Term
Combined Oral Contraceptives (COC)
contains 2 hormones: |
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Definition
estrogen (almost always ethinyl estradiol)
progestin (norethindrone, norgestimate, desogestrel, levonorgestrel, drospireonone, ect) this will vary btwn types of BC |
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Term
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Definition
monophasic- same dose in all 28 pills
biphasic- changes dose every day
triphasic- changes dose 3 times a month |
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Term
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Definition
| minimize/eliminate menstral period all together for 3-4 months |
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Term
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Definition
prevent of unintended preg
mgt of abnormal vag bleeding esp in adolescents
mgt of certian medical issues: endometriosis, PCOS, menstrual migrane (without aura)
context: preg is the leading cause of death around the world |
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Term
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Definition
inhibits feedback of pituitary hormones
suppresses FSH- no follicles, no ovulation
no follicles- no lutenizing hormone- menstruation disrupted
increases sex hormone binding globulin, binds free androgen |
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Term
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Definition
fluid retention
mood changes
headache
nausea
blood clots(get a good fam hx)
n/v
lack of withdrawal bleeding (no period) |
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Term
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Definition
thicken cervical muscus (sperm can't get in)- PRIMARY action
this uterine lining (endometrium), inhibits implantation (also helps with heavy irregular bleeding adn cramping
alters tubal transport time (may have increases risk for ectopic pregnancy)
mood changes, acne, weight gain, irregular bleeding(if taken without estrogen) |
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Term
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Definition
progestin
increase K+ higher rate of blood clots (Yaz, Yasmine, Ocella) |
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Term
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Definition
blood clots in legs or lungs
unintended pregnancy (not taking correctly)
risks of clots more serious in smokers >35 (give them the lowest estrogen dose)
effects on lipids
lab test- hx, STDs, lipids, obese, fam hx of VTE |
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Term
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Definition
ACHES
correct use- reminders, back up method
when to start
missed pills
managing side effects
drug interactions- antibiots, metab of some drugs effected |
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Term
Progestin-only Pills (POP)
why? |
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Definition
| some women can not use estrogen |
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Term
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Definition
HTN (160/100, vascular disease)
Diabetes (>20 yrs, retinopathy, nephropathy)
Hx thromboembolism, CVA, PE
breast feeding, early postpartum, pregnancy
liver disease
breast cancer
35 and smoking
major surgery
migraine with aura
structural heart disease, PH, A fib
Factor V Leiden mutation-genetic cond
hypercholesterolemia |
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Term
| Differences btwn POP and COC |
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Definition
POP- irreg cycle control
POP have no drug free time
precision of POP use is much more important
POP have higher failure rates
causes ovarian cysts
ectopic pregnancy-higher in COC |
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Term
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Definition
when to start-diff for diff pt
use of back-up method (not effective right away)
diff bleeding pattern- unpredictable, irreg spotting
use EXACTLY as directed- miss POP increase risk of pregnancy
timing is important
no missed pills- 3 hrs late is missed dose!!!!
