Combined hormonal contraceptive drugs.pptx

In this ppt you will get to know all about how CHCs work and when it will be used.

1. Combined hormonal contraceptives Patient Evaluation Indication contraindications of use By:- Gaurav 1957

2. Introduction Combined Hormonal Contraceptives :  includes:  Combined Oral Contraceptives (Pills)  Contraceptive vaginal ring  Transdermal patch  

3. Evaluation Medical history and lifestyle factors: Medical eligibility must be assessed prior to prescription of any contraceptive method including CHC. The UK Medical Eligibility Criteria for Contraceptive Use provides recommendations for the safe use of CHC by women with different personal characteristics and medical conditions. Each of the personal characteristics or medical conditions considered by the UKMEC is assigned to one of four categories

4. Category 1 Category 2 Category 3 Category 4 A condition for which there is no restriction for the use of the method A condition where the advantages of using the method generally outweigh the theoretical or proven risks. A condition where the theoretical or proven risks usually outweigh the advantages of using the method. The provision of a method requires expert clinical judgement and/or referral to a specialist contraceptive provider, since use of the method is not usually recommended unless other more appropriate methods are not available or not acceptable A condition which represents an unacceptable health risk if the method is used.

5. Women with severe hypertension (systolic pressure ≥160 mmHg or diastolic pressure ≥100 mmHg) should not use CHC ). Women with less severe hypertension (systolic pressure 140–159 mmHg or diastolic pressure 90–99 mmHg), or with adequately controlled hypertension should not use CHC . Blood pressure should therefore be evaluated before initiating CHC Because risk of MI and ischemic stroke is higher among women who do not have their blood pressure measured before initiating C HC . A drug history should identify:- ► any prescribed or non-prescribed drug that could affect the effectiveness of the contraceptive ► any prescribed or non-prescribed drug that could itself be affected by the contraceptive

6. Specific attention should be given to enquiring about : ► Thrombophilia or previous VTE ► Ischemic heart disease, stroke or transient ischemic attack, peripheral vascular disease ► Additional risk factors for venous or arterial thromboembolism (e.g. smoking, obesity, recent-childbirth, immobility, hypertension, migraine, diabetes, hyperlipidemia, antiphospholipidantibodies, arrhythmia, complicated congenital/valvular heart disease or cardiomyopathy) ► Personal history of breast cancer/known breast cancer-related gene mutation ► Hepatobiliary disease ► Recent childbirth, current breastfeeding.

7. Choosing method of contraception Eligible: Women requesting CHC who are assessed as medically eligible should be provided with the following information about CHC to enable them to make an informed decision as to whether the method is suitable for them:► Effectiveness and factors that can affect effectiveness . ► Non-contraceptive benefits )► Health risks )► Side effects In Eligible: Women assessed as medically ineligible for CHC should be told why, and the risk to their health should be explained. Alternative contraceptive methods which can be safely used should be discussed and offered. Women with medical conditions or using medications that could reduce contraceptive effectiveness should be given advice regarding (and where possible provided with) alternative methods that would be effective for them.

8. Contraindications: