Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
82 Cards in this Set
- Front
- Back
|
All available contraceptive methods act to.....?
|
prevent sperm and egg from uniting, or to prevent implantation and growthof the embryo
|
|
|
Name the numerous forms of contraception methods.
|
hormonal, barrier, iud's, natural family planning, postcoital/emergency contraception, permanent
|
|
|
what are the 6 types of hormonal contraception?
|
combination pill
progestin-only pill contraceptive patch nuva ring depo-provera implanon |
|
|
name the 5 types of barrier contraceptives
|
condoms
spermicides female condoms cervical cap diaphragm and spermicide |
|
|
name the 2 most common types of iud's
|
progesterone iud (mirena)
copper T 380A |
|
|
____ contraceptives provide the most effective reversible pregnancy prevention available.
|
hormone-based
|
|
|
the theorhetical failure rates of OCP's are...
|
< 1%
|
|
|
what is the usual cause of OCP failure?
|
missed pills
|
|
|
most OCP's are combos of ___&___
|
estrogen and progestin
|
|
|
The estrogenic component of OCP acts by suppression of ___thus preventing selection and emergence of a __ __
|
FSH
dominant follicle |
|
|
what are the progesterone actions of OCP's?
|
-thickening of the cervical mucus
-alteration of fallopian tube peristalsis |
|
|
oral contraceptives that introduce varying amounts of estrogen throughout the month are called?
|
phasic
|
|
|
what is the mini pill?
|
progestin only
|
|
|
how does the mini pill primarily act/work?
|
makes the endometrium hostile to implantation
-thick cervical mucus that is relatively impermeable |
|
|
for pt's taking the mini pill ovulation continues in __% of the pt population
|
40
|
|
|
the mini pill is of special usfulness in 2 situations..what are they?
|
-women over 40
-lactating women |
|
|
progestin only formulations of OCP's is a good alternative for ...?
|
have contraindications to estrogen formulations
|
|
|
what is a major side effect of the mini pill?
|
it MUST be taken at the same time every day, if a pt is more than 3 hrs late taking the pill, a backup method must be used for 48 hours.
|
|
|
hormonal contraception affects more than the ___ system.
|
reproductive
|
|
|
hormonal contraception affects what other body systems?
|
-lipid metabolism
-potentiate sodium and water retention -increase renin substrate -stimulate cytochrome P450 -sex hormone-binding globulin -reduce antithrombin III |
|
|
progestins increase ___, and ___ and ___ hair. Induce smooth muscle__ and increase the risk of cholestatic ___.
|
sebum, facial and body hair. induce smooth muscle relaxation, cholestatic jaundice
|
|
|
OCP users have the beneficial effects of what other medical dos?
|
-lower incidence of endometrial and ovarian cancer
-benign breast and ovarian disease -pelvic infxn's -ectopic or uterine pregnancy |
|
|
With OCP's there appears to be a protective effect against __ __
|
rheumatoid arthritis
|
|
|
With OCP's menstrual periods are...what?
|
-predictable
-short -less painful -reduced chance of iron deficiency anemia |
|
|
breakthrough bleeding occurs in __-__% of women taking low dose OCP's.
|
10-30
|
|
|
Breakthrough bleeding after about 3 months is assoc with __ induced decidualization.
|
progestin
|
|
|
A __ and __ endometrium is prone to asynchronous breakdown and bleeding.
|
shallow and fragile
|
|
|
If breakthru bleeding with low dose OCP's becomes problematic, what can it be tx's with?
|
1.25mg conjugated estrogen daily for 7 days, usually stops it.
|
|
|
lack of menses is called...
|
amenorrhea
|
|
|
serious complications of OCP's include:
|
-venous thrombosis
-PE -cholestasis -CVA, -MI |
|
|
What 3 factors such be weighed when deciding if a pt. should be put on OCP?
|
age, weight, and smoking status
|
|
|
T/F
the risk of thromboembolic disease is greater during pregnancy than in women taking OCP |
true
|
|
|
what are some less serious side effects of OCP
|
bloating
wt. gain breast tenderness h/a nausea fatigue |
|
|
less serious but more common side effects depend on the ___and___ of hormones used.
|
dosage and type
|
|
|
What is the therapeutic principal of contraception?
|
to select themethod providing effective contraception with the greatest margin of safety, so that the pt. can use it as long as they desire
|
|
|
What is postpill amenorrhea?
|
approx. 3% of pts may experience problems with resumption of their periods after prolonged oral contraceptive use
|
|
|
What drugs can interfere with the efficacy of OCP's?
|
-pcn based abx
-tetracycline -barbituates -benzodiazepines -dilantin -carbamazepine -rifampin -sulfonamides |
|
|
before prescribing OCP's to a pt the clinician should consider if there could be possible ___ reactions
|
drug
|
|
|
what is the name of the first transdermal contraceptive patch is?
|
ortho evra
|
|
|
howwhen should ortho evra be started?
|
started on the 1st day of the menstrual cycle, replace it weekly for 3 weeks, the 4th week is patch free, which allows for menses.
|
|
|
what are the s/e of ortho evra?
|
same as regular OCP's except for some women have allergic rxn's to the adhesive
|
|
|
what pt. population should ortho evra probably not be used in and why?
