Term
| What is the dose, route, and frequency of Depo Provera? |
|
Definition
| DMPA 150mg/mL is given by IM injection Q 12 weeks |
|
|
Term
| What is the effectiveness of Depo? |
|
Definition
Correct and consistent use: Probability of pregnancy is 0.3%
Typical use: 3% |
|
|
Term
|
Definition
| Primary MOA is inhibition of ovulation. (Suppresses levels of FSH and LH and eliminates LH surge.) Also thickens and decreases quality of cervical mucus. |
|
|
Term
| What hormones are contained in Depo? |
|
Definition
| Progestin-only contraceptive |
|
|
Term
| What is the return to fertility when a patient stops the Depo shot? |
|
Definition
| As many as 9-10 months after last dose |
|
|
Term
| Is there a decrease in efficacy of Depo for overweight/obese women? |
|
Definition
|
|
Term
| What is the effect of Depo on the menstrual cycle? |
|
Definition
| Irregular bleeding and amenorrhea. 10-30% amenorrheic after one injection; 40-50% after the fourth injection |
|
|
Term
| What are the advantage to how Depo affects the menstrual cycle? |
|
Definition
| Decreased ovulation pain, cyclic menstrual cramps, mood changes, headaches, breast tenderness, and nausea |
|
|
Term
|
Definition
Minimal drug interactions (aminoglutethimide-Cushing's only)
Decreased grand mal seizures
Reduction in sickle cell crisis
Reduced pain from endometriosis, decreased PID |
|
|
Term
| 20-25% of women will discontinue Depo in the first year for this reason |
|
Definition
|
|
Term
| Disadvantage of Depo (not irregular cycle) |
|
Definition
|
|
Term
| How does Depo affect depression? |
|
Definition
| May experience increase in depression on Depo; not considered a contraindication |
|
|
Term
| How does Depo affect bone density? |
|
Definition
| Temporary and reversible decreased bone density |
|
|
Term
| How long does it take for Depo to clear from a woman's body? |
|
Definition
| 6-8 months after last injection (keep in mind when considering reasons for discontinuing) |
|
|
Term
| What is the one absolute contraindication for Depo? |
|
Definition
|
|
Term
| How long should a post partum woman wait until beginning progestin-only methods of BC? |
|
Definition
| Several organizations have recommended waiting until 6 weeks so as to not slow breast milk production |
|
|
Term
| What is the rate of bone density return after stopping Depo? |
|
Definition
| For women over 21, returns to rates of non Depo users by 30 months after discontinuation |
|
|
Term
| When is a back up method needed for Depo? |
|
Definition
| First 7 days after first injection (unless given within 5 days of beginning of period) and past due for injection |
|
|
Term
| How long is Depo effective for? |
|
Definition
|
|
Term
| When can you begin pills or other contracpetion when switching from Depo? |
|
Definition
| Start BEFORE it is time for next injection |
|
|
Term
|
Definition
Repeated, painful HAs
Heavy bleeding
Depression
Severe, lower abdominal pain (may be pregnancy)
Pus, pain, redness, itching, or bleeding at the injection site |
|
|
Term
| Medical contraindications to EC? |
|
Definition
| Pregnancy-only because it will be ineffective, not because it will be harmful to fetus. |
|
|
Term
| What hormone does Plan B contain? |
|
Definition
|
|
Term
| What is the time frame for use of EC? |
|
Definition
| 120 hours (5 days) after intercourse |
|
|
Term
| Does availability of EC increase sexual risk taking? |
|
Definition
|
|
Term
| Who is able to purchase EC OTC? |
|
Definition
|
|
Term
| What is the primary MOA of emergency contraception? |
|
Definition
|
|
Term
| Other possible MOAs of Plan B? |
|
Definition
| Interference with corpus luteum function, thickening of cervical mucus, interferes with migration of sperm |
|
|
Term
| What other method can be used as ED? |
|
Definition
|
|
Term
| Side effects of hormonal EC |
|
Definition
| Nausea and vomiting (less common in Progestin only EC, such as Plan B) and menstrual changes |
|
|
Term
|
Definition
| Ok 6 weeks post partum (progestin only preferable to estrogen containing EC |
|
|
Term
|
Definition
| Not as effective as regular contraceptives/frequent use decreases efficacy |
|
|
Term
| Multiple acts of intercourse |
|
Definition
| If more than 120 hours since first unprotected exposure, ECP less effective at preventing pregnancy |
|
|
Term
|
Definition
| Exclude possibility that she is already pregnant, is she using form of contraception? |
|
|
Term
|
Definition
| RTC if period does not start in 3 weeks for PT; do not have unprotected intercourse in the coming days/weeks (Plan B does not protect you) |
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