Contraceptions and STI prevention

What is the recommended age for routine HPV vaccination according to ACIP?

11-12 years

What is the dosing schedule for the HPV vaccine for individuals under 15?

2 doses at 0 and 6-12 months

What is the dosing schedule for the HPV vaccine for individuals 15 and older?

3 doses at 0, 1-2 months, and 6 months

What are the most common side effects of the HPV vaccine?

Irritation at injection site, malaise, syncope

Why should patients be monitored after receiving the HPV vaccine?

Due to risk of syncope

What is the vaccination schedule for Hepatitis B?

0, 1, and 6 months

Who are the candidates for the Hepatitis B vaccine besides newborns?

Individuals with multiple sexual partners, injection drug users, healthcare and emergency response personnel, individuals with diabetes, end-stage renal disease, HIV infection or liver disease, international travelers, residents of correctional, drug abuse or HIV treatment facilities

What are the most common side effects of the Hepatitis B vaccine?

Soreness at injection site, fatigue

What types of condoms can be used for both contraception and STI protection?

Latex and synthetic (non-latex) condoms

Which condom types can be degraded by oil-based lubricants?

Latex and polyisoprene condoms

Name three water-based lubricants safe for use with latex condoms.

Contraceptive foams and gels, water-based personal lubricants (K-Y Jelly), silicone-based lubricants (Astroglide)

Name three oil-based lubricants that are unsafe for use with latex condoms.

Baby oil, petroleum jelly (Vaseline), olive oil

What is the onset of action for vaginal spermicide gel?

Immediate

What is the duration of action for vaginal spermicide foam?

1 hour after application

How long before intercourse should a vaginal spermicide suppository be inserted?

10-15 minutes

What is the duration of action for vaginal contraceptive film?

3 hours after application

How long can the vaginal contraceptive sponge be left in place after intercourse?

At least 6 hours but no longer than 30 hours total

Do spermicides provide protection against STIs when used alone?

No

How long should douching be delayed after intercourse when using spermicide?

At least 6 hours

What is a potential risk of frequent use or high concentration spermicide products?

Irritation or damage to vaginal and cervical epithelium

What is the Standard Days Method and for whom is it recommended?

Counts the first day of menstruation as day 1 and fertile days as days 8-19; recommended for women with cycles 26-32 days in length

How does the Cervical Mucus Method work?

Women check cervical mucus for increase in quantity and elasticity; clear, stretchy mucus indicates fertility

What is the Two-Day Method?

Women monitor secretions daily; if secretions are present that day or the day before, they are likely fertile

How does the Basal Body Temperature Method indicate fertility?

A slight increase in body temperature (0.4-0.8°F) indicates ovulation has occurred; fertile period is from the start of the cycle until 3 days after the temperature rise

What is the Symptothermal Method?

Combines Basal Body Temperature and Cervical Mucus methods

How do ovulation detection kits work?

Measure luteinizing hormone (LH) levels in urine; a surge in LH indicates ovulation is about to occur

What is the Lactational Amenorrhea Method and its limitations?

Relies on breastfeeding to suppress ovulation; effective only if the infant is <6 months old, breastfeeding is exclusive and frequent, and menses has not returned

What factors can affect the efficacy of levonorgestrel emergency contraception?

Time since unprotected intercourse (>120 hours), BMI (>26), vomiting within 1-2 hours after taking the pill

What should be recommended for emergency contraception if BMI >26?

Ulipristal acetate (Ella) or copper IUD

What is the most common side effect of emergency contraception?

Nausea and vomiting

What can pharmacists prescribe if more than 3 days have passed since unprotected intercourse?

Ella (ulipristal acetate), which is effective up to 5 days

When is the best time to take emergency contraception?

As soon as possible after unprotected intercourse

What should a patient do if they vomit within 1-2 hours of taking emergency contraception?

Repeat the dose

What OTC medications can be recommended to prevent nausea/vomiting with emergency contraception?

Meclizine (Bonine), diphenhydramine (Benadryl), dimenhydrinate (Dramamine), cyclizine (Marezine)

What does a surge in LH indicate in the context of ovulation?

Ovulation is about to occur

Why are fertility awareness-based methods not optimal for women with irregular cycles?

Because these methods rely on predictable cycle lengths to determine fertile days