OTC Final Exam Content:

What is the primary contraceptive agent?

Progestin

What does a low dose of progestin do?

thickens cervical mucus which prevents sperm penetration

What does a moderate dose of Progestin do?

often prevents LH surge → often prevents ovulation

What does a high dose of Progestin do?

prevents LH surge → prevents ovulation

What is another reproductive system effect that Progestin has and what does it do?

Endometrial atrophy → lightens period

What are some non-contraceptive effects of Progestin?

abnormal bleeding or amenorrhea, acne, hirsutism, reductions in bleeding and cramps, may potentially decrease risk of endometrial cancer

What is the dose window for progestin?

3 hrs

What do you do if progestin is not taken within the dose window?

Backup should be used for 48 hours

What is “Day 1 Start” for POPs?

taken on day 1 of menses, no backup required

What is “quick start” of POPs?

taken on day obtained, backup should be used for 48 hours

What is Class A recommended screenings?

essential and mandatory for safe & effective use

What is Class B recommended screenings?

contributes substantially to safe & effective use

What is Class C recommended screenings?

does NOT contribute substantially to safe & effective use

What screening(s) are required for POPs?

None required (all class C)

POPs are not effective if taken with which drugs?

Rifampin/Rifabutin or anticonvulsants

What are contraindications for POPs?

Current breast cancer and Chronic Kidney Disease patients can start using POPs but may have to stop

What is the ova’s viability?

12-24 hours after ovulation

What is the sperms viability?

5 days after ejaculation

Ulipristal Acetate (UPA) Brand:

Ella

Levonorgestrel (LNG) Brand:

PlanB

Which emergency contraceptive is anti-progestin?

Ulipristal / Ella

Which emergency contraceptive is progestin only?

Levonorgestrel / PlanB

Are Ella and PlanB both OTC?

No, only PlanB (levonorgestrel) is

Levonorgestral (Plan B) is most effective:

Within 72 hours of intercourse, but may work up to 120 hrs (5 days)

What BMI is Levonorgestrel (Plan B) less effective?

BMI > 25

What BMI is Levonorgestrel (Plan B) ineffective?

BMI > 30

When can hormonal contraception be resumed after taking Levonorgestrel (Plan B)?

immediately

When can hormonal contraception be resumed after taking Ulipristal (Ella)?

5 days after EC

What is LNG (Plan B) MOA:

delays ovulation and release of the oocyte IF LH surge has not started

What is UPA (Ella) MOA:

delays ovulation and release of oocyte sometimes even after LH surge has started

Is double-dosing LNG (Plan B) effective in obese patients?

No!

What is the efficacy of EC?

about 75%

After taking EC, when should menses begin?

within 3 weeks

Who can purchase OTC LNG?

Anyone of any age or gender. No ID check required

What is nonoxynol-9?

a spermicide (surfactant that destroys the sperm cell membrane)

Who should not use spermicides?

Women who are HIV infected or are at high risk of acquiring HIV

How long is Foam or Gel spermicide effective?

1 hr

How long should you wait to have sex after inserting a spermicide suppository and how long is it effective?

15 min. Effective for 1 hr

How long should you wait to have sex after inserting a spermicide film and how long is it effective?

15 min. Effective 3 hrs

What is Narcan (Naloxone)?

a competitive opioid antagonist

What is Narcan’s onset of action (nasal)?

2-17 min, usually 2-3 min

What is Narcan’s duration?

30-120 min

What do someones eyes look like if they are overdosing?

Pinpoint pupils (don’t react to light)

What drug class is Ranitidine (Zantac)?

H2 receptor antagonist

Original Pepto Bismol:

Bismuth subsalicylate

Pepto Kids:

calcium carbonate

Pepto Nausea tablet:

Meclizine

Pepto Nausea Gummy:

Ginger

Pepto Gas & Bloating:

Simethicone

Pepcid AC:

Famotidine

Pepcid Complete:

famotidine, calcium carbonate, & magnesium hydroxide

Pepcid Heartburn Relief & Stress Relief:

tricalcium phosphate & lemon balm extract

Pepcid Heartburn relief & sleep support:

tricalcium phosphate & melatonin

Which type of condom does not degrade with oil-based lubricants?

Non-latex & natural membrane

which type of condom is only for pregnancy prevention, not STIs?

natural membrane

What is vulvovaginal candidiasis?

“yeast infection” or “vaginal thrush”

Relief of VVC symptoms should occur within how many days of starting treatment?

1-2 days

ALL VVC symptoms should be resolved how long after starting treatment?

1 week

If VVC symptoms persist beyond the first 48 hours, what do you do?

Refer!

What is atrophic vaginitis due to?

reduction in estrogen which leads to inflammation of the vagina

Atrophic Vaginitis treatment focuses on:

alleviating primary symptoms of dryness

What is dysmenorrhea?

painful menstruation

what is first line treatment for dysmenorrhea?

NSAIDS (ibuprofen 400 mg or naproxen 500 mg then 220 mg)

What is Premenstrual Dysphoric Disorder (PMDD)?

a severe form of PMS

What is caused when there are fluctuations in estrogen and progesterone?

PMS