Term
| 50 mcg estrogen MONOPHASIC COCs |
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Definition
| Necon 1/50; Ortho-Novum 1/50; Ovcon/50; Ogestrel 0.5/50; Ovral; Ovral-28; Demulen 1/50; Demulen 1/50E; Zovia 1/50E |
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Term
| sub-50 mcg estrogen MONOPHASIC COCs |
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Definition
| Aleese, Aviane 28, Allesse-28, Lessina 28, Levlite; Brevicon 28-day, Necon 0.5/35, Nortrel 0.5/35; Apri 28; Portia 28; Cryselle, Low-Ogestrel 28; Necon-1/35, Nortrel 1/35, Ortho Novum 1/35; Sprintec; Levlan; Nordette; Loestrin; Microgestin; Ovcon, Seasonale, Yasmin |
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Term
| sub-50 mcg estrogen BIPHASIC COCs |
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Definition
| Necon 10/11-21; Necon 10/11-28 |
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Term
| sub-50 mcg estrogen TRIPHASIC COCs |
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Definition
| Cycleassa; Estrostep; Estreostep Fe; Ortho Tri-Cyclen; Tri-Sprintec; Ortho Tri-Cyclen LO; Necon 7/7/7; Ortho-Novum 7/7/7; Tri-Norinyl-28; Enpresse; Tri-Levlen; Triphasil; Trivora-28 |
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Term
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Definition
| COC that provides a fixed dose of estrogen AND progestin during cycle |
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Term
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Definition
| COC that provides a constant amount of estrogen but PROGESTIN dose changes TWICE during cycle |
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Term
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Definition
| COC that provides doses of estrogen & progestin that are changed THREE times during cycle |
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Term
| First day of menses or first Sunday following menses |
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Definition
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Term
| Physiological Effects of Estrogen |
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Definition
in females: development of vagina, uterus, uterine tubes, breasts; promotes axillary & pubic hair growth, fat distribution; promotes proliferation of endometrium during follicular phase, important role in ovulation & menstrual cycle; maintenance of blood vessels & skin structure; decrease bone resorption; increase renin substrate, sex-hormone binding globulin, & production of clotting factors; alters plasma lipids: increase HDLs & TGs, decrease LDLs, T-Cholesterol;
Both Males & Females: during puberty, responsible for accelerated growth of long bones & closure of epiphyses; |
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Term
| Physiological Effects of Progesterone |
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Definition
| inhibits estrogen-induced proliferation of endometrium & converts endometrium to a secretory tissue; produces thick cervical mucous & suppresses estrogen-induced contraction of myometrium; promotes secretory development of breasts; elevates basal body temp. by 0.5 degrees |
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Term
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Definition
| nausea; chloasma; acne; hirsutism; HTN; MI & stroke (women >35 yrs old & smoke); thromboembolic disorders; cholestatic jaundice - gall stone formation; decreased glucose tolerance; increased LDLs & TGs; breakthrough bleeding; increased risk of Candida vaginitis; depression; fatigue, dizziness, nervousness, emotional lability, anxiety, irritability; migraine HAs; may worsen myopia or nearsightedness; increased risk of cervical cancer; impaired fertility; decreased lactation |
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Term
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Definition
Abdominal pain (severe) - blood clot or gallbladder dx/pancreatitis, hepatic adenoma;
Chest pain (severe) - blood clot in lung or MI;
Headaches (severe) - stroke, HTN, or migraine;
Eye problems (blurred vision, flashing lights, or blindness) - stroke or HTN;
Severe leg pain (calf or thigh) - blood clots in legs; |
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Term
| Progestin only COCs - Micronor, Orvette, Depo-Provera |
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Definition
| types of COCs indicated for women >35 yrs old and who smokes a pack of cigerettes per day |
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Term
| Beneficial Effects of COCs |
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Definition
contraception;
decreased cancer incidence: endometrial cancer, ovarian cancer, *NO increased risk of breast cancer*;
tx of acne vulgaris (specifically triphasics) |
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Term
| Antibiotics, Anticonvulsants (carbamazepine, phenytoin, phenobarbital, primidone) |
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Definition
| drugs that cause decreased levels of COCs and decrease contraceptive effectiveness |
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Term
| Contraindications for use of COCs |
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Definition
