Women's Health Pharm UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS
progestin only pills are also called mini pills
3 types of estrogen used in COCs ethinyl estradiol, mestranol, and estradiol valerate
MC type of estrogen used in COCs ethinyl estradiol
1st generation progestins norethindrone, ethynodiol
2nd generation progestins Norgestrel
Levonorgestrel
3rd generation progestins desogestrol, drospirenone, ad norgestimate
most low dose COCs contain how much EE 20-35 mcg
high dose COCs contain how much EE 50 mcg
is there a difference in the effectiveness of mono phasic no
and multiple phasic COCs
indications for high dose COCs spotting o absence of bleeding with lower dose pills, acne, ovarian cysts, and
endometriosis
what are the most potent progestins found in COCs desogestrel, levonorgestrel, and norgestrel
, least potent progestin in COCs norethindrone
what are the most adrogenic progestins jorgestrel and levonorgestrel
s/s of too much estrogen in COC N/V, breast enlargement, dizziness, bloating, melasma, dysmenorrhea, increased
BP
signs that amount of estrogen made need to be early or mid cycle breakthrough bleeding, continuous bleeding, hot flashes,
increased in COC hypomenorrhea
s/s of too much progestin breast tenderness, headache, depression, decreased libido
signs that the amount of progestin may need to be late breakthrough bleeding
increased in COC
which progestins are likely to cause acne, oily skin, norgestrel and levonorgestrel
decreased libido, hirsutism, weight gain
effect of COCs on ovaries prevention of follicular development and ovulation
effect of COCs on cervix thickening of cervical mucus to inhibit passage of sperm
effect of COCs on the uterus reduction in development of the endometrium (making it thinner) inhibits
implantation
patient education if they have missed 2 or more COCs take most recent pill ASAP and continue remaining pills as usual. needs to used
backup contraception for next 7 days
a missed pill is concerned most concerning at what point before and after the hormone free interval (ovulation can occur if hormone free
in time? period > 7 days)
describe the relationship between estrogen level and risk lower the dose, higher the risk
of contraceptive failure if pill is missed
COCs increase the risk of what conditions stroke, MI, CAD associated with VTE
contraindications for COCs active liver disease, active breast cancer, SLE
what conditions are exacerbated by COCs migraines and gall bladder disease
warning signs for COCs abdominal pain, chest pain, headaches, eye problems, severe leg pain (ACHES)
what are some benefits of COCs decreased blood loss and anemia, decreased PID, decreased risk of
ovarian/endometrial/colorectal cancer, decreased risk of benign breast disease,
possible increase in BMD
what precautions should be taken if a patient is on a COC do not give to patients with kidney or adrenal disease, check if patients are on
contained drospirenone medications that cause hyperkalemia (ACEI/ARBs, etc)
progestin only pills are also called mini pills
3 types of estrogen used in COCs ethinyl estradiol, mestranol, and estradiol valerate
MC type of estrogen used in COCs ethinyl estradiol
1st generation progestins norethindrone, ethynodiol
2nd generation progestins Norgestrel
Levonorgestrel
3rd generation progestins desogestrol, drospirenone, ad norgestimate
most low dose COCs contain how much EE 20-35 mcg
high dose COCs contain how much EE 50 mcg
is there a difference in the effectiveness of mono phasic no
and multiple phasic COCs
indications for high dose COCs spotting o absence of bleeding with lower dose pills, acne, ovarian cysts, and
endometriosis
what are the most potent progestins found in COCs desogestrel, levonorgestrel, and norgestrel
, least potent progestin in COCs norethindrone
what are the most adrogenic progestins jorgestrel and levonorgestrel
s/s of too much estrogen in COC N/V, breast enlargement, dizziness, bloating, melasma, dysmenorrhea, increased
BP
signs that amount of estrogen made need to be early or mid cycle breakthrough bleeding, continuous bleeding, hot flashes,
increased in COC hypomenorrhea
s/s of too much progestin breast tenderness, headache, depression, decreased libido
signs that the amount of progestin may need to be late breakthrough bleeding
increased in COC
which progestins are likely to cause acne, oily skin, norgestrel and levonorgestrel
decreased libido, hirsutism, weight gain
effect of COCs on ovaries prevention of follicular development and ovulation
effect of COCs on cervix thickening of cervical mucus to inhibit passage of sperm
effect of COCs on the uterus reduction in development of the endometrium (making it thinner) inhibits
implantation
patient education if they have missed 2 or more COCs take most recent pill ASAP and continue remaining pills as usual. needs to used
backup contraception for next 7 days
a missed pill is concerned most concerning at what point before and after the hormone free interval (ovulation can occur if hormone free
in time? period > 7 days)
describe the relationship between estrogen level and risk lower the dose, higher the risk
of contraceptive failure if pill is missed
COCs increase the risk of what conditions stroke, MI, CAD associated with VTE
contraindications for COCs active liver disease, active breast cancer, SLE
what conditions are exacerbated by COCs migraines and gall bladder disease
warning signs for COCs abdominal pain, chest pain, headaches, eye problems, severe leg pain (ACHES)
what are some benefits of COCs decreased blood loss and anemia, decreased PID, decreased risk of
ovarian/endometrial/colorectal cancer, decreased risk of benign breast disease,
possible increase in BMD
what precautions should be taken if a patient is on a COC do not give to patients with kidney or adrenal disease, check if patients are on
contained drospirenone medications that cause hyperkalemia (ACEI/ARBs, etc)
