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DFSRH > POP > Flashcards

POP Flashcards

1
Q

Who is the POP definitely NOT suitable for?

A
  • Previous hormone dependent cancer in last 5 years
  • severe decompensating cirrhosis or liver tumours
  • sensitivity to any of the components of the POP (e.g. peanut allergy - desogestrel contains soybean oil)
  • IHD or CVD developed whilst taking a POP
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2
Q

What is the MAIN mechanism of action of desogestrel?

A
  • inhibits ovulation
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3
Q

What is the MAIN mechanism of action of levonorgestrel/norethisterone?

A
  • thickening cervical mucus
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4
Q

What are the advantages to POP?

A
  • simple, convenient, under the patient’s control
  • can be taken when breastfeeding
  • can reduce dysmenorrhoea and severity of migraines
  • ideal for women who suffer oestrogenic effects of CHC
  • suitable for smokers
  • no dose adjustment in obese women
  • good for those with CIs against CHC
  • no increased risk of CVD, clots or strokes
  • minimal change in carbohydrate/lipid metabolism therefore good for diabetics
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5
Q

What are the disadvantages to POP?

A
  • side effects like breast tenderness, mood changes, headaches, acne
  • overall risk of pregnancy is reduced but 1 in 10 of those pregnancies may be ectopic
  • disruption of menstrual bleeding (breakthrough, spotting, amenorrhoea)
  • risk of functional ovarian cyst development - usually self resolve
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6
Q

At what point do you require condoms/abstinence when you have missed a pill?

A
  • norethisterone/levonorgestrol: 3 hours
  • desogestrel: 12 hours
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7
Q

Name some drugs that interact with POP

A
  • carbamazepine
  • phenobarbital
  • phenytoin
  • topiramate
  • rifabutin
  • rifampicin
  • some ARVs
  • ellaOne
  • Bonsentan
  • st john’s wort
  • lamotrigine
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8
Q

How long does it take for fertility to return?

A

There is no delay

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9
Q

What happens with women’s bleeding on POP?

A
  • 20% have no periods
  • 40% have irregular bleeding
  • 40% will have regular cycles
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10
Q

Which POP is likely to cause no or infrequent or no bleeding after 1 year?

A
  • Desogestrel
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11
Q

Dose of desogestrel?

A

75micrograms

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12
Q

Dose of levonorgestrel?

A

30micrograms

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13
Q

Dose of norethisterone?

A

350micrograms

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DFSRH (6 decks)

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