Amniellys Rodriguez Diaz

2 hours ago, at 8:55 PM

Before prescribing an OCP regiment, it would be important to conduct cardiovascular examination. This is because the risk of cardiovascular disease increases with the use of contraception in women. Since the patient’s father had two heart attacks, with the second one that killed him, it would be important to assess for heart disease (Abarbanell et al., 2019). This would include blood test for lipids, as well as echocardiogram, and stress test. 

Some contraceptive regimens that could be chosen for the patient would include levonorgesterol, which prevents 95% of the pregnancies when it is taken within twenty-four hours of intercourse. This is available in pharmacies without any prescriptions. Other than that, Yuzpe regimen can also be used, which is 77% effective (Matyanga & Dzingirai, 2018). A third regimen would be combined hormonal contraceptives. 

Some of the side effects that would be expected would include vomiting, nausea, stomach cramps, diarrhea, constipation, as well as increased weight (Leelakanok & Methaneethorn, 2020). Some of the side effects for which J.L. should seek immediate medical care would include severe headache, severe vomiting, speech problems, dizziness or faintness, weakness or numbness of an arm or leg, and crushing chest pain or chest heaviness, as that could be indicative of heart problems. 

References

Abarbanell, G., Tepper, N. K., & Farr, S. L. (2019). Safety of contraceptive use among 

women with congenital heart disease: a systematic review. Congenital heart disease, 14(3), 331-340.

Leelakanok, N., & Methaneethorn, J. (2020). A systematic review and meta-analysis of 

the adverse effects of levonorgestrel emergency oral contraceptive. Clinical Drug Investigation, 40(5), 395-420.

Matyanga, C. M., & Dzingirai, B. (2018). Clinical pharmacology of hormonal emergency 

contraceptive pills. International journal of reproductive medicine, 2018.

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Laura Rosa Alonso Salido

17 hours ago, at 5:52 AM

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The female's health history and a blood pressure test are the most fundamental prerequisites prior to the prescription of Oral Contraceptive Pills. Most OCPs contain estrogen, which may raise the patient's blood pressure, increasing the risk of cardiovascular complications (Guillebaud, 2019). Because the health history of J.L. is already known, a blood pressure test is required prior to the prescription of OCPs. To be sure she's not pregnant, she'll need to take a pregnancy test.

A combination tablet, progestin, and prolonged/continuous usage are three of the regimens accessible for this patient. Estrogen and progestin hormones are packaged in 21- or 28-day packets in a combo tablet. In a 28-day pack, progestin contains just the hormone progesterone, but the continuous pill contains only the active hormones estrogen and progestin and is taken over a lengthy period of time, generally three months. All three forms of OCP are highly successful in preventing pregnancy and have no impact on sexual intercourse. However, because a combination tablet minimizes heavy menstruation, it is preferable to a progestogen-only pill.

The three birth control alternatives each have their own set of adverse effects. Bleeding between periods, intense period pain, large flows, and a significant risk of ectopic pregnancy if the IUD fails by accident are all negative effects of IUD insertions (NallN, 2018). Minipill is also linked to irregular menstruation, acne, and a lack of sexual desire. Barrier measures such as diaphragms, sponges, and vaginal caps may cause vaginal burning and irritation as a result of spermicide usage. Allergic responses to diaphragms and vaginal caps can cause intense vaginal scents. The use of these barrier measures may potentially raise the risk of UTIs.

References

Cooper, D. B., Patel, P., & Mahdy, H. (2022). Oral contraceptive pills. In StatPearls. StatPearls Publishing.https://www.ncbi.nlm.nih.gov/books/NBK430882/

NallN, R. (2018). IUD side effects: What they are and how to manage them. Retrieved from

Guillebaud, J. (2019). Contraception today. CRC Press.

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Vianet Blanco

3/29/22, 10:57 AM 

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Advance Pharmacology

1. Before prescribing an OCP regimen, what tests or examinations would you like to perform?

It's critical to assess J. L’s blood pressure as well as medical records before recommending the Oral Contraceptive Pills (OCP) regimen. In addition to familiarizing with the patient's sex life and sexual history, doing a pelvic examination is essential. As J.L.'s caregiver, I would seek data on the birth control methods she previously employed. A Pap test is used to perform the pelvic exam, which is only necessary for teenagers but is not always required when giving an OCP regimen. In addition, as J. L’s caregiver, I would find out if she ever experienced blood clots and ask her if she smokes anything currently (Turrini, 2021). When recommending an OCP regimen, significant risk factors like hypertension, smoking, and blood clots must be considered.

