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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®)

Read more at Wikipedia.org


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DRUG CHALLENGE
From Nursing, 3/1/04 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. Percodan (Endo)

_____2. Cosopt (Merck)

_____3. Trinalin (Schering)

_____4. Loestrin Fe (Parke-Davis)

_____5. Unasyn (Pfizer)

SECTION II

a. oxycodone HCl, 4.5 mg; oxycodone terephthalate, 0.38 mg; aspirin, 325 mg

Prescribed to relieve moderately severe pain, this Schedule II combination contains the analgesics oxycodone, an opioid, and aspirin, a nonopioid. Warn your patient to gauge his response before driving-the drug may cause dizziness, sedation, nausea, and vomiting.

b. norethindrone acetate, 1.0 mg, 1.5 mg; ethinyl estradiol, 20 mcg, 30 mcg; ferrous fumarate, 75 mg

A woman with dysmenorrhea may receive this oral contraceptive to decrease bleeding and the risk of anemia. The first 21 white or green tablets contain norethindrone, a progestin, and ethinyl estradiol, an estrogen. The 7 brown tablets contain ferrous fumarate (iron)tell your patient not to skip them.

c. each ml contains: dorzolamide, 20 mg; timolol, 5 mg

Both drugs in this combination help decrease elevated intraocular pressure, such as that caused by open-angle glaucoma and ocular hypertension: dorzolamide, a carbonic anhydrase inhibitor, and timolol, a nonselective beta-blocker. Tell your patient to administer doses at least 10 minutes apart from other topical ophthalmic drugs.

d. ampicillin sodium, 1 gram, 2 grams; sulbactam sodium, 0.5 gram, 1 gram

Used to treat intra-abdominal and gynecologic infections caused by beta-lactamase producing Staphylococcus aureus, Escherichia coli, and Klebsiella, this combination contains ampicillin, a penicillin-type antibiotic, and sulbactam sodium, which inactivates beta-lactamase enzymes. Doses may be administered I.M. or I.V.

e. azatadine maleate, 1 mg; pseudoephedrine sulfate, 120 mg

This combination is prescribed to relieve allergy symptoms. Azatadine is an antihistamine; pseudoephedrine, a decongestant. Warn your patient that the medication can cause drowsiness and dizziness and to see how she reacts before doing anything that requires alertness.

BY MARCY PORTNOFF GEVER, PHARMD. MED

Marcy Portnoff Gever is an independent pharmacist consultant and educator in Ringoes, N.J.

Copyright Springhouse Corporation Mar 2004
Provided by ProQuest Information and Learning Company. All rights Reserved

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