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Oral contraceptives come in a variety of formulations. The main division is between combined oral contraceptive pills, containing both estrogen and progesterone, and progesterone only pills (mini-pills). Combined oral contraceptive pills also come in varying types, including varying doses of estrogen, and whether the dose of estrogen or progesterone changes from week to week. more...

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Combined oral contraceptive pills

All contain the estrogen ethinyl estradiol, although in varying amounts, and one of a number of different progesterones. They are taken for 21 days with then a 7 day gap during which a withdrawal bleed (often, but incorrectly, referred to as a menstrual period) occurs. These differ in the amount of estrogen given, and whether they are monophasic (only one dose of estrogen and progesterone during the 21 days) or multiphasic (varying doses).

Monophasic

These are given as 21 tablets of estrogen and progesterone, followed by 7 tablets of placebo. Different formulations contain different amounts of estrogen and progesterone:

  • 20 mcg estrogen
    • 0.1 mg levonorgestrel (Alesse®, Levline®)
    • 1 mg norethindrone acetate (Loestrin 1/20®Fe)
  • 30 mcg estrogen
    • 0.15 mg levonorgestrel (Levlen®, Levora®, Nordette®)
    • 0.3 mg norgestrel (Lo-Ovral®)
    • 0.15 mg desogestrel (Desogen®, Organon; Ortho-Cept®, Ortho-McNeil)
    • 1.5 mg norethindrone acetate (Loestrin® 1.5/30)
    • 3.0 mg drospirenone (Yasmin®)
  • 35 mcg estrogen
    • 0.25 mg norgestimate (Ortho-Cyclen®)
    • 0.4 mg norethindrone (Ovcon-35®, Warner Chilcott)
    • 0.5 mg norethindrone (Modicon®, Brevicon®)
    • 1 mg norethindrone (Ortho-Novum 1/35®, Necon®, Norethin®, Norinyl 1/35®)
    • 1 mg ethynodiol diacetate (Demulen 1/35®, Zovia 1/35E®)
  • 50 mcg estrogen
    • 0.4 mg norethindrone (Ovcon-50®, Warner Chilcott))
    • 1 mg norethindrone (Necon 1/50®, Norinyl 1/50®, Ortho-Novum 1/50®, Ovcon-50®)
    • 0.5 mg norgestrel (Ovral®)
    • 1 mg ethynodiol diacetate (Demulen 1/50®, Zovia 1/50E®)

Multiphasic

  • Desogestrel 0.15 mg and ethinyl estradiol 0.02 mg x 14 tablets, followed by ethynil estradiol 0.01 mg x 2 tablets, followed by 5 tablets of placebo (Kariva®, Barr Laboratories; Mircette®, Organon)
  • Desogestrel 0.1 mg ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.125 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by desogestrel 0.15 mg and ethynil estradiol 0.025 mg x 7 tablets, followed by 7 tablets of ferric oxide (Cyclessa®, Organon; Velivet®, Barr Laboratories)
  • Norethindrone 0.5 mg and ethinyl estradiol 0.035 mg x 7 tablets, followed by 0.75 mg of norethindrone and 0.035 mg of ethinyl estradiol x 7 tablets, followed by 1 mg of norethindrone and 0.035 of ethinyl estradiol, followed by 7 tablets of placebo (Ortho-Novum 7/7/7®)
  • Norethindrone 0.5 mg and 0.035 mg of ethinyl estradiol x 10 tablets, followed by 1 mg norethindrone and 0.035 ethinyl estradiol x 11 tablets, followed by 7 tablets of placebo (Ortho-Novum 10/11®)

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Drug challenge
From Nursing, 8/1/00 by Gever, Marcy Portnoff

You routinely administer combination drugs...but do you know what's in them? To find out match each combination of ingredients in Section II with its correct name in Section I.

SECTION I

___1. Zephrex LA (Bock)

___2. Zovia (Watson)

___3. Uroqid-Acid No. 2 (Beach)

___4. Aggrenox (Boehringer)

___5. Percodan-Demi (Du Pont)

SECTION II

a. oxycodone HCl, 2.25 mg; oxycodone terephthalate, 0.19 mg; aspirin, 325 mg

This schedule II pain reliever contains oxycodone, a potent opioid analgesic, and aspirin, a nonopioid analgesic. Your patient may feel drowsy or dizzy while taking it.

b. pseudoephedrine HCl, 120 mg; guaifenesin, 600 mg

Prescribed to relieve cough and cold symptoms, this time-release tablet contains pseudoephedrine, a nasal decongestant, and guaifenesin, an expectorant. Tell your patient to call her health care provider if she feels nervous or dizzy or has trouble sleeping.

c. sodium acid phosphate, 500 mg; methenamine mandelate, 500 mg

This medication is given to prevent chronic, recurrent urinary tract infections. Sodium acid phosphate acidifies the urine, which methenamine needs to hydrolyze to bactericidal formaldehyde.

d. dipyridamole, 200 mg; aspirin, 25 mg

This extended-release combination helps prevent recurrent transient ischemic attacks or stroke. Dipyridamole, an antiplatelet agent, and aspirin work together to prevent blood clot formation. Both interact with various other drugs, so tell your patient to check with his health care provider before taking any overthe-counter or prescription medications.

e. ethinyl estradiol, 35 or 50 mcg; ethynodiol diacetate, 1 mg

A woman with dysmenorrhea is likely to see an improvement in her cycle after a few months taking this combination. Ethinyl estradiol is an estrogen and ethynodiol diacetate a progestin. To help your patient comply with treatment, tell her to take the medication at the same time every day.

ANSWERS: 1b, 2e, 3c, 4d, 5a.

Marcy Portnoff Gever, RPh, MEd, author of Drug Challenge, is a contributing editor for Nursing2000.

Copyright Springhouse Corporation Aug 2000
Provided by ProQuest Information and Learning Company. All rights Reserved

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