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A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Contraception A 28 year old female has 2 children, came to the clinic seeking for a contraceptive method. She is lactating so her physician...

A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Contraception A 28 year old female has 2 children, came to the clinic seeking for a contraceptive method. She is lactating so her physician prescribed minipill hormonal contraception. 1. What is the composition of these pills? Low dose progestin alone. 2. After weaning of her baby the physician prescribed combined oral contraceptive pills.  Mention 2 adverse effects of them. 1) Headache and nausea. 2) Fluid retention, weight gain & increased blood pressure.  Other adverse effects 1. Vascular disorders: i. Thrombo-embolism. ii. Myocardial infarction. iii. Cerebrovascular disease. 2. GIT: cholestatic jaundice (progestin-containing drugs). 3. Cancer: No evidence that hormonal contraceptives can increase the risk of developing breast cancer, but there may be an earlier onset of it 4. Withdrawal bleeding, amenorreah 5. Acne, hirsutism (androgen-like progestin) 86 Semester 4 2023 / 2024  A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ 6. Break-through bleeding (with progestin-only preparations) 7. Vaginal infection 8. Skin pigmentation (estrogen and progestin) 9. Others: alopecia, erythema multiforme, erythema nodosum and depression. 10. Breast fullness & mastalgia. 3. Enumerate 3 contraindications for oral contraceptives. 1. History of thromboembolic disease or varicose vein. 2. Breast cancer. 3. Liver disease.  Other contraindications for oral contraceptives 4. Women who are 35 years of age or older. 5. Smoke 15 or more cigarettes/day 6. Migraines 7. Gallbladder disease 8. Hypertension 4. Describe mechanism of action of oral contraceptive pills 5. What are the different forms of combined pills? 87 Semester 4 2023 / 2024 A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ 6. Enumerate 4 non contraceptive benefits of combined hormonal contraception a. Acne: both norgestimate (less androgenic) and drospirenone(antiandrogenic) b. Menstrual cycle benefits: help regulate menstrual cycles and reduce monthly blood loss c. Endometrial Cancer d. Premenstrual syndrome and premenstrual dysphoric disorder : two products, drospirenone/EE, e. Ovarian Cancer and Functional Ovarian Cysts 7. What is the route of administration of levoprogestrol Subcutaneous implantation 88 Semester 4 2023 / 2024 A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Methods of hormonal Contraception 89 Semester 4 2023 / 2024  A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Pediatric dosage forms A. Oral liquid dosage forms 90 Semester 4 2023 / 2024 A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ B. Oral solid dosage forms: 1. Tablets: swallowed with water 2. Capsules: swallowed with water. 3. Mini - tablets: its size is 2 - 3 mm, used as lots of mini - tablets. 4. Chewable tablets. 5. Orodispersible tablets: dissolve on the tongue without need for water. 6. Multiparticulate/sprinkle: small granules put on soft food or directly swallow. 91 Semester 4 2023 / 2024  A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Pediatric drug dosage Example 1: Calculate the dose of amoxicillin suspension in mLs for otitis media for a 1-yr-old child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400 mg/5 mL. Step 1. Convert pounds to kg: 22 lb × 1 kg/2.2 lb = 10 kg Step 2. Calculate the dose in mg: 10 kg × 40 mg/kg/day = 400 mg/day 400 mg/day ÷ 2 (BID) = 200 mg/dose Step 3. Divide the dose by thefrequency: BID 200 mg/dose ÷ 400 mg/5 mL =2.5 mL Step 4. Convert the mg dose to mL: BID 92 Semester 4 2023 / 2024  A PLUS in GIT  PRACTICAL PHARMACOLOGY Your Guide To A+ Example 2: Calculate the dose of ceftriaxone in mLs for meningitis for a 5-yr-old weighing 18 kg. The dose required is 100 mg/kg/day given IV once daily and the drug comes prediluted in a concentration of 40 mg/mL. Step 1. Calculate the dose in mg: 18 kg × 100 mg/kg/day = 1800 mg/day Step 2. Divide the dose by the 1800 mg/day ÷ 1 (daily) = 1800 mg/dose frequency: Step 3. Convert the mg dose to mL: 1800 mg/dose ÷ 40 mg/mL = 45 mL once daily 93 Semester 4 2023 / 2024