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Pharm Lec 1 - Contraceptives Flashcards | StudBud
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Pharm Lec 1 - Contraceptives
Pharm Lec 1 - Contraceptives
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Don't pull the goalie!
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Answers
1
Pt is 25 using the vaginal ring develops migraines but no c/o of spots/zig zags (no aura). Next step?
Switch to a low dose CHC pill
Discontinue vaginal ring, consider progestin only option
Remove pt from all hormonal birth control
2
T/F backup nonhormonal method should be used after emergency contraception for 7 days
false
true
3
T/F a pap smear is necessary before a combined hormonal contraceptive is Rx'd
false
true
4
T/F the copper IUD can be used to terminate a fertilized egg up to 5 days
true
false
5
T/F typical use vs perfect use efficacies are significant in long acting reversible contraceptives
true
false
6
How long until maximum effectiveness for a newly started BC method?
2 days
7 days
1 month
3 months
7
WOF is an IUD that contains copper?
ParaGard
Skyla
Liletta
Nexplanon
8
What would you want to give to a pt with high androgen levels?
Ortho Evra
Nexplanon
Depo-Provera
Levonorgestrel
9
Pt w/o coexisting med conditions, an OC w/ 35mcg or less of EE and <0.5 progestin is recommended
false
true
10
__ thicken cervical mucus, induce endometrial atrophy, inhibit ovulation by blocking LH surg
Estrogens
Progestins
11
Pt asks how long to leave in the sponge after sex, and how long is the max it can stay in?
6 hours post sex, no more than 12 hours total
Not needed post sex, keep in no more than 6 hours
6 hours post sex, no more than 24-30 hrs total
24-30 hours post sex, 6 additional hours total
12
Pt admits she doesn't always take her pill on time, sometimes forgets. What is her estimated efficacy?
85%
92%
99%
71%
13
Pt had her baby 8 weeks ago and is wanting to start CHCs, is this ok?
True - let's get you started!
False - pt still can't have 'em
14
Depot Medroxyprogesterone has a BBW for WOF
Risk of severe bleeding
Thromboembolism
Breast cancer
Short term bone density loss
15
A small increase in risk of what cancer is associated with oral contraceptives?
Breast Cancer
Endometrial Cancer
Uterine Cancer
Ovarian Cancer
16
What is the longest amount of time the ring can be out and still be effective?
24 hr
1 hr
3 hr
6 hr
17
WOF is not a benefit to CHC use?
Relief from menses issues: heavy bleeding, irregularity
Reduced risk of cysts, ectopic, PID
Reduced risk of ovarian and endometrial cancer
Increase in iron deficiency anemia
18
WOF is ABSOLUTE contraindication for CHCs? (choose 2)
Diastolic BP >100 mmHg
Systolic BP >100 mmHg
Diastolic BP >100 mmHg
Systolic BP >160 mmHg
19
T/F pts starting a progestin only method, will exp bleeding, but over time become amenorrhoeic
false
true
20
WOF does not match for return of fertility after discontinuation?
Subdermal Implant: 30 days
IUDs: Almost immediate
Pill: 1-2 weeks
Shot: 2 months
21
Underweight, adolescents, pt >35 and perimenopausal pts should receive how much EE?
>40 mcg
Empty choice
30-35 mcg
20-25 mcg
22
Why would a pt newly started on BC contract an STD?
They wouldn't get an STD, they are protected
Because they're protected from prego and don't use condoms!
Because certain BC methods cover STDs and some don't
Because BC makes you more susceptible to STDs
23
Pt is taking Yaz which contains Drosperinone, along with Losartan, what is she at increased risk for?
Hyperkalemia
Hypokalemia
Hypertension
Hypotension
24
WOF drugs are NOT known to decrease the efficacy of oral contraceptives?
Rifampin
Phenobarbital
Medroxyprogesterone
Carbamazepine
25
Ortho-Novum 1/35 is commonly Rx'd. The 1 refers to ___ and the 35 refers to ___.
Micrograms Estrogen, Milligrams Progestin
Milligrams Progestin, Milligrams Estrogen
Micrograms Estrogen, Micrograms Progestin
Milligrams Progestin, Micrograms Estrogen
26
What can decrease the efficacy of a Nexplanon implant?
