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CMN572-801 > Module 1 - Contraceptives > Flashcards

Module 1 - Contraceptives Flashcards

(53 cards)

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1
Q

Types of Barrier Methods

A

Diaphragm
Vaginal sponge
Males Condoms
Female Condoms
Spermicides

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2
Q

Diaphragm
-reusable or one time use?
-can spermicide be used?
-things to remember
-timeline of placement before sex; how long can it stay in after sex

A

-reusable
-yes, spermicide
-NEEDS TO BE FITTED. MUST BE REFITTED WITH WT GAIN/LOSS, AFTER PREGNANCY
-can be placed up to 2 hours prior to sex. must stay in place 6 hours after intercourse

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3
Q

Diaphragm
-contraindications (7)

*allergy, HIV, TSS, anatomy, UTIs, user error, 6wks PP

A

-silicone/spermicide allergy
-high risk for HIV infection or dx w/ HIF infection
-hx of toxic shock syndrome
-hx of frequent UTIs
-abnormalities of uterine anatomy that prevent a satisfactory fit
-inability to insert correctly
-full-term pregnancy delivered w/i prior 6 weeks

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4
Q

Vaginal Sponge
-can spermicide be used?
-how long must person leave in place after intercourse?

A

-Yes, meant to be used with spermicide
-6 hours

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5
Q

Vaginal Sponge
-contraindications (5)

*allergy, HIV, TSS, menses, PP

A

-must be 6wks PP
-no use during menses
-no use w/ hx of TSS
-risk of HIV infection
-allergy

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6
Q

Male condoms
-contraindications
-can oil based creams/lubricants be used with condom?

A

-allergy to latex or spermicide
-do not use oil based creams/lubricants

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7
Q

Female condoms
-safe for those with latex allergies?
-contraindications?

A

-Yes
-None

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8
Q

Spermicides
-can it be used alone or does it need condom/diaphragm?
-contraindications

A

-yes, can be used alone or with condom. more effective if used with condom.
-allergy, HIV infection/high risk for HIV infection

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9
Q

Spermicides
-how long before intercourse can spermicides be placed inside the vagina?
-SE

A

-minimum 15 minutes before intercourse; can wait up to 1-3hr before intercourse
-sensitivity rxn

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10
Q

Combined Hormonal Contraception
-contraindications (most important)

A

age >=35 and smokes >=15 cigarettes/day

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11
Q

Combined Hormonal Contraception
-absolute contraindications
*circulatory (9)

A

BP >= 160/100
Uncontrolled HTN
Complex valvular heart disease
Hx stroke
Multiple risk factors for coronary artery disease
Peripartum cardiomyopathy
Hx of ischemic heart disease
Thromboembolic disorder (pulmonary embolus thormbogenic mutations; major surgery with prolonged immobilization)
Hx of (or current) thrombophlebitis

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12
Q

Combined Hormonal Contraception
-absolute contraindications
*digestive

A

acute viral hepatitis
active liver cirrhosis or liver CA

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13
Q

Combined Hormonal Contraception
-absolute contraindications
*endocrine

A

diabetes 20 years
diabetes w/ end-organ damage
complicated solid organ transplant

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14
Q

Combined Hormonal Contraception
-absolute contraindications
*immune

A

hx of lupus w/ + antiphospholipid antibodies

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15
Q

Combined Hormonal Contraception
-absolute contraindications
*nervous

A

migraine with aura

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16
Q

Combined Hormonal Contraception
-absolute contraindications
*reproductive

A

less than 21 days PP (risk for thromboembolism)
pregnancy, known or suspected
current breast CA

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17
Q

Combined Hormonal Contraception
-relative contraindications
*circulatory (6)

A

age >=35 and smokes <= 15 cigarettes per day
SBP 140-159mmHg or DBP 90-99mmHg
well controlled HTN
hyperlipidemia
prolonged immobility
hx of superficial venous thrombosis

