Therapeutics - Contraception 3

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Author:
kyleannkelsey
ID:
294668
Filename:
Therapeutics - Contraception 3
Updated:
2015-02-02 22:05:20
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Therapeutics Contraception
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Therapeutics - Contraception
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Therapeutics - Contraception
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  1. What is the contraceptive patch?
    OrthoEvra (150 mcg norelgest and 20 mcg EE)
  2. How often should you apply the Contraceptive patch (OrthoEvra)?
    Wear for 3 weeks then one week patch free
  3. What are the AE of OrthoEvra (patch)?
    • Higher estrogen = higher risk of thromboembolism
    • Les effective in women = to or > 90kg
  4. If the OrthoEvra patch is detached for < or = to 24 hours what should the patient do?
    Reapply without back-up
  5. If the OrthoEvra patch is detached for > 24 hours what should the patient do?
    • New 4 week cycle should be started
    • Use back-up method fr 7 days
  6. What is the combination injection?
    Lunelle (Medroxyprogesterone acetate and Estradiol cypionate injectable suspension)
  7. What is the return to fertility after taking Lunelle (Combo injection)?
    ~ 1month
  8. What is the frequency of dosing for Lunelle (Combo injection)?
    • Once monthly
    • NMT 33 days
  9. What is the route of administration for Lunelle (Combo injection)?
    IM
  10. What is the added benefit of Lunelle (Combo injection)?
    Less amenorrhea, decrease in cycle irregularities after 3 cycles
  11. Adverse effects that are dose related are due to the estrogen or progestin component?
    Estrogen
  12. Adverse effects that are dose related are due to the estrogen or progestin component?
    Progestin
  13. N/V is usually cause by Etrogen or Progestin?
    Estrogen
  14. Acne is usually cause by Estrogen or Progestin?
    Progestin
  15. If a patient has: N, breast tenderness, HA, weight gain and fluid retention, what changes would you make to their contraception?
    • Decrease estrogen
    • Consider IUD or Progestin only contraception
  16. If a patient has: Dysmenorrhea, menorrhagia or uterine fibroid growth, what changes would you make to their contraception?
    • Decrease estrogen
    • Consider extended cycle or continuous regimen
    • Just the 1st 2 symptoms:
    • Increase progestin
    • Consider extended or continuous, consider progestin only or IUD
    • NSAIDs for dysmenorrhea
  17. If a patient has: Vasomotor symptoms, nervousness and decreased libido, what changes would you make to their contraception?
    Increase estrogen
  18. If a patient has: Early cycle break through bleeding (days 1-9), what changes would you make to their contraception?
    Increase estrogen
  19. If a patient has: Absence of withdrawal bleeding, what changes would you make to their contraception?
    • Exclude pregnancy
    • Increase estrogen for menses
    • Continue for amenorrhea
  20. If a patient has: Increased appetite, weight gain, bloating and constipation, what changes would you make to their contraception?
    Decrease progestin
  21. If a patient has: Acne, oily skin and hirsutism, what changes would you make to their contraception?
    • Increase estrogen
    • Choose a less androgenic progestin
  22. If a patient has: Late cycle breakthrough bleeding (days 10-21), what changes would you make to their contraception?
    Increase progestin
  23. What are the serious side effects of contraceptives?
    • A abdominal pain = gallbladder or hepatic adenoma
    • C chest pain, cough and SOB = MI or PE
    • H HA, Dizziness, Numbness, Slurred speech and tingling in extremities = Stroke, HTN or migraine
    • E Eye problems (blurring or vision loss) = Stroke or HTN
    • S severe leg pain = DVT
    • Breast mass, pain or swelling = breast cancer
    • Excessive spotting or bleeding = endometrial, cervical or vaginal cancer
  24. What are the absolute CIs for COCs?
    • Thrombophlebitis, thromboembolic disorders
    • Cerebral vascular disease
    • Coronary artery disease
    • Peripheral vascular disease
    • Markedly impaired liver function
    • Known or suspect breast CA, or other estrogen dependent tumor
    • Undiagnosed abnormal vaginal bleeding
    • Known or suspected pregnancy
    • Smokers > 35 years of age
    • Migraine headache with focal aura
    • Uncontrolled hypertension
  25. A lower or higher dose of hormone in a contraceptive has a greater risk of resulting in decreased efficacy with a DDI?
    Lower
  26. What antibiotics may alter GI flora and reduce the efficacy of OCs?
    Rifampin, Beta-lactams, tetracyclines, erythromycin, SMX/TMP
  27. What drug categories generally have interactions with OCs?
    • Antibiotics
    • Antifungals
    • Anticonvulsants
    • NNRTIs
    • Protease inhibitors
  28. What interaction do Anticonvulsants have with OCs?
    Make OCs not last as long
  29. A smoker who is over 35 and smokes more than 15 cigarettes a day should get what type of OC?
    • Progestin only
    • If have to have estrogen, choose a low dose <20 mcg formulation
  30. A women over 35 who hasn’t smoked for at least a year should get what OC?
    Lowest dose of estrogen possible
  31. A woman with HTN should get what OC?
    Progestin only
  32. When taking Drosperinone (Yasmin) in a patient with HTN, what should be monitored?
    K

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