Term
| Pharmacological Methods of Contraception |
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Definition
| oral contraceptives, injections, transdermal patch, vaginal ring, intrauterine devices |
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Term
| Non-pharmacological Methods of Contraception |
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Definition
| condoms, spermicide, diaphragm, cervical cap, sponge, permament, abstinence |
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Term
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Definition
fixed ratio of estrogen/progesterone daily;
"Low-dose": <50 mcg EE;
"Ultra low-dose": 20-25 mcg EE |
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Term
| Biphasic/Triphasic/Four Phase OCs |
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Definition
mimics pattern of normal menstrual cycle;
doses of E/P change throughout month |
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Term
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Definition
"mini pills";
used in women w/ C/I to estrogen;
more breakthrough bleeding & lower efficacy;
used mostly in lactating women |
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Term
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Definition
1st 4-phase OC;
Caution use in women w/ BMI >31;
Manufacturer does NOT recommend Sunday-start |
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Term
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Definition
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Term
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Definition
extended-cycle OC;
12 wks of active pills followed by 1 wk of INACTIVE pills;
Menstruation occurs during 13th wk of cycle |
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Term
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Definition
extended-cycle OC;
12 wks of active pills followed by 1 wk of LOW-DOSE EE;
Menstruation occurs during 13th wk of cycle;
May be better in women with endometriosis |
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Term
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Definition
contains EE & drospirenone;
more extended-cycle type OC;
24 days of active pills, 4 days of inactive pills;
may result in shorter days of menses |
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Term
| Yasmin (EE + drospirenone) |
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Definition
OC w/ EE and spironolactone analog --> watch hyperkalemia!;
NOT a weight loss agent |
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Term
| Continuous-use OC - Lybrel (levonorgestrel/EE) |
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Definition
1st continuous-use, low dose OC;
28-day pack w/ all active tabs;
eliminates menstrual periods in most women |
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Term
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Definition
Estrogen:
- inhibits ovulation by suppressing FSH & LH;
- prevents implantation by altering uterine secretions;
Progestin effects:
- inhibits ovulation by suppressing LH;
- thickens cervical mucus --> decreasing sperm transport & inhibiting implantation by altering uterine lining |
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Term
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Definition
take 1st active pill on Sunday after your period begins;
If period begins on Sunday, start that day;
Use back-up method of contraceptoin for 1 month |
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Term
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Definition
Take 1st active pill within 24 hrs of day that your first period starts;
Use a back-up method for 1 month |
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Term
| Estrogenic Side Effects of OCs |
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Definition
| HA, thromboembolic effects, irritability, nausea, bloating/fluid retention, breast tenderness, increase in breast size |
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Term
| Progestinic Side Effects of OCs |
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Definition
| breakthrough bleeding, acne, oily scalp/skin, increased appetite, weight gain, depression, breast tenderness, HA |
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Term
| Androgenic Side Effects of OCs |
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Definition
| increased appetite, depression, acne, oily skin, increased breast size |
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Term
| Absolute Contraindications for use of OCs |
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Definition
| thromboembolic disease, cerebral vascular dx, coronary occlusion, impaired liver fcn, benign hepatic adenoma, liver cancer, breast cancer, undiagnosed abnormal vaginal bleeding, pregnancy, >35 yr & smoking (>=15 cigs/day) |
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Term
| Relative C/I's with OCs - Use clinical judgement |
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Definition
Use clinical judgement:
- HTN, migraines, DM or GDM, surgery requiring immobilization, uterine leiomyoma, sickle cell disease, epilepsy, lactation, gallbladder dx, >50 months old, <6 monhts post-partum, FH of premature heart dx or hyperlipidemia |
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Term
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Definition
jaundice reported;
decreases quality & quantity of breast milk;
Recommend non-hormonal method of contraception;
use combo OC 6 months post-partum |
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Term
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Definition
Check package insert for best guidelines;
In general:
- if miss 1 day, take as soon as remembered, no backup method needed;