|
women over 98 kg, due to decreased efficacy
|
|
|
the first vaginal contraceptive is called? How does it work?
|
nuva ring
works by releasing 120mcg of etonogestrel and 15 mcg of ethinyl estradiol daily. |
|
|
the nuva ring increases pt compliance since it replaced __
|
monthly-3 weeks in, 1 week out with menses
|
|
|
t/f there is an increased incidence of breakthrough bleeding with nuva ring compared to ocp's
|
false, a decrease incidence of breakthrough bleeding with nuva ring
|
|
|
what is the name of the injectable progestin presently available in the US?
|
depo provera
|
|
|
how much/how often is depo provera given?
|
150mg every 3 months
|
|
|
the injections should be started when?
|
within the first 5 days of the menstrual cycle
|
|
|
how does depo provera work?
|
increases the thickness of the cervical mucus and decidualization of the endometrium. also acts by having circulating levels of progestin high enough to block the LH surge and hence, ovulation
|
|
|
t/f depo provera does not suppress FSH, therefore with follicular devlopment and maintenance of estrogen production, so there is no vaginal atrophy, decrease in breast size, or other estrogen deficiency symptoms
|
true
|
|
|
t/f concerns have been raised about adverse effects of depo provera on bone mineral density r/t decreased estrogen levels?
|
true
|
|
|
the efficacy of depo provera is roughly equivalent to that of __?
|
sterization
|
|
|
t/f the efficacy of depo provera is altered by the pt's weight or other medications that alter hepatic fcn
|
false, it's all good!
|
|
|
what are some contraindications for use of depo provera?
|
-high risk for osteoporosis
-known or suspected pregnancy -undiagnosed vag. bleeding -known or suspected breast ca -active thrombophlebitis or hx of thrombembolic event -hx of cva -liver dysfcn or dx -known sensitivity to depo provera |
|
|
indications for use of depo provera
|
desire of >1yr of contraception
women with difficulty remembering to take OCP's breast feeding is fine estrogen contraindications seizure dos-not affected sickle cell anemia anemia r/t menorrhagia |
|
|
oligomenorrhea means?
|
infrequent, often irregular uterine bleeding, intervals more than 34 days
|
|
|
hypomenorrhea means?
|
light, but regular uterine bleeding
|
|
|
polymenorrhea means?
|
frequent, regular uterine bleeding, intervals less than 22 days
|
|
|
menorrhagia means?
|
heavy, regular uterine bleeding
|
|
|
menometorrhagia means?
|
heavy, irregular uterine bleeding
|
|
|
what is the most worrisome symptomatic problem with depo provera?
|
irregular vaginal spotting
|
|
|
how can you treat irregular breakthru bleeding from depo provera?
|
7 days of conjugated estrogen 1.25mg/qd
|
|
|
Implanon is an investigational ___method of birth control that is effective for __years
|
sub q
3 years |
|
|
name 3 types of barrier contraception
|
condoms
diaphragms cervical caps |
|
|
every method of barrier contraception efficacy depends on what primary factor?
|
effective and appropriate placement and use of the device
|
|
|
which method is the most effective in reducing the transmission of STD's?
|
barrier, reduces the risk by at least 50%
|
|
|
what is most widely used form of contraception?
|
barriers-provide a barrier between the sperm and egg
|
|
|
if placed correctly the diaphragm should cover what female anatomy?
|
cervix
|
|
|
when should the diaphragm be inserted and how long should a woman leave it in after coitus?
|
1 hour before and left in for 6-8 hours after
|
|
|
what can effect the fitting of a diaphragm?
|
weight changes, vaginal birth or pelvic surgery
|
|
|
What are the 2 steps to fitting a diaphragm?
|
1) pelvic exam followed by a trial & error fitting until the proper size is fit
2) pt. to practice insertion, with checking for proper placement, and the ability to remove under supervision until she is comfortable |
|
|
cervical caps are not widely used due to what factors?
|
improper placement
cervicitis TSS can be difficult to properly place |
|
|
what 2 agents in spermicides are effective in killing or immobilizing sperm?
|
nonoxynol-9 and octoxynol-3
|
|
|
when/how should spermicides be placed?
|
high into the vagina 1 hour before intercourse, via gel, cream, suppository, foams, etc
|
|
|
t/f a woman using spermicide should immediately douche after intercourse
|
false, should be avoided for at least 8 hours
|
|
|
what is the names of the 2 accepted iud's
|
mirena
copper T |
|
|
how do iud's work?
|
releases 20mcg of progesterone per day. iud's make the uterus hostile to implantation of eggs. copper release enhance the inflammatory response within the uterus.
|
|
|
there are 2 types of infection r/t iud use, what are they?
|
insertional infxn, usually with in 6-8 weeks of implantation tx with doxy or zithromax
PID after 3 mths should be presumed a STD |
|
|
how long are iud's good for?
|
mirena 5 years
copper T 10 years |
|
|
iud's are contraindicated in what population
|
multiple sexual partners
|
|
|
iud insertion is best accomplished when the pt is
|
menustrating
|
|
|
what are 2 methods of emergency contraception?
|
-2 tabs of ovral (high-dose estrogen) bid x3 days
-plan b, levonorgestrel 2 tabs, 1-12 hours apart, used within 72 hours |
