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Class oral contraceptives

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Oral hormonal contraceptive
Oral hormonal contraceptive
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Class oral contraceptives

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this class is in brief for under graduate understanding ans examination purpose

this class is in brief for under graduate understanding ans examination purpose

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Class oral contraceptives

  1. 1. ORAL CONTRACEPTIVES
  2. 2. Birth control pills (oral contraceptives) are prescription medications that prevent pregnancy. Birth control (contraceptive) medications contain hormones (estrogen and progesterone or progesterone alone). Birth control pills may also be prescribed to reduce menstrual cramps or prevent anemia. Some women experience various levels of side effects of birth control pills.
  3. 3. Hormonal birth control medications prevent pregnancy through the following ways: By blocking ovulation(release of an egg from the ovaries), thus preventing pregnancy By altering mucus in the cervix, which makes it hard for sperm to travel further By changing the endometrium(lining of the uterus) so that it cannot support a fertilized egg By altering the fallopian tubes so that they cannot effectively move eggs toward the uterus
  4. 4. Birth control(contraceptive) medications contain hormones (estrogen and progesterone or progesterone alone). The medications are available in various forms, such as pills, injections (into a muscle, topical (skin) patches, and slow-release systems (vaginal rings, skin implants, and contraceptive-infused intrauterine devices
  5. 5. Estrogens- Ethinyl estradiol-30 micro grams Mestranol-50 micro grams Progesterones Norethindrone- 1mg Norethindrone acetate Norgestimate Desogestrel 150 micro grams Norgestrel -0.5mg Levonorgestrel 150 micro grams
  6. 6. Combination contraceptives, that is, contraceptive medications containing both estrogen and progesterone, are the most effective means for contraception with the exception of surgical sterilization. Several types of combination birth control pills exist, including monophasic pills, biphasic pills, triphasic pills, and 91-day-cycle pills.
  7. 7. Monophasic pills have a constant dose of both estrogen and progestin in each of the hormonally active pills throughout the entire cycle (21 days of ingesting active pills). Several of the brands listed above may be available in several strengths of estrogen or progesterone, from which doctors choose according to a woman’s individual needs.
  8. 8. Biphasic pills typically contain 2 different progesterone doses. The progesterone dose is increased about halfway through the cycle. Ethinyl estradiol 35 micro gram+ Norethindrone 0.5mg (day1 to day 10) Ethinyl estradiol 35 micro gram+ Norethindrone 1mg (day12 to day 21)
  9. 9. Triphasic pills gradually increase the dose of progesterone and provides higher dose of estrogen Three different increasing pill doses are contained in each cycle Ethinyl estradiol 35 micro gram+ Norgestrol 0.05mg (day1 to day 6) Ethinyl estradiol 35 micro gram+ Norgestrol 0.075 mg (day 7 to day 11) Ethinyl estradiol 35 micro gram+ Norgestrol 0.125 mg (day 12 to day 21)
  10. 10. Two tablets of progestin levonorgestrol containing 1500mg Or single 1500mcg tablet taken as soon as possible after unprotected intercourse (up to 72 hours after) Preferably within 12 hours, no later than 72 hours Ethinyl estradiol 50 micro gram+ levonorgestrol 250 micro gram. Two such tablets are to be taken with in 72 hrs of unprotected sex Ulipristal (SPRM-Selective Progesterone Receptor Modulator) single dose 30mg effective with in 120hrs/5days
  11. 11. Non steroidal estrogen receptor antagonist-serm Centchroman- 30mg twice in a week for first 3month and once in a week subsequently as long as the contraception is preferred Reversible in 6 months It is potent competitive antagonist at peripheral estrogen receptors and supresses proliferative stage of endometrium It accelerates ovum transport, without affecting ovulation No risk of teratogenesis C/I- hepatic dysfunction, polycystic ovarian disease, cervical hyperplasia, tuberculosis, renal disease