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18
Q

Combined Hormonal Contraception
-relative contraindications
*digestive

A

active gallbladder disease
malabsorptive bariatric surgery
hx of cholestasis

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19
Q

Combined Hormonal Contraception
-relative contraindications
*nervous

A

migraine w/o aura
migraine HA that starts after OC initiation
use of oxcarbazepine, lamotrigine, barbiturates, phenytoin, carbamazepine, primidone and/or topiramate

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20
Q

Combined Hormonal Contraception
-relative contraindications
*reproductive

A

<42 days PP (risk for venous thromboembolism may still be present)
past hx of brst CA, not no active disease for 5 years

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21
Q

Combined Hormonal Contraception
-relative contraindications
*other

A

conditions that make it difficult to take pills consistently

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22
Q

Combined Hormonal Contraception
-EB’s Contraindications (10)

Study These Flashcards
A
  1. SMOKER age >=35yr
  2. hx of clot (MI, DVT, stroke)
  3. hx of current breast CA
  4. uncontrolled HTN/DM
  5. prolonged immobilization
  6. triglycerides
  7. active/liver disease
  8. women at risk for cardiac dx
  9. active SLE (lupus)
  10. undiagnosed vag. bleeding
23
Q

Combined Hormonal Contraception
-how much ethinyl estradiol in oral contraceptive

24
Q

Combined Hormonal Contraception
-how does it work?

Study These Flashcards
A

-suppressing pituitary gonadotropins (FSH and LH) = inhibiting ovulation
-increasing viscosity of cervical mucous, reduce endometrial thickness (reducing chances of implantation)

