W 2011 Hormone Birth Ctrl For Pas

Front 1

Drugs that may diminish effectiveness
of
OCs

Back 1

–Carbamazepine
-Phenytoin
(increase hepatic metabolism of OC)

antibiotics
~PCN
~Tetracyclines
Eradicate intestinal flora for enterohepatic cycling of contraceptive steroids = diminish effectiveness

Front 2

Act primarily by preventing ovulation

Back 2

Mechanism of action by which oral contraceptives (OC’s) prevent pregnancy

Nm MOA ?

Hint 2

Act primarily by preventing ovulation

Front 3

Act on feedback inhibition of GNrH secretion
from the
hypothalamus

~Decreased gonadotropin secretion
and
inhibition of ovulation.

Back 3

Estrogen-Progestin

MOA

Hint 3

Act on feedback inhibition of
GNrH secretion
from
hypothalamus

~Decreased gonadotropin secretion
and
inhibition of ovulation.

Front 4

Inhibits the mid-cycle

LH surge

Back 4

Progestin


Inhibits

Hint 4

mid-cycle ....

LH surge

Front 5

Decreases FSH

Back 5

Estrogen

MOA

Hint 5

Decreases FSH

(therefore decreases maturation of follicle)

Front 6

Constant in all

monophasic
biphasic
most triphasic contraceptive.

Back 6

Estrogen content

Front 7

-acne vulgaris/ lesions

-manage dysmenorrhea

Back 7

Other clinical indications for

Estrogen-Progestin combinations besides contraception.

Nm them
2ct

Hint 7

-acne vulgaris/ lesions

-manage dysmenorrhea

Front 8

~Breast enlargement
~Cyclic Wt Gain
~Dizziness
~Dysmenorrhea
~Edema
~HA
~Irritability
~N/V

Back 8

Effects of:

~Estrogen Excess

A/E
8ct

Hint 8

~Breast enlargement
~Cyclic Wt Gain
~Dizziness
~Dysmenorrhea
~Edema
~HA
~Irritability
~N/V

Front 9

~Acne
~Depression
~Fatigue
~Hirsutism
~Libido Changes
~Oily Skin
~Weight Gain

Back 9

Effects of
Progestin Excess


S/E
6ct

Hint 9

~Acne
~Depression
~Fatigue
~Hirsutism
~Libido Changes
~Oily Skin
~Weight Gain

Front 10

~DM
~Gallstones
~HTN
~MI
~Stroke
~Thromboembolic Complications

Back 10

Less frequent
but
more serious adverse effects of
~OC-s

A/E
6ct

Hint 10

~DM
~Gallstones
~HTN
~MI
~Stroke
~Thromboembolic Complications

Front 11

Greater risk of thromboembolic complications
should use another form of contraceptives

Pt Contraindicators
AGE
Acivity

Back 11

Smokers over 35 yo

Risk of what A/E?

Hint 11

Greater risk of

thromboembolic complications

Front 12

Contraindicated for women with:


~Breast CA
~CAD (hx of)
~Hepato Dz
~Gallbladder Dz
~MI (hx of)
~Reproductive Tract CA
~Thromboembolic Dz

Back 12

Estrogen OC's


Contraindicated for women with:

Hint 12

~Breast CA
~CAD (hx of)
~Hepato Dz
~Gallbladder Dz
~MI (hx of)
~Reproductive Tract CA
~Thromboembolic Dz

Front 13

Contraindicated for those W:

~Active Breast CA
~Endometrial CA
~Ovarian CA

Back 13

OCs

Contraindications
3ct

Hint 13

~Active Breast CA
~Endometrial CA
~Ovarian CA

Front 14

Studies show reduced incidence for

~Ovarian Ca
~Endometrium Ca

but

high dose estrogen preps associated w increased risk of ~Breast CA

Back 14

OC use

oral contracept

Hint 14

reduced incidence for

~Ovarian Ca
~Endometrium Ca

but

high dose estrogen preps associated w increased ris of ~Breast CA

Front 15

other clinical indications for
~Estrogen-Progestin Combos
besides contraception:

~Manage Dysmenorrhea
~Good for acne

What Rx?

Back 15

~Combination OC

~Good for acne

– Desogestrel (least androgenic)


Rx Nm that is Bad for acne:?

Hint 15

– Norgestrel (most androgenic)

Front 16

Highly Androgenic

Back 16

Norgestrel


Is Highly what?

Hint 16

Highly Androgenic

1. producing masculine characteristics.
2. pertaining to an androgen.

Front 17

Drugs(2ct)
increase the hepatic metabolism of OCs

thus

reducing plasma levels

Back 17

~Carbamazepine

~Phenytoin

A/E is what?