drug interactions |
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Term
| non-contraceptive benefit of OC's |
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Definition
regular, predictable cycles
better iron counts
decreased fibrocystic breast disease
decreased risk of ovarian cancer
improve acne
PMDD (only YAZ)
decreased menstrual pain, heavy bleeding |
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Term
| depot medroxyprogesterone acetate |
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Definition
the "shot"
progestin only= irreg bleeding
injectable q 3 months
low failure rate
weight gain 1yr=5-6 lbs
bone thinning >5 yrs (extra calcium and vit D)
reversible (5-6 months can get preg) |
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Term
emergency contraception
plan B/next choice/ella/postinor |
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Definition
post-coital (3-5 days)
progestin-only
could prevent 2 million unintended pregnancy, 1 mil abortions
OTC >17 yrs or older
FDA approved
Cooper T also approved |
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Term
| plan b is primary used for |
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Definition
| sexual assaults, incest, method failure |
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Term
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Definition
effective up to 5 days after sex
safe
range 50%-100%
most COC can be combined to use as morning after contraception- contact PCP
no intended for regular use |
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Term
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Definition
class: macrolide antibiotic
related to erythromycin (longer half life)
interferes with protein synthesis of cell wall but does not effect human
bacteriostatic action |
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Term
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Definition
class: tetracycline antibiotic
effective against gram+ and - bacteria
increased sensitivity to light
not given in pregnancy (affects skeletal development of fetus, discolors teeth)
blocks protein synthesis, action is bacteriostatic |
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Term
| drugs that treat genital herpes simplex type 1 and 2 |
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Definition
| class- nucleoside analogue- valacyclovir, famciclovir, acyclovir |
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Term
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Definition
| selective inhibitory action against certain types of viruses by binding to their DNA and inactivating its enzymes |
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Term
acyclovir
pharmacokinetics |
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Definition
| oral preparation dose varies for initial acute phase, chronic recurrent or preventive (to an uninfected partner) therapy |
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Term
imiquimod
class- immune response modifier: MOA |
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Definition
| targets body's immune system (cytokines, receptors and inflammatory cells) and activates antigen-presenting cells to combat disease |
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Term
imiquimod
class- immune response modifier: indications |
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Definition
| treatment of ext genital warts (HPV), superficial basal/squamous cell cancer |
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Term
condylox
class- antimitotic: MOA |
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Definition
| unknown- necrotizes visible wart tissue |
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Term
Quadrivalent and bivalent HPV vaccine
Gardasil and Cervarix |
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Definition
preventive, not therapeutic
give before exposure 99.9% effective (before sexual content)
FDA approved fro girls and boys 9-26 |
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Term
| podofilox .5% cream or gel |
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Definition
pt applied
not used in pregnancy-suppresses immune function and warts block birth canal |
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Term
podofilox .5% cream or gel
pt teaching |
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Definition
3 x weekly up to 16 weeks
wash off in the AM
redness, hyper/hypo pigmentation occurs, skin irritiation
must be able to visualize all warts
not used internally
avoid sex during treatment |
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Term
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Definition
active against HSV 1&2, epstein barr, varicella zoster and CMV
offers no cure, but capable to altering clinical course of disease, reducing symptoms, decreasing recurrences, reduce partner transmission |
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Term
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Definition
| selectively inhibits the replication of HSV (types 1 and 2) and VZV (shingles) |
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Term
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Definition
all partners need to receive treatment
no cure for viral infections
can pt afford medication? |
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Term
| teaching pts for imiquimod |
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Definition
apply externally, good results may take 12 weeks
this is not a cure
very readily spread to partners/safe sex practices
opportunity to discuss vaccines
use is 3 x weekly at night, wash off in am
expensive-
skin may turn red, inflammed- d/c use temporarily |
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Term
Fluconazole (Diflucan)
MOA |
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Definition
| disrupts cell wall membrane via inhibition of cytochrome P450 enzyme |
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Term
Fluconazole (Diflucan)
pt teaching |
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Definition
single tablet dose (150-200 mg)
drug interactions (less common with single dose)
symptoms improvement may take 2-3 days
side effects- n/v, head ache, liver effects |
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Term
Fluconazole (Diflucan)
used for |
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Definition
| HIV, chronic recurring vaginal complaints |
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Term
| issues with OTC vaginitis drugs |
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Definition
treating the right diagnosis
consequences to disruption of normal vag flora
vaginal irritation sometimes worsens with drug
treat after menses
avoid tampon use
may diminish condom effectiveness |
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Term
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Definition
| oral 250 mg, 500 mg, 750 mg single dose |
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Term
metronidazole (Flagyl)
used for |
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Definition
| treatment of anaerobic and protozoal organisms |
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Term
metronidazole (Flagyl)
moa |
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Definition
| enters the cell, reductive activiation by intracellular transport proteins, cytotoxic, breaks down cellular DNA |
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Term
metronidazole (Flagyl)
pt teaching |
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Definition
avoid alcohol- induces severe vomiting
complete all therapy
metallic taste orally
sometimes vag yeast results-may co-prescribe antifungal
prolonged treatment sometimes helpful in decreasing recurrences
avoiding BV: condoms, limit partners, urine may discolor to orange |
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