25
Combined Hormonal Contraception -dose-related SE of OC's *Too much estrogen
N, bloating, HTN, breast tenderness, edema
26
Combined Hormonal Contraception -dose-related SE of OC's *Too little estrogen
early or midcycle breakthrough bleeding, increased spotting
27
Combined Hormonal Contraception -dose-related SE of OC's *Too much progestin
inc. appetite, wt. gain, fatigue, mood changes
28
Combined Hormonal Contraception -dose-related SE of OC's *Too little progestin
late breakthrough bleeding, amenorrhea
29
Combined Hormonal Contraception -noncontraceptive health benefits of OC
-dec menstrual flow and dysmenorrhea, improvement of menstrual sx -improvement of acne, regularity of menses, protection against anemia, reduced ovarian cysts -reduced incidence of endometrial CA, colorectal CA, gynecological diseases that cause infertility
30
Combined Hormonal Contraception -impact on milk supply
Decreases milk supply
31
Combined Hormonal Contraception -serious/life-threatening complications
-thrombophlebitis/thromboembolism -hepatocellular adenomas -stroke -gallbladder disease -HTN
32
Combined Hormonal Contraception -SE
-N, fatigue, acne, mild HA -Inc. appetite -breast fullness and/or tenderness -cyclic wt gain and fluid retention -BREAKTHROUGH BLEEDING (esp first 3MO of use) -decreased menstrual flow and/or amenorrhea
33
Combined Hormonal Contraception -education
ACHES -severe abd pain -severe chest pain -severe HA -eye problems -severe leg pain
34
Combined Hormonal Contraception -F/U
weight and BP after 3MO on OC, then annually as clinically indicated
35
Combined Hormonal Contraception -missed pills *1 missed pill *2 missed pills (consecutively) *3 or more missed pills
*take ASAP; if not remembered until next pill, take 2 pills *take 2 pills per day for next 2 days, then resume 1 pill per day -used additional contraception for remained of cycle *depends on what type of OC, and where in pack the pills were missed; refer to product info for that OC
36
Contraceptive Patch -what hormones are used? -does it have noncontraceptive health benefits? -does it decrease milk production? -SE
-estrogen and progestin -yes -yes -breakthrough bleeding (esp. first 3MO), irritation at application site
37
Contraceptive Patch -appropriate locations -partially detached patch instructions -what to look out for -F/U
-upper arm, back, abd, buttock (NO BREAST) -can reapply or tape as long as it hasn't been off for 24 hrs -ACHES (severe abdominal pain, severe chest pain, severe AH, eye problems, severe leg pain) -wt check and BP after 3MO, then annually
38
Contraceptive Vaginal Ring -what hormones are involved? -does it have noncontraceptive health benefits? -SE -education
-estrogen and progestin -yes -vaginitis, skin irritation; all other SE are same (breast tenderness, BTB, etc.) -insert deep/posterior, leave in during sex; keep out of direct sunlight; can reinsert <3hr w/o backup method (otherwise backup method for 7 days)
39
Emergency Contraception -efficacy -types for 72hrs from intercourse; types for 120hrs from intercourse -teratogenic effects?
-85% -Plan B (no prescription needed); Ella or Copper IUD -no reports of teratogenic effects
40
Emergency Contraception -contraindications -when is it less effective?
-copper IUD in pregnancy (suspected) -less effective in higher BMI (Plan B BMI>25; Ella BMI>34)
41
Emergency Contraception -Considerations
-Insulin-dependent diabetics require closer monitoring -higher BMI --> less effective (but still offer) -bariatric surgery --> malabsorptive process --> less effective -copper IUD --> check for strings monthly and after sex
42
Emergency Contraception -F/U
-no menstrual bleeding w/i 3 weeks of emergency oral contraception -less than 2 days bleeding -signs of early pregnancy -annual examinations as clinically indicated -ongoing contraception counseling
43
IUD -hormone involved -impacts on breastfeeding -SE
-progesterone (levonorgestrel) -no impact on breastfeeding -abd adhesions/infections, sepsis, cervical infection/erosion; spotting/heavy flow; embedding
44
IUD -absolute containdications
pregnancy, current STD, unexplained vaginal bleeding, anatomical abnormality, fibroids, cervical/endometrial cancer, infections, postpartum endometritis; infected abortion, pelvic TB; gestational trophoblastic disease
45
IUD -how long each lasts: *skyla *liletta *kyleena *mirena *paragard
*3yr *up to 6yr *every 5yrs *every 5yrs *10yrs
46
Progestin-only contraceptive -MOA -available forms
-suppresses ovulation, creates thin/atrophic endometrium; thickens cervical mucous making sperm penetration difficult -progestin-only OC (mini pill), depo provera, nexplanon
47
Progestin-only contraceptive -Mini pill *age *effect time has on function *sx
-<40yrs -take at same time everyday (w/i 3 hour window) -GI upset, breast tenderness, dec. libido; severe HA or HTN
48
Progestin-only contraceptive -Mini pill *benefits *SE *education
*protection against endometrial CA, dec. risk of PID, dec. menstrual cramps, evetually less heavy bleeding and shorter menses; dec premenstrual syndrome sx; dec breast tenderness *inc. risk of ectopic pregnancy *spotting, BTB; can start anytime in cycle (use backup method x1 week); if pill missed, take ASAP (use backup method 48hrs)
49
Progestin-only contraceptive -Mini pill *F/U (when D/C needs to happen)
new onset of migraine, new CV risk = D/C this med
50
Progestin-only contraceptive -Mini pill *when should patient return for F/U? *how much supply at one time can you prescribe?
-3M -6M
51
Progestin-only contraceptive -Depo Provera *advantages *how often? *SE *lactation effects? *good for certain patients
*dec risk of ectopic pregnancy, risk of endometrial CA, frequency of SSSC, improves endometriosis -IM q 12 weeks -decreases bone density (GIVE Ca2+ supplement); irregular + prolonged bleeding (first 6 months); amenorrheic by 1 yr; weight gain; mood changes; depression -no impact on lactation -lactating/postpartum patients, sickle cell anemia; PID hx
52
Nexplanon -how long does this last? -does this impact lactation? -SE -use caution in these patients
-3Y -no -irregular menses; follicular cysts (resolve on own); fluid retention; increased acne; weight gain -DM, depression, HTN
53
Nexplanon -contraindications -can it be seen on x-ray?
-known/suspected pregnancy -current or past hx of clot -all liver tumors -active liver disease -undiagnosed vag bleeding -known/suspected breast CA/ personal hx of breast CA -allergic rxn to components of nexplanon (barium) -yes

CMN572-801 (2 decks)

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