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MAOIs (monoamine oxidase inhibitors) isocarboxide, phenelzine, tranylcypromine ■ Rarely used because of serious food (high tyramine content) and drug interactions - (elevates BP, risk of stroke) ■ Do not combine with SSRIs, TCAs, MAO-B (selegiline/Eldepryl), serotonin receptor agonists (sumatriptan/Imitrex, zolmitriptan (Zomig) Inevitable abortion vaginal bleeding with pain, cervical dilation, and/or cervical effacement threatened abortion vaginal bleeding without dilation of the cervix (cervix is closed, long and thick) no passage of tissue no or minimal pain incomplete abortion moderate to diffuse vaginal bleeding, with incomplete expulsion of the products of conception, and painful uterine cramping contractions Severe preeclampsia can cause placental abruption, hypertensive encephalopathy, liver failure, kidney failure, pulmonary edema, seizures, retinal detachment, DIC, and death palpable ovary in a menopausal woman always abnormal. Rule out ovarian cancer. Order a pelvic/intravaginal ultrasound and refer to a gynecologist. Satisfactory Pap smear should contain what cell types endocervical cells & squamous epithelial cells precocious puberty in girls / boys is onset of secondary sex characteristics before age..... age 8 in girls age 9 in boys precocious puberty in girls / boys is onset of secondary sex characteristics before age..... age 8 in girls age 9 in boys precocious puberty in girls / boys is onset of secondary sex characteristics before age..... precocious puberty girls / boys Satisfactory Pap smear should contain what cell types endocervical cells & squamous epithelial cells BCP danger signs 'ACHES' A Abdominal pain C Chest pain H Headaches E Eye problems; change in vision S Severe leg pain menopausal changes in women include: -decreased tactile stimulation of skin -decreased erectile response in breast with sexual stimulation -shortened vagina with loss of elasticity and decreased secretions d/t decreased estrogen levels -hot flashes Drug interactions with oral contraceptives ■ Anticonvulsants: Phenobarbital, phenytoin ■ Antifungals: Griseofulvin (Fulvicin), itraconazole (Sporanox), ketoconazole (Nizoral) ■ Certain antibiotics: Ampicillin, tetracyclines, rifampin ■ St. John's wort: May cause breakthrough bleeding use an alternative form of birth control (condoms) when taking these drugs and for one pill cycle afterward. Yaz best for women with- Higher risk of - acne, PCOS, hirsutism, or premenstrual dysphoric disorder (PMDD). Higher risk of DVT and hyperkalemia 21 to 24 years with LSIL Pap result repeat Pap test in 12 months. BCP for breastfeeding women Progestin-Only Pills (Micronor) known as minipill Low-dose birth control pills contain how much ethinyl estradiol (estrogen, Estrogen Receptor Agonist) 20 to 25 mcg of ethinyl estradiol. 25 to 29 years with LSIL Pap result follow up with colposcopy and with cervical biopsy. BCP for acne Desogen Ortho-TriCyclen Yaz/Yasmin Avoid using Depo-Provera in which pts? anorexic and bulimic patients (very high risk of osteoporosis). Absolute Contraindications for BCP "My CUPLETS" My Migraines with focal neurological aura C CAD or CVA (HTN>160/100) U Undiagnosed genital bleeding P Pregnant or suspect pregnancy L Liver tumor or active liver disease E Estrogen-dependent tumor T Thrombus or emboli S Smoker age 35 or older NSAID that is very effective for menstrual pain Mefenamic acid (Ponstel)
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