"The Use of Hormonal Contraceptives" is a wonderful example of a paper on drug therapy. Based on the assessment, Patient Jennifer has visited the health center for a well-female exam with a pap smear. The pap smear is vital as she is sexually active. Question 1 Based on Jennifer’ s request, I have prescribed a combination of oral contraceptives namely TriNessa. I have chosen this medication in this situation based on her clear medical history as well as sexual life. Considering the other alternatives, this is the best medication based on her age, marital status, and sexual life.
The pharmacodynamics action of this medication is the inhibition of ovulation as well as the thickness of cervical mucus which stops sperm entry into the uterus (Edelman et al. , 2014). Question 2 Patient education is vital in marinating their well-being. Instructional points I would use in educating Jennifer include the following The pill should not be skipped and should be taken consistently at the same time so as to get the best results One pill should be taken daily The pill should be administered as prescribed; not in larger nor smaller amounts nut according to the directions on the prescription label When the pills end, a new pack has to be started the next day Question 3 Adverse reactions include nausea, vomiting, spotting, breakthrough bleeding, abdominal cramps, change in menstrual flow, bloating, amenorrhea, edema, breast tenderness and enlargement, weight increase or decrease, migraine, and vaginal candidiasis.
These effects wear off after some time, therefore initially; the patient will have to adjust to the changes; as the medication contains hormones, explaining the side effects. Worst-case scenarios include recurrent abnormal vaginal bleeding. As a medical practitioner, I would take the highest measures to rule out malignancy.
Other worst-case scenarios include pre-menstrual syndrome, cataracts, and dizziness, loss of scalp hair, Erythema nodosum, Hemorrhagic eruption, and hemolytic uremic syndrome. If these occur, then the patient must halt administration of the current medication and consult a physician immediately (Nelson, 2007). Question 4 Contraceptive effectiveness diminishes when hormonal contraceptives are co-administered with anticonvulsants and antibiotics. This may result in unwanted pregnancy or bleeding. Management for such a case is not taking the medication at the same time, taking one and administering the other one after two to three hours (Greenstein & Greenstein, 2007). Question 5 I prescribed a generic name TriNessa (Ethinyl estradiol and norgestimate).
The brand name is Ortho-Tri-Cyclen. Yes, there is a generic version of this medication. I prescribed a generic version since it is affordable as compared to the brand version. Question 6 The brand version Ortho Tri-Cyclen costs $41.99 while TriNessa the generic version costs $27.99. This medication cannot be found on the $4 list at area stores. Question 7 I would expect the medication to work after a month. In the first month, I would advise the patient to use a condom during intercourse so as to prevent pregnancy cases.
I would monitor the efficiency of the medication by a pregnancy test. I would know the medication is efficacious if the pregnancy test is negative and Jennifer is adjusting well to the side effects (Hatcher, 2008). Moreover, if the medