK?
Rotavirus
WHat vaccine can be given intranasally
Influenza vaccine in children
