Oral Contraceptives- Pharmacology
J. L., a 27-year-old African-American female account executive, presents to the Family Medicine office for her annual checkup with her CNP. She has no significant past medical history. Her medications include calcium carbonate 500 mg orally twice a day and a multivitamin daily. She exercises regularly. Her family history is significant for cardiovascular disease (her father had an MI at age 54 and died of a further MI at age 63). She notes that she has been dating her current partner for approximately 5 months. She is interested in a reliable form of contraception. After discussing the various contraceptive options, she decides that an oral contraceptive (OC) would best fit her needs.
In this discussion forum:
1. Discuss what tests or examinations the CNP would likely perform before prescribing an OC regimen, and why.
2. Discuss two different OC regimens that could be chosen for J. L. Discuss their differences and why you chose them.
3. Discuss the potential side effects of each OC regimen that need to be relayed to J. L. Discuss especially those effects for which she should seek immediate medical care.
4. Discuss health promotion recommendations you would consider for J. L.
5. What ethical issues should be considered?
Oral Contraceptives- Pharmacology
Course Name: Course Code
Tests or Examinations done before the prescription of Oral Contraceptive Regimen
Before the use of oral contraceptives, and even hormone replacement therapy, the health of patients must be ascertained. The need for screening is therefore necessary in identifying patients who are legible for oral contraceptives. In this case, the clinical nurse practitioner would simply take the patients history, through an oral interview or through physical exams such as blood pressure, blood studies as well as electrocardiogram. This is due to the patient’s family history with Myocardial Infraction.
Different OC Regimens For J.L
The typical discharge of oral contraceptives consists of a cyclic method of twenty-one-day active pills followed by seven days of placebo. In the recent years, new contraceptives (oral) have been introduced that strive to shorten the length of placebo intake period and lengthen the duration of the active pills is termed as (extended cycle), or generally provide active pills everyday which is continuous. Combined estrogen-progesterone oral contraceptives contain estrogen component and one of a dozen various progestins. Both of these oral contraceptive regimens are available for all J.L.
Potential Side Effects of Each OC Regimen
Patients of Combined Oral contraceptives may experience breast tenderness, nausea and bloating. These are some of the concerns that a new patient like J.L may be having. This might also include, bleeding that is unscheduled but resolves within three months. Combined Oral contraceptives has been associated with risks of hypertension, stroke as well as myocardial infarction. But these are usually low among women of reproductive age. However, J.L should seek medical attention if she feels or sees any signs of the previously mentioned illnesses (Dinger et al., 2016).
Health Promotion Recommendations for J.L
J.L can minimize complication during childbirth and pregnancy by using contraceptives, as they effectively control the timing of their childbirth. This fosters health before conception.
Ethical Issues During Oral Contraception
During recent years a variety of contraceptive methods have been put in place so as women are able to delay the birth of their first child as never seen in history before. The basic ethics of contraception lie with the patient herself, in this case J.L who should be served with the facts of and understand the gravity of the potential risks of taking up oral contraceptives (Upadhya et al., 2017).
Dinger, J., Möhner, S., & Heinemann, K. (2016). Cardiovascular risks associated with the use of drospirenone-containing combined oral contraceptives. Contraception, 93(5), 378-385.
Upadhya, K., Santelli, J., Raine-Bennett, T., Kottke, M., & Grossman, D. (2017). Over-the- Counter Access to Oral Contraceptives for Adolescents. Journal Of Adolescent Health, 60(6), 634-640.