If you miss 3 days, throw out current pack and start a new pack that same day, use backup for 7 days |
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Term
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Definition
| anticonvulsants, antifungals, Vitamin C, anti-infectives (rifampin, griseofulvin), broad spectrum antibiotics, St. John's wart, garlic |
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Term
| Counseling Patients on OCs |
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Definition
if pt thinks she is pregnant, stop taking pills immediately, contact HCP, and use another form of contraception;
Take pill at same time every day;
They DO NOT provide protection against STDs/HIV;
Encourage pts NOT to smoke;
Side effects should improve after 3 cycles; |
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Term
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Definition
reversible;
most improve acne & hirsutism;
decreases risk of endometriosis, PID, ovarian cancer, ectopic pregnancy;
Fewer days & amt of bleeding, cramping, and pain;
Fewer PMS symptoms;
Improves dysmenorrhea, menopausal symptoms, irregular menstruation, PMS |
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Term
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Definition
if non-compliant --> high failure rate;
higher risk of cardiovascular events (especially EEs >50 cmg, smokers);
cost;
breakthrough bleeding, missed periods;
side effects;
no protection against STDs/HIV |
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Term
| Ortho Tri-Cyclen, Estrostep, Yaz |
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Definition
| OCs FDA-labeled for treatmetn of acne |
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Term
| Advantages of Progestin-only pill |
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Definition
no estrogenic side effects;
does not disrupt breast milk production;
menstrual cycle benefits;
reversible;
beneficial for estrogen-intolerant women |
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Term
| Disadvantages of Progestin-only OCs |
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Definition
less efficacy than combined pills;
MUST be taken at same time every day (if taken >3 hrs late, backup contraceptoin MUST be used for 48 hrs);
C/I in women with breast cancer;
breakthrough bleeding is very common |
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Term
| Ortho-Evra contraceptive patch |
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Definition
skin patch worn on lower abs, buttocks, or upper body (NOT breasts);
releases EE & progestin into bloodstream;
patch worn for 1 week, then replaced with new patch on same day of every week;
Total of 3 wks of patch-wearing, 4th week is patch-free week;
less effective in women >90 kg;
Starting up: Use backup method for 1 month
>48 hrs (forget to change patch): apply new patch, backup for 7 days;
patch falls off:
- <24 hrs: reapply patch, no backup
- >24 hrs: start new patch, back up for 7 days;
May increase risk of EE-related SEs (blood clots) |
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Term
| Advantages for Vaginal Drug Delivery |
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Definition
| no hepatic first pass effect, use lower doses, longer-term dosing to increase compliance |
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Term
| Disadvantages of Vaginal Drug Delivery |
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Definition
| misconceptions of vaginal anatomy |
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Term
| NuvaRing - vaginal contraception |
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Definition
flexible ring inserted into vagina & releases EE & progestin;
Remains in vag for 3 wks, removed for 1 week to allow for menstruation;
If ring is out of place >3 hrs during "active" phase of cycle, use back up contraception for 7 days;
SEs: vaginal discharge, vaginitis, irritation;
Store in fridge in pharmacy, at room temp for up to 4 months; |
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Term
| Depo-Provera - injectable contraception |
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Definition
injectable progestin (medroxyprogesterone acetate) inhibits ovulation, prevents sperm from reaching egg, & prevents fertilized egg from implanting;
one IM injection q3 months;
one SC injection q3 months; |
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Term
| Advantages of Injectable Contraception |
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Definition
99% effective;
option for women who cannot take E;
option for pts who are breastfeeding;
amenorrhea |
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Term
| Disadvantages of Injectable Contraception |
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Definition
SEs: irregular bleeding, breast tenderness, weight gain, bone loss;
does not protect against STDs;
return to fertility takes longer than OCs |
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Term
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Definition
contraceptive implant;
match-stick sized, progestin-only;
inserted/removed by HCP into upper inner arm;
requires replacement every 3 years; |
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Term
| intrauterine devices (IUD) - copper IUD (ParaGard), levonorgestrel (Mirena) |
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Definition
small T-shaped device inserted into uterus (lasts several years);
about 1% of pts will choose this form;
no protection against STDs/HIV;
For women:
- long-term BC OR
- monogamous relationships |
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Term
| Non-pharm Contraceptive Options |
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Definition
| male condom, female condom, spermicide, diaphragms, caps, shields, Today Sponge |
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