Anorexia nervosa
Obese pt
Diabetes
SLE
27
WOF is not one of the three synthetic found in hormonal contraceptives in US?
Ethinyl Estradiol (EE)
Mestranol
Estradiol Valerate
Conjugated Estrogens
28
Is there a difference in efficacy/AE profile between multiphasic/monophasic OCs?
Research says.... No
Yes
29
Pt had her baby 2 weeks ago and is wanting to start CHCs - is this ok?
False - hypercoagulable for first 21 days
True - let's get you started!
30
WOF accurately describes monophasic OCs?
21 days of variable amnts of estrogen/progestin
21 days of same amnt of estrogen/progestin
31
WOF should be considered for patients who smoke?
Paragard IUD (copper)
Nexplanon implant
Depo-Provera injection
Progestin-only pill
32
T/F the levonorgestrel IUDs have many drug interactions
true
false
33
WOF are possible AEs of progestin Tx if pt has a low level of sex hormone binding globulin?
Weight Gain
Painful menses
Hirsutism, acne, depression
Painful breasts
34
WOF is a transdermal patch that is changed weekly for 3 weeks?
Paragard IUD
Depo-Provera injection
NuvaRing
OrthoEvra
35
WOF populations best benefit from the use of Depo Provera injection?
Seizures
Pt intolerant to estrogen
Adherence issue
Breastfeeding pt
36
WOF are BBWs for hormonal contraceptives?
Risk increases esp in pt >35
Smoking increases CV events
Risk increases w/ # of cigarettes smoked
Smoker >35 = absolute CI'd
37
This chemical is what is most important to destroy sperm cell walls w/in spermicides
Nonoxynol-9
Oxybutynin
Cycloheptadiene
Mifepristone
38
In which example should a pt toss the rest of her OCP pill pack and start fresh? (and use condoms for 7 days)
Missed none - do this every time
Missed 2 or more consecutive tablets
Missed tablets in the last hormonal week
Missed 1 day of hormonal pills
39
WOF accurately describes multiphasic OCs?
21 days of same amnt of estrogen/progestin
21 days of variable amnts of estrogen/progestin
40
__ suppress FSH release, stabilize endometrial lining, provide cycle control
Progestins
Estrogens
41
WOF is the regimen of choice for unintended pregnancy?
Ethinyl Estradiol
Ulipristal
Levonorgestrel
Mestranol
42
T/F spermicides may increase the risk of HIV transmission
false
true
43
CHCS are not recommended in which population?
>35 w/ migraine
Diabetes/smoker
>35, healthy, non-obese
Uncontrolled HTN/vascular dz
44
T/F all women should be considered candidates for LARCs?
true
false
45
Pt is 21 y/o and gets migraines with aura - is she ok to get a combined hormonal method?
TRUE - she's under 35 she's good
FALSE - aura at ANY age increases risk of stroke
46
WOF is NOT an example of a barrier method of birth control?
Sponge
Condom
IUD
Diaphragm
47
Most combined OCs, the patch, the ring contain doses of ___ of Ethinyl Estradiol
50-75mcg
20 - 50mcg
35-80mcg
10 -15mcg
48
Pts should immediately discontinue CHCs if the experience WOF?
Chest Pain - hemoptysis
Eye Problems - loss of vision, diplopia
Abdominal Pain - hepatic mass/tenderness
Severe Leg Pain or numbness or tingling
49
WOF is NOT a contraindication to an IUD?
Current STD
Undiagnosed abnormal vaginal bleeding
Current pregnancy
Typical uterine anatomy
50
WOF birth control methods does a pt need to replace least frequently?
Paragard IUD
Subdermal Implant
Patch
Ring
51
There is a difference in bleeding/spotting w/ pts who have used OCs for extended period
Research says.... False
true
52
A disadvantage of the ParaGard compared to a levonorgestrel IUD is what?
ParaGard is more challenging to remove
ParaGard can result in heavier, crampier periods
ParaGard is effective for up to 10 years
ParaGard can cause Wilson's disease
53
What instructions should be given if pt has nausea/bloating/bleeding after 1 mo of using OCs?
D/C immediately
Keep going! Try at least 3 months
54
Incidence of thromboembolism and mortality is increased by ____ in current OC users vs non users
3x
5x
0x
10x
