NR 602 Midterm Study Guide Latest 2021

NR 602 Midterm Study Guide 2021 ■ First day start ​ - NO BACKUP method ○ Mechanism of Action: ​ (Progestin and estrogen inhibit the hypothalamic-pituitary -ovarian axis and subsequent steroidogenesis ■ The progestin in COCS is the main actor in preventing pregnancy. ○ Prevents the luteinizing hormone (LH) surge thereby inhibiting ovulation ○ Thickening the cervical mucus→ inhibits sperm penetration and transport ○ Changes the fallopian tubes so that transport of sperm or ova is impaired ○ Causes endometrium to become atrophic. ■ The estrogen primarily inhibits follicle-stimulating hormone secretion. ■ The estrogen also works synergistically with the progestin to affect the uterine lining and cervical mucus production. ○ Candidates: ■ Women with dysmenorrhea and menorrhagia ■ Women who want to regulate menses ■ Women who will use a daily method consistently ■ Post abortion (any trimester) ■ Past ectopic pregnancy ○ Advantages: ■ Reduced menstrual flow and dysmenorrhea for most users ■ Reduce the risk of ovarian cancer ​ 20 % for every 5 years- Even after discontinuing COC use, protection continues for 15-20 years. ■ COCs also ​ reduce the risk of endometrial cancer ​ by 40-50%, and like ovarian cancer, protection increases with duration of use. ■ Reduces risk of colon cancer ■ 90 percent protection from ectopic pregnancy with current OC use. ■ Reduced incidence of benign breast disease ■ Effective in reducing acne. ■ Lower incidence of endometriosis ■ Possible Advantages: 1) May preserve bone density, and 2) May protect against iron deficiency anemia, ovarian cysts with higher doses, and pelvic inflammatory disease. ○ Contraindications: ■ Multiple risk factors for arterial cardiovascular disease, such as smoking, diabetes, hypertension ■ Known thrombogenic mutations ■ Current or history of current ischemic heart disease, history of stroke, history of or current deep venous thrombosis or pulmonary emboli ■ Vascular disease ■ Complicated valvular heart disease ■ Hypertension (systolic ≥160 or diastolic ≥ 100) ■ Smoking (>15 cigarettes/day and age 35 or older) ■ Migraine headache with aura ■ Major surgery with prolonged immobilization ■ Current breast cancer ■ Active viral hepatitis