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Contraceptives and Progestins

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zidazije's version from 2017-04-05 05:40

Section

Question Answer
MifepristoneAntagonizes the GC receptors and Progesterone Receptors, used as emergency postcoital contraceptive and in Cushing's syndrome
Ulipristal acetatePartial agonist of the PR, emergency contraception within 120 hrs
COCscombination of estrogen and progestins
POPs Progestin only Pills, less effective than COCs, can cause irregular menstrual cycles
Ethinyl estradiolEstrogen used in COCs
NorethindroneSole component of POPs
LevonorgestrelProgestin used as emergency contraceptive
Triphasic Oral ContraceptivesEstrogen dose held constant, progestin dose increased q 7 days for 3 weeks
Monophasic Oral Contraceptive Estrogen and Progestin dose held constant for 21-24 days
Transdermal patchescomparable efficacy to COCs, worn weeks 1-3, patients must be less than 90 Kg
medroxyprogesterone accetateInjection every 3 months, provides high levels of progestin
Progestin implantssubdermal etonorgestrel, 3 yr contraception
Postcoital ContraceptivesHigh dose levonorgestrel (sometimes with ethinyl estradiol), take within 72 hrs, Ulipristal can be taken within 5 days
Contraceptive Failure causesone or more missed doses, enzyme inducers, some antibiotics
Mild ADRs of contraceptives (progestins)depression, libido changes, acne
Mild ADRs of contraceptives (estrogens)Nausea, increased BP, breakthrough bleeding
Moderate ADRs of ContraceptivesBreakthrough Bleeding, Weight gain, skin pigmentation, vaginal infections, amenorrhea
Severe ADRs of ContraceptivesVascular disorders: DVT, MI. Cholestatic jaundice, Depression (p)
CIs & CautionsCV risks, pregnancy, possible Breast tumor (ER+), unknown vaginal bleeding, liver disease
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