2. Identify three different contraceptive regimens that could be chosen for J.L. Note their differences and why you chose them.

OCP had a 91 percent success rate and OCP has non-contraceptive advantages such as dysmenorrhea, menorrhagia therapy. Because J.L has menstruation-related difficulties, such as menorrhagia, the extended-cycle or continuous OCP regimens are a good fit for her. Taking into account J. L’s family medical background of cardiovascular illness, the best OCP regimens to administer will be progestin-only regimens that help sustain normal blood pressure (Monterrosa-Castro et al., 2021). In addition, given J.L.'s multivitamins and calcium carbonate 500mg, it that means injectable medroxyprogesterone acetate is not a suitable technique because its adverse effects result in decreased bone mineral density.

3. Identify the potential side effects that need to be relayed to J.L. Note especially those side effects for which J.L. should seek immediate medical care.

Some common adverse effects of OCP regimens include irregular and frequent bleeding produced by progestin-only tablets. Nonetheless, vomiting and nausea have been identified as typical side effects in patients using OCPs with high estrogen levels (Cooper et al., 2022). Other adverse effects include breast soreness, headaches, bloating, and mood swings. If J.L. experiences abrupt menstrual bleeding accompanied by dizziness and stomach pain, she should seek medical attention because this indicates a serious health problem requiring instant medical assistance.

References

Cooper, D. B., Patel, P., & Mahdy, H. (2022). Oral Contraceptive Pills. In StatPearls [Internet]. StatPearls Publishing. 

Monterrosa-Castro, A., Redondo-Mendoza, V., & Monterrosa-Blanco, A. (2021). Current Knowledge of Progestin-Only Pills. Electronic Journal of General Medicine, 18(6).

Turrini, M., & Bourgain, C. (2021). Appraising screening, making risk in/visible. The medical debate over Non‐Rare Thrombophilia (NRT) testing before prescribing the pill. Sociology of Health & Illness, 43(7), 1627-1642.

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JEAN OMEGA FLEURGIN

3/29/22, 4:35 AM 

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   Student :Jean omega Fleurgin

1-. Before prescribing an OCP regimen, what tests or examinations would you like to perform?

Before getting birth control pills, patient may have done a pelvic exam with a Pap test. Patient should get a complete medical history before giving a prescription for birth control pills.

 Based on the patient age and health history. Patient should have pelvic exams and Pap tests. But Patient does not need an exam or Pap test just to get a prescription for birth control pills.

Before getting birth control pills, patient should always have done a basic medical exam and:

· Check blood pressure.

· Ask if ever had blood clots history.

· Ask if smoking.

2– Identify three different contraceptive regimens that could be chosen for J.L. Note their differences and why you chose them.

The Oral Contraceptive Pill

It’s the little tablet taken once a day. The oral contraceptive pill is the most commonly reported method of contraception used by Australian women. There are a few different types of pill to choose from, so it’s about finding the one that’s right for you. The combined pill contains estrogen and progestin and mini pill contains only one hormone, a progestin. The pill can have many benefits, however remembering to take it on time is a must.

Intrauterine Device (IUD)

This small, T-shaped device is made from made of material containing progesterone hormone or plastic and copper and is fitted inside a woman’s uterus by a trained healthcare provider. It's a long-acting and reversible method of contraception, which can stay in place for three to 10 years, depending on the type.

Some IUDs contain hormones that are gradually released to prevent pregnancy. The IUD can also be an effective emergency contraception if fitted by a healthcare professional within five days (120 hours) of having unprotected sex.

IUDs containing coppers are 99% effective and the ones containing hormones are 99.8% effective, so you’re about as protected as you possibly can be by a contraceptive method.

The Contraceptive Implant

In this method, a small, flexible rod is placed under the skin in a woman’s upper arm, releasing a form of the hormone progesterone. The hormone stops the ovary releasing the egg and thickens the cervical mucus making it difficult for sperm to enter the womb. The implant requires a small procedure using local anesthetic to fit and remove the rod and needs to be replaced after three years.

3- Identify the potential side effects that need to be relayed to J.L. Note especially those side effects for which J.L. should seek immediate medical care.

OCP may cause dizziness, headache, lightheadedness, stomach upset, bloating, or nausea. If these effects persist or worsen, contact your doctor. Notify doctor if experience: severe depression, groin or calf pain, sudden severe headache, chest pain shortness of breath, lumps in the breast, weakness or tingling in the arms or legs, yellowing of the eyes or skin. If you notice other effects not listed above, contact your doctor or pharmacist.

