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37 Cards in this Set
- Front
- Back
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In general, to prevent conception you can.....
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inhibit egg release
impose a barrier between the egg and sperm alter the ability of the egg/sperm to implant control spermatogenesis |
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To inibit the egg you can use:
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estrogen/progestin or Progestin-only contraception
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To impose a barrier you can:
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Mechanical: condom, diaphram, cervical cap
Chemical barrier: foam Temporal barrier: rhythm method Surgical barrier: sterilize |
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to alter the ability of the egg to implant/grow you can:
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use an intauterine device
post-coital contraceptives abortion (RU486/mifepristone/misoprostol) |
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what are the types of contraceptive steroids?
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Monophasic
Bi/tri phasic extended cycle transdermal, injectable, vaginal post-coital progestin- onl |
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what is the advantage in using a 24 day OC instead of a 21 day OC
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lower steroid dose per day results in lighter periods
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In an obese person, what must you consider?
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Can be sequestered in fat and have an increased failure rate
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How are the contraceptive steriods metabolized?
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Hepatic metabolism!
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How are the contraceptive steroids excreted?
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renal/biliary
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what are the severe effects reported with contraceptive steroids?
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DVT, PE, MI
GI disorder Cancer |
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What are the benefits of contraceptive steroids?
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decrease cysts/cancer ectopic pregnancy
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what are the contraindications to the use of contraceptive pills?
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Thromboembolic event
Cerebrovascular event hepatic adenoma impaired liver fxn pregnancy breast cancer varicose veins headaches hypertension diabetes blood disorders surgery depression |
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How do steroids affect anti-coags?
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decrease effectiveness
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What should you counsel your pt on when giving drosirenone?
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that they may have an increased risk of hyperkalemia when taking a drug that also increases K+
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A progesterone containing pill will cause?
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acne/depression
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an estrogen containing pill will cause
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weight gain, nausea, fatigue
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Who is a good candidate for the pill?
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NON smoking woman >35 with no risk for STD
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effectiveness of OC is decreased by?
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antibiotics, seizure meds, barbiturates
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T or F progesterone only pills can be used during breast feeding?
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T
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Ortho Evra uses what two drugs?
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ethinyl estradiol and norelgestromin
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A concern with Ortho Evra
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VTE is 2X the risk of an OC user
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what are some side effects of Nuva ring?
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Vagnitis, HA, URI, nausea
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How long is Depo good for?
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14 weeks (3 months)
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how long is Implanon good for?
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3 yrs
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how long is Jadelle good for?
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5yrs
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what is the MOA of a long acting progestin?
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inhibit LH/FSh release and produce endometrial thinning. Also decreases estradiol levels which ma decrease bone density
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What are the three medical conditions in which you should consider a Depo or Implantable?
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seizures, sickle-cell anemia, anemia
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what are the contraindications for depo/implants
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breast cancer, VTE, liver disease
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spermacides are typically.......
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nonooxynol
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Ideal IUD candidate
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Multigravid, monogamous, long term contraception
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complications with an IUD
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Uterine perforation, ectopic pregnancy
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Mirena lasts for
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5 yrs
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Mirena is also useful for
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endometrium issues
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In a pt taking OCs, they develop early breakthrough bleeding and hypomenorrhea. What type of OC are they on? And what do you need to change?
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estrogen, they are deficent so increase the dose
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In a pt taking OCs, they develop migraine headaches, hypertension Nausea and breast fullness. What kind are they on? What would you need to do?
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Estrogen, lower the dose
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In a Pt taking OCs , they develop late breakthrough bleeding and amenorrhea. What would you want to do?
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They are on progestin, increase the dose because they are deficent
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In a pt taking OCs, they develop weight gain, acne, hirsutism and breast regression. What are they on?
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TOO MUCH progestin!
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