AGPCNP MEGA REVIEW
What is the most common estrogen preparation? – answer ESTRODIOL
Combined contraceptive pills alter the doese of what during the cycle? - answer
Estrogen & Progestin
Are progestin-only (min pills) as effective as combination pills? - answer NO
What are 4 estrogenic effects of contraceptives? - answer1. Ovulation inhibited by
suppression of FSH/LH
2. Implantation inhibited by alteration of the endometrium
3. Ovum transport accelerated
Leutolysis as progesterone levels fall
What are 5 presentational effects of contraceptives? – answer 1. Thick cervical mucus
interrupts sperm transport
2. Capacitiation may be inhibited
3. Ovum tranport may be slowed
4. Inplantation is hampered by suppression of the endometrium
5. Ovulation inhibited by hypothalmic-pituitary-ovarian disturbance
Advantages of oral contraception? - answerExcellent protection against pregnancy
Safe for most women
Excellent reversibility
May provide protection againd endometrial CA, PID, ovarian cysts, fibroids etc...
3 non-contraceptive benefits of OCs? - answer1. Decreased menstrual cramps
2. Less menstrual blood flow
3. Improvement in facial acne
Disadvantages of OCs? - answerMood changes
No HIV protection
Rare circulatory complications
Must be take every day
SE of N/V, HA, breakthrough bleeding
Excessive estrogen effects? - answerCVA
DVT
PE
Hepatic tumors
Cholasma
cervical changes
, Estrogen deficiancy effects? - answerPOST-MENOPAUSE
Decreased duration in menstrual bleeding
Continuous spotting
Breakthrough bleeding DOC 1-9
Atrophic Vaginitis
Excess progesterone effects? - answerHTN
DEPRESSION
INCREASED APPETITE
Progesterone deficiency effects? - answerBreakthrough bleeding DOC 10-21
Delayed menses
Ecessive androgenic effects? - answerHirsuitism
Acne
Oily skin
Edema
Increased libido
What is a major absolute contraindications to OC's? - answerUNDIAGNOSED
UTERINE BLEEDING
Where to begin with OC's? - answerLow-dose COMBINED or multi-phasic (35mcg or
less)
Which OC to use in hx of migraines? - answerProgestin-only
What to do for missed pills with OC's? - answerMiss ONE day - Take 2 pills use backup
Miss TWO days - Take 2 X 2 and use backup
Miss THREE days - Throw out and restart next cycle with backup
What to do with abnormal bleeding with OCs? - answerMay need higher dose
Should breast CA hx take OC's? - answerNO
HTN on OC's? - answerLook at changing contraception first
What to do with weight gain, depression, etc... on OC's? - answerMay need to lower
dose
Should heavy smokers be on OC's? - answerNO
What can decrease the effectiveness of OC's? - answerAntibiotics and anticonvulsants
What is the most common estrogen preparation? – answer ESTRODIOL
Combined contraceptive pills alter the doese of what during the cycle? - answer
Estrogen & Progestin
Are progestin-only (min pills) as effective as combination pills? - answer NO
What are 4 estrogenic effects of contraceptives? - answer1. Ovulation inhibited by
suppression of FSH/LH
2. Implantation inhibited by alteration of the endometrium
3. Ovum transport accelerated
Leutolysis as progesterone levels fall
What are 5 presentational effects of contraceptives? – answer 1. Thick cervical mucus
interrupts sperm transport
2. Capacitiation may be inhibited
3. Ovum tranport may be slowed
4. Inplantation is hampered by suppression of the endometrium
5. Ovulation inhibited by hypothalmic-pituitary-ovarian disturbance
Advantages of oral contraception? - answerExcellent protection against pregnancy
Safe for most women
Excellent reversibility
May provide protection againd endometrial CA, PID, ovarian cysts, fibroids etc...
3 non-contraceptive benefits of OCs? - answer1. Decreased menstrual cramps
2. Less menstrual blood flow
3. Improvement in facial acne
Disadvantages of OCs? - answerMood changes
No HIV protection
Rare circulatory complications
Must be take every day
SE of N/V, HA, breakthrough bleeding
Excessive estrogen effects? - answerCVA
DVT
PE
Hepatic tumors
Cholasma
cervical changes
, Estrogen deficiancy effects? - answerPOST-MENOPAUSE
Decreased duration in menstrual bleeding
Continuous spotting
Breakthrough bleeding DOC 1-9
Atrophic Vaginitis
Excess progesterone effects? - answerHTN
DEPRESSION
INCREASED APPETITE
Progesterone deficiency effects? - answerBreakthrough bleeding DOC 10-21
Delayed menses
Ecessive androgenic effects? - answerHirsuitism
Acne
Oily skin
Edema
Increased libido
What is a major absolute contraindications to OC's? - answerUNDIAGNOSED
UTERINE BLEEDING
Where to begin with OC's? - answerLow-dose COMBINED or multi-phasic (35mcg or
less)
Which OC to use in hx of migraines? - answerProgestin-only
What to do for missed pills with OC's? - answerMiss ONE day - Take 2 pills use backup
Miss TWO days - Take 2 X 2 and use backup
Miss THREE days - Throw out and restart next cycle with backup
What to do with abnormal bleeding with OCs? - answerMay need higher dose
Should breast CA hx take OC's? - answerNO
HTN on OC's? - answerLook at changing contraception first
What to do with weight gain, depression, etc... on OC's? - answerMay need to lower
dose
Should heavy smokers be on OC's? - answerNO
What can decrease the effectiveness of OC's? - answerAntibiotics and anticonvulsants