Reference

Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016;65(No. RR-3).

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Dania Morejon Torres

3/28/22, 6:22 PM 

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Test before OCP Regimens Prescription

The basic requirements prior to prescription of Oral Contraceptive Pills are the female’s health history and blood pressure test. Most OCPs contain estrogen, which could increase the patient's blood pressure resulting in further risk factors such as stroke and myocardial infarction (Guillebaud, 2019). According to the J.L’s case, her health history is already known, a blood pressure test is, therefore, necessary before OCPs prescription. A pregnancy test is also necessary to ascertain that she is not pregnant.

Alternative Contraception Regimens

Majority of contraception methods have associated risks either from their chemical compositions, method of use, or depending on the female's body compatibility to the method. Considering myocardial infarction is significant in J.L’s family health history, it is safer to opt for a non-hormonal method that will not attract the risk of a heart attack in the future. Therefore, she could opt to use an IUD, especially a hormone-free copper. She could also choose OCPs that do not contain estrogen, such as the minipill, to lower the risk of high blood pressure. The minipill is a safer choice as it only contains progestin (Glisic et. al., 2018). Additionally, barrier methods such as insertion devices like a diaphragm, sponge, or cervical cap used alongside a spermicide could be viable options for J.L.

Potential Side Effects

Certain side effects are associated with the three birth control options. The side effects associated with IUD insertions are bleeding in between periods, severe period pain, heavy flows, and high chances of ectopic pregnancy if the IUD fails by any chance (NallN, 2018). Minipill is also associated with irregular menstruation, acne, and reduced sex drive. In using barrier methods, diaphragms, sponges, and vaginal caps could bring about vaginal burning and irritation resulting from the use of spermicides. Diaphragms and vaginal caps may also result in allergic reactions causing strong vaginal odors. Using these barrier methods may also increase the chances of contracting UTIs.

 References

Glisic, M., Shahzad, S., Tsoli, S., Chadni, M., Asllanaj, E., Rojas, L. Z., … & Franco, O. H. (2018). Association between progestin-only contraceptive use and cardiometabolic outcomes: a systematic review and meta-analysis. European journal of preventive cardiology, 25(10), 1042-1052.

Guillebaud, J. (2019). Contraception today. CRC Press.

Henly Rojas

3/28/22, 5:33 PM 

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Tests and Examinations

When it comes to prescribing an OCP regimen for such a patient, the most important tests, and exams to consider are the Pap smear and the pelvic exam. The Pap smear is done as a routine test to screen for precancers or abnormal cell changes in the cervix so that early interventions can be made. The pelvic exam is highly regarded in determining the patient's overall sexual and reproductive health. It also helps determine the presence or absence of life-threatening conditions, such as infections and cancers. It is vitally important to maintain control of blood pressure and the presence of blood clots in this patient based on the family history of cardiovascular disease. It is vitally important to keep in mind that birth control pills are not a good option for patients with risk factors for cardiovascular disease.

Contraceptive Regimen

Among the regimens available for this patient, there are three that are a combined pill, progestin and prolonged/continuous use. A combination pill comprises estrogen and progestin hormones contained in 21- or 28-day packs. Progestin is made up of the hormone progesterone only in a 28-day pack, while the continuous pill consists of the active hormones estrogen and progestin only that is taken over a long period of time, usually 3 months. All three types of OCP do not affect sexual intercourse and are very effective in preventing pregnancy. However, keep in mind that a combined pill is better than the progestogen-only pill because it reduces heavy menstruation.

Potential Side Effects

Combined pill and progestin contraceptives have few complications that such a patient should consider. Such side effects include irregular and heavy bleeding, breast tenderness, headaches, nausea, and high blood pressure. The patient should be aware of any side effects and report episodes of irregular bleeding and high blood pressure, as these can become life-threatening in a short period of time. It is of vital importance that the patient immediately informs the doctor of any type of incident mentioned above.

References

Cooper, D. B., Patel, P., & Mahdy, H. (2022). Oral contraceptive pills. In StatPearls. StatPearls Publishing.https://www.ncbi.nlm.nih.gov/books/NBK430882/

Elwan, D., & Raidoo, S. (2020). Reproductive autonomy and choice of contraceptive method. Fertility and Sterility, 114(3), e174.

Farley, N. R. (2018). Combined oral contraceptives, smoking, and cardiovascular risk. Journal of Epidemiology and Community Health, 52(12), 775–785.

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Anilemys Paneca

3/28/22, 4:23 PM

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