Hint 17

increase the hepatic metabolism of OCs

Front 18

Antibiotics that eradicate intestinal flora involved in the enterohepatic cycling of OC

Back 18

Penicillins
tetracyclines

Front 19

~Norethindrone minipills
~subdermal implants
~IUDs

~Class of Hormone?
~That release (Rx Nm)

long acting IM injections of
~medroxyprogesterone acetate

Back 19

Progesterone-Only
Contraceptives

~Levonorgestrel


Nm Them?

Hint 19

~Norethindrone minipills
~Subdermal Implants
~IUDs

(They Release)
~levonorgestrel

Long acting IM Injections of
~Medroxyprogesterone Acetate

Front 20

Mechanisms by which

~Progestin-only contraceptives

prevent pregnancy

Back 20

Decrease frequency of gnrh pulse generator
to blunt
LH surge

What Rx?
does what?

Hint 20

Mechanisms by which

~Progestin-only contraceptives

~ thickens cervical mucus
&
~slows endometrial growth
~Thinning Endometrium
~Prevent pregnancy

Front 21

What OC to use?

Smoker
Older woman
Hormone/Rx is contraindicated

Back 21

Progestin only

Estrogen contraindicated

Nm contraindications
3ct
when to use this Rx
3ct Contras....

Hint 21

Smoker
Older woman
Estrogen is contraindicated

Front 22

Amenorrhea
Ectopic Preg (Increased Risk)
Frequent Spotting
Irregular Menses

Most common problems –w this Rx

Back 22

Progestin only


4ct Most common problems –

Hint 22

Amenorrhea
Ectopic Preg (Increased Risk)
Frequent Spotting
Irregular Menses

Front 23

Used as an emergency postcoital contraceptive

when no other contraceptives have been in use

Back 23

Levonorgestrel (Plan B)

Front 24

Time-limitation for

~Levonorgestrel
(Plan B)

Back 24

Still effective up to 120 hours


What Rx

Hint 24

~Levonorgestrel
(Plan B)

Front 25

DMPA injection disadvantages

3ct

Back 25

~Decreased bone density

~Irregular Bleeding

~Irregular Menses...
(...up to 1 year after)

disadvantages of:

Hint 25

DMPA injection

Front 26

Does not affect bone density like DMPA
but
May cause irregular vaginal bleeding


Depo-Provera
Depot medroxyprogesterone acetate

Back 26

Implant

Reason to use it 1ct

AE 1ct

Hint 26

Does not affect bone density like DMPA
but
May cause irregular vaginal bleeding

Front 27

Not for women > 198 lbs.

Back 27

Patch (combination)

Front 28

Efficacy
Mechanism of action
Systemic side effects

are similar to those associated with
oral contraceptives.

In addition users may experience an
~Increased incidence of vaginal discharge.

Back 28

Ring


Efficacy
Mechanism of action
Systemic side effects

Oral Contraceptives.

In addition users may experience an

Hint 28

****
same as OCs


~Increased Vaginal Discharge.

Front 29

Thought to involve either spermicidal or inhibitory effects on sperm capacitation and transport.

Back 29

Mechanism of action of

IUDs

Front 30

If the string is not visible ....
Pt wants to continue pregnancy.....

Back 30

Pt should be informed of serious risk of sepsis & poss death with such pregnancies

IUDs

Front 31

Relieve pain of :
endometriosis
adenomyosis

Endometrial protection for women taking
Estrogen Therapy

Back 31

IUD-Progestin


-Relieve pain of :
-Endometrial protection for women taking

Hint 31

endometriosis
adenomyosis

Estrogen Therapy

Front 32

Is the ring
estrogen or progesterone based?

Back 32

Combination

Front 33

May be optimal method for women with

~Breast CA
~Breast feeding
~DM
~Dysmenorrhea
~Hepatic Dz
~Menorrhagia
~Thromboembolia

Back 33

IUD
(Progestin Only)

Optimal Indications for:
7ct
May be optimal method for women with

Hint 33

~Breast CA
~Breast feeding
~DM
~Dysmenorrhea
~Hepatic Dz
~Menorrhagia
~Thromboembolia

Front 34

Indications:

Medical termination of pregnancy thru 49th day (7Wks)
of
Gestation.
Nm Rx?

MOA
causes breakdown of endometrium (decidua)
which causes detachment of blastocyst.

Adverse Effects:

-Anorexia
-Nausea
-Vomiting
-Abd Pain
-Fatigue
-Uterine Bleeding (heavy )

Back 34

Mifepristone



~Indications: (Rules of Use)
~MOA:
~Adverse Effects (6ct):

Hint 34

-Medical termination of preg thru 49th day (7wks)
of
Gestation.

-Causes breakdown of endometrium (decidua)
which causes detachment of blastocyte

-Anorexia
-Nausea
-Vomiting
-Abd Pain
-Fatigue
-Uterine Bleeding (heavy )