Pharmacist Letter CE Flashcards

Questions and Answers

What is the standard dose range for ethinyl estradiol?

10-50 mcg

Which estrogen component of COCs is converted to the naturally occurring estrogen, estradiol?

Estradiol valerate

What COC is estradiol valerate found in?

Natazia

What mg doses is estradiol valerate found in, in COC products?

1 mg, 2 mg, 3 mg Signup and view all the answers

The different progestins all have a ___________ affinity for the progesterone receptors.

high Signup and view all the answers

What are the first generation progestins?

Norethindrone, Norethindrone acetate, Ethynodiol diacetate Signup and view all the answers

What are the second generation progestins?

Norgestrel, Levonorgestrel Signup and view all the answers

What are the third generation progestins?

Norgestimate, Desogestrel Signup and view all the answers

Which generation of progestins has the highest affinity for androgen receptors?

2nd generation Signup and view all the answers

What are some side effects of a higher affinity to androgen receptors?

Acne, hirsutism, dyslipidemia, weight gain Signup and view all the answers

Which of the first 3 progestin generations has the least androgenic side effects/least affinity for androgen receptors?

Third generation Signup and view all the answers

Third generation progestins and drospirenone are associated with which possible side effect?

Nonfatal venous thromboembolism Signup and view all the answers

Too much estrogen results in which side effects?

Nausea, breast tenderness, headache, bloating, increased blood pressure, melasma Signup and view all the answers

Too much progestin results in which side effects?

Breast tenderness, headache, fatigue, mood changes Signup and view all the answers

Too much activity on androgen receptors results in which side effects?

Weight gain, acne, hirsutism, increased LDL, decreased HDL Signup and view all the answers

Too little estrogen results in which side effect(s)?

Spotting, breakthrough bleeding early/midcycle Signup and view all the answers

Too little progestin results in which side effect(s)?

Breakthrough bleeding late cycle Signup and view all the answers

What's a good starting dose of ethinyl estradiol for patients who want to do a monophasic COC regimen?

20 mcg Signup and view all the answers

For monophasic COC regimens, what dose of ethinyl estradiol would you consider in a patient taking a CYP3A4 inducer?

30 mcg or more Signup and view all the answers

In which patients should you avoid ethinyl estradiol 50 mcg?

Obese patients, smokers Signup and view all the answers

Where can the Xulane patch be placed?

Upper arm, stomach, back, or buttock Signup and view all the answers

The Xulane patch may not work well in patients who weigh over _______ pounds?

198 Signup and view all the answers

Which contraceptive can decrease bone mineral density?

Medroxyprogesterone Signup and view all the answers

What patient characteristics increase the risk of VTE when CHCs are used?

Smoking, obesity, age 35 or older, recent major surgery Signup and view all the answers

Study Notes

Ethinyl Estradiol

Standard dose range is 10-50 mcg.
Starting dose for monophasic COC regimens is 20 mcg.
In patients taking CYP3A4 inducers, consider a dose of 30 mcg or more.
Avoid 50 mcg ethinyl estradiol in obese patients and smokers.

Estradiol Valerate

Converts to naturally occurring estrogen, estradiol.
Found in COC product Natazia.
Available in doses of 1 mg, 2 mg, and 3 mg.

Progestins

All generations of progestins display high affinity for progesterone receptors.
First generation includes norethindrone, norethindrone acetate, and ethynodiol diacetate.
Second generation includes norgestrel and levonorgestrel, which have the highest affinity for androgen receptors.
Third generation includes norgestimate and desogestrel, having the least androgenic side effects.

Side Effects

High androgen receptor activity leads to acne, hirsutism, dyslipidemia, and weight gain.
Excess estrogen may cause nausea, breast tenderness, headaches, bloating, increased blood pressure, and melasma.
Excess progestin can result in breast tenderness, headaches, fatigue, and mood changes.
Too little estrogen results in spotting and breakthrough bleeding early/midcycle.
Insufficient progestin leads to breakthrough bleeding late in the cycle.

Contraceptive Patches

The Xulane patch can be placed on the upper arm, stomach, back, or buttock.
Effectiveness may diminish in patients weighing over 198 pounds.

Bone Density and VTE Risks

Medroxyprogesterone can decrease bone mineral density.
Risk factors for venous thromboembolism (VTE) when using combination hormonal contraceptives include smoking, obesity, age 35 or older, and recent major surgery.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge with these Pharmacist Letter CE flashcards focused on contraceptive oral contraceptives (COCs) and the estrogen component ethinyl estradiol. Each card provides key information regarding dosages and components, perfect for pharmacists and students in pharmaceutical education.