PGD & EHC

Question 1

Define what a patient group direction is

Answer 1

A PGD provides legal mechanisms by which medicines can be supplied and/or administered to patients by a specified range of healthcare professionals, without seiing a doctor or dentist first.

Question 2

Benefits of PGD

Answer 2

• supporting self care and improving health of patients
• improving choice, convenience and access to treatment
• providing advice and sport to patients alongside treatment or prophylaxis for the condition being managed
• improving primary care capacity, e.g by reducing medical practice workload or augmenting

Question 3

Describe the need for supplying EHC via a PGD

Answer 3

• to increase the knowledge especially among young people, of the availability of Emergency contraception and contraception from pharmacies
• to improve acces
• for privacy
• to increase use of women who have had UPSI and prevent unwanted pregnancies
• to refer clients esp from hard to reach groups into mainstream contraceptive services
• to increase knowledge

Question 4

Apply principles of supplying EHC to patients in case-based scenarios

Answer 4

Check workshop answers

Question 5

Emergency contraception

Answer 5

Measures taken after UPSI to avoid pregnancy

Question 6

Inclusion criteria for PGD

Answer 6

..

Question 7

Exclusion criteria for PGD

Answer 7

Bb

Question 8

Drug interactions for levonelle

Answer 8

ANTIEPILEPTICS
- carbomazepine, eslicarbazepine , oxcarbazepine , phenytoin, phenobarbital, primadone, rufinamide, topiramate

ABX
Rifampicin, rifabutin

ANTIVIRALS
- protease inhibitors, ritonavir, amprenavir, nelfinavir, pinavir, saquinavir, tipranavir, darunavir, fosamprenavir, lopinavir, non-nucleotide reverse, transcriptase inhibitors, efavirenz, nevirapine

RESPIRATORY DRUGS
Bosentan

CNS DRUGS
Modafinil, aprepitant

HERBAL:
St johns wort

Potential outcome if taken with levonelle: metabolism of levonelle enhanced, therefore reduces efficacy

Question 9

Interaction ls of Ella one

Answer 9

Gg

Question 10

Side effects of levonelle

Levonorgestrol

Answer 10

GENERAL SIDE EFFECTS
Common or very common
- Gastrointestinal discomfort; headaches; menstrual cycle irregularities; nausea; skin reactions

SPECIFIC side-effects:
Common or very common:
With intra-uterine use:
- Back pain; breast abnormalities; depression; device expulsion; hirsutism; increased risk of infection; libido decreased; nervousness; ovarian cyst; pelvic disorders; uterine haemorrhage (on insertion); vaginal haemorrhage (on insertion); vulvovaginal disorders; weight increased

WITH ORAL USE:
Breast tenderness; diarrhoea; dizziness; fatigue; haemorrhage; vomiting

UNCOMMON:

• With intra-uterine use
• Alopecia; endometritis; oedema; uterine rupture

RARE OR VERY RARE:
With oral use
-Face oedema; pelvic pain

Question 11

Side effects of Ella one

Ulipristral

Answer 11

Common or very common

Back pain; breast tenderness; dizziness; fatigue; gastrointestinal discomfort; headaches; menstrual cycle irregularities; mood altered; myalgia; nausea; pelvic pain; vomiting

Uncommon

Anxiety; appetite disorder; chills; concentration impaired; diarrhoea; drowsiness; dry mouth; fever; flatulence; hot flush; increased risk of infection; insomnia; libido disorder; malaise; skin reactions; vision disorders; vulvovaginal disorders

Rare or very rare

Abnormal sensation in eye; disorientation; dry throat; eye erythema; genital pruritus; ovarian cyst ruptured; painful sexual intercourse; syncope; taste altered; thirst; tremor; vertigo

Frequency not known

Hepatic disorders