hx/presence of thromboembolic dx, cerebrovascular dx, MI, CAD; congenital hyperlipidemia; carcinoma of breast; hx/presence of liver tumors; impaired liver fcn; women >35 yrs old that smoke heavily;
Relative: migraine HAs, HTN, diabetes mellitus, gallbladder dx |
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Term
| Ortho Evra transdermal patch COC |
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Definition
transdermal COC - ethinyl estradiol & norelgestromin;
place patch on abs, butt, upper torso, or upper arm;
Apply on 1st day of menses, replace weekly for 3 wks, 4th wks is patch free;
Efficacy of patch decreases if pt >90 kg;
Increased exposure to drug --> possibly higher SEs (i.e. thromboembolism) |
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Term
| NuvaRing vaginal ring COC |
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Definition
vaginal ring COC;
releases drug over 3 wk period;
insert prior to 5th day of menstrual cycle, keep inserted for 3 wks;
remove after 3 wks to permit withdrawal bleeding;
Not as popular --> remove ring b/c of sensation of foreign body, accidental expelling |
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Term
| Oral Progestin-only COCs - Micronor, Nor-Q.D., Orvette |
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Definition
"minipills" used in women who have C/Is for use of estrogen-containing contraceptives;
start on 1st day of menstruation & take pill at same time of day each day; NO PILL-FREE DAYS!
If pt is 3 hrs late taking pill, use back-up contraception for 48 hrs;
DO NOT consistently inhibit ovulation;
ADRs: menstrual irregularities (unpredictable spotting, heavy bleeding), weight gain, breast tenderness, HA, depression |
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Term
| Injectable Progestin-only COC - medroxyprogesterone acetate 150 mg/mL [Depo-Provera] |
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Definition
administerd IM injection into gluteal or deltoid muscle EVERY 3 MONTHS;
Inject within 5 day sof beginning of menstrual bleeding;
Inhibits ovulation in most pts;
If pt is at RISK FOR OSTEOPOROSIS - DO NOT USE;
ADRs: menstrual irregularities (unpredictable spotting, heavy bleeding), weight gain, breast tenderness, HA, depression, nervousness, ectopic pregnancy |
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Term
| Paraguard (intrauterine copper release), Mirena (levonorgestrel) |
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Definition
| NOT POPULAR forms of COCs; devices must be inserted by HCP; left in place for 5-10 yrs; can cause low grade inflammation; Insertion may introduce bacteria into genital tract --> development of PID |
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Term
| Plan B Kit - 2 tabs of levonorgestrel; Preven - 4 tabs of ethinyl estradiol + levonorgestrel |
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Definition
emergency contraception prevention;
first dose MUST be taken within 72 hrs of intercourse followed by 2nd dose in 12 hrs; tx is totally ineffective 7 days after intercourse;
ADRs: nausea, vomiting - prescribe antiemetic |
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Term
| ERT - conjugated equine estrogens [Premarin] |
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Definition
| estrogen replacement therapy |
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Term
| HRT - conjugated equine estrogens + medroxyprogesterone acetate [Prempro] |
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Definition
| hormone (estrogen + progestine) replacement therapy |
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Term
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Definition
| permanent cessations of menses that occurs around 50 yrs of age in women who have had 12 consecutive months of amenorrhea |
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Term
| Clinical Presentation of Menopause |
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Definition
| vasomotor symptoms (hot flashes, night sweats), sleep disturbances, mood changes, sexual dysfunction, problems with memory & concentration, vaginal dryness & dyspareunia; urogenital atrophy |
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Term
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Definition
progestin MUST be taken with estrogen when giving HRT therapy to these types of women;
Purpose: prevent estrogen-induced endometrial hyperplasia & endometrial cancer;
Prevention: take progestin at least 12-14 days each month |
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Term
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Definition
| Tx of vasomotor symptoms (hot flashes, night sweats), vaginal dryness & atrophy, premature ovarian failure |
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Term
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Definition
| prevention of osteoporosis & other chronic conditions, prevention of cardiovascular disease, tx of Alzheimer's dx |
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Term
| Adverse Effects & C/Is of Postmenopausal HRT |
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Definition
| increased risk of invasive breast cancer; breast tenderness; NAUSEA; THROMBOEMBOLISM; GALLBLADDER DX; |
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