  12. 12. Depot medroxy progesterone acetate (Depot-Provera) -DMPA The first injection is given within 5 days following the onset of menstruation. After that, an injection is needed every 11-13 weeks. Side effects: Since progesterone is the only hormonal ingredient, estrogen-related side effects are avoided. A side effect unique to this method of birth control is that most women eventually stop having their periods. Depo-Provera may last in the body for several months in women who have used it on a long-term basis and can actually delay the return to fertility after stopping the drug. Other side effects include weight gain and depression.
  13. 13. Norelgestromin /ethinyl estradiol The topical patch may be applied to clean, on the shoulders, upper arms, buttocks or abdomen. The patch may be less effective in women weighing more than 198 pounds (90 kg). Use: A new patch is applied on the same day of the week, each week for 3 weeks in a row. The first patch is applied either on the first day of the menstrual period or on the Sunday following menses. On the fourth week, no patch is applied. This 4-week period is considered 1 cycle. Another 4-week cycle is started by applying a new patch following the 7-day patch-free period.
  14. 14. Side effects are similar to other birth control agents containing both estrogen and progesterone. Effects include menstrual irregularities, weight gain, and mood changes. Other specific side effects include a skin reaction at the site of application and problems with contact use
  15. 15. Norethindrone Progesterone-only pills (POPs), also known as mini-pills. Less than 1% of users of oral contraceptives use them as their only method of birth control. Those who use them include women who are breast feeding and women who cannot take estrogen. Use: POPs are ingested once daily, every day. POPs may be started on any day, and there are no pill-free days or different-colored pills to track. Since progesterone is the only hormonal ingredient, estrogen-related side effects are avoided. However, since POPs do not include estrogen, they have a higher failure rate. Users must take this pill at the same time daily for greatest effectiveness.
  16. 16. Women with the following conditions should not use estrogen- containing birth control medications: to any component of the product History of blood clotting disorders History of stroke or heart attack heart valve disease with complications Severe hypertension Poorly controlled diabetes Recent major surgery with prolonged bed rest Breast cancer, Liver cancer (or liver disease) Uterine cancer or other known or suspected estrogen-dependent cancers jaundice during pregnancy or jaundice with prior hormonal contraceptive use
  17. 17. The effectiveness of oral contraceptives, Progesterone Only Pill and post coital pill will be reduced by interaction with drugs that are enzyme inducers Drugs that may cause this effect include: many antibiotics (e.g., cephalosporins, chloramphenicol, macrolides, penicillins, tetracyclines, sulfas), aprepitant, bexarotene, Broad spectrum antibiotics may reduce effectiveness of OCPs by altering the bacterial flora of the bowel
  18. 18. Nausea, breast tenderness, fluid retention, weight gain, acne, breakthrough bleeding, missed periods, headaches, depression, change in vision, other mood changes, and lower sexual desire. Additionally, the following more serious side effects may occur: thromboembolism(blood clots) Breast cancer, cervical cancer Benign liver tumors Diabetes
  19. 19. Smoking cigarettes while using this medication increases your chance of having heart problems. Do not smoke while using this medication. The risk of heart problems increases with age (especially in women greater than 35 years of age) and with frequent smoking (15 cigarettes per day or greater) If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include nausea and vomiting. May experience vaginal bleeding.
  20. 20. 1. Menstrual Bleeding Disorders 2. Dysmenorrhea 3. Symptoms of Androgenisation (Seborrhea, Acne, Hirsutism, Alopecia) 4. Premenstrual Syndrome (PMS) and Premenstrual Disphoric Disorder (PMDD ) 5. Ovarian Cysts 6. Endometriosis/Adenomyosis 7. Pelvic Inflammatory Disease (PID) 8. Multiple Sclerosis 9. Menstrual Migraine 10. Endometrial Hyperplasia 11. Benign Breast Disease 12. Prevention of Ovarian Cancer 13. Endometrial Cancer 14. Colon Cancer

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