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Questions and Answers
What is the standard dose range for ethinyl estradiol?
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?
Which estrogen component of COCs is converted to the naturally occurring estrogen, estradiol?
Estradiol valerate
What COC is estradiol valerate found in?
What COC is estradiol valerate found in?
Natazia
What mg doses is estradiol valerate found in, in COC products?
What mg doses is estradiol valerate found in, in COC products?
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The different progestins all have a ___________ affinity for the progesterone receptors.
The different progestins all have a ___________ affinity for the progesterone receptors.
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What are the first generation progestins?
What are the first generation progestins?
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What are the second generation progestins?
What are the second generation progestins?
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What are the third generation progestins?
What are the third generation progestins?
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Which generation of progestins has the highest affinity for androgen receptors?
Which generation of progestins has the highest affinity for androgen receptors?
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What are some side effects of a higher affinity to androgen receptors?
What are some side effects of a higher affinity to androgen receptors?
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Which of the first 3 progestin generations has the least androgenic side effects/least affinity for androgen receptors?
Which of the first 3 progestin generations has the least androgenic side effects/least affinity for androgen receptors?
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Third generation progestins and drospirenone are associated with which possible side effect?
Third generation progestins and drospirenone are associated with which possible side effect?
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Too much estrogen results in which side effects?
Too much estrogen results in which side effects?
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Too much progestin results in which side effects?
Too much progestin results in which side effects?
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Too much activity on androgen receptors results in which side effects?
Too much activity on androgen receptors results in which side effects?
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Too little estrogen results in which side effect(s)?
Too little estrogen results in which side effect(s)?
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Too little progestin results in which side effect(s)?
Too little progestin results in which side effect(s)?
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What's a good starting dose of ethinyl estradiol for patients who want to do a monophasic COC regimen?
What's a good starting dose of ethinyl estradiol for patients who want to do a monophasic COC regimen?
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For monophasic COC regimens, what dose of ethinyl estradiol would you consider in a patient taking a CYP3A4 inducer?
For monophasic COC regimens, what dose of ethinyl estradiol would you consider in a patient taking a CYP3A4 inducer?
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In which patients should you avoid ethinyl estradiol 50 mcg?
In which patients should you avoid ethinyl estradiol 50 mcg?
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Where can the Xulane patch be placed?
Where can the Xulane patch be placed?
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The Xulane patch may not work well in patients who weigh over _______ pounds?
The Xulane patch may not work well in patients who weigh over _______ pounds?
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Which contraceptive can decrease bone mineral density?
Which contraceptive can decrease bone mineral density?
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What patient characteristics increase the risk of VTE when CHCs are used?
What patient characteristics increase the risk of VTE when CHCs are used?
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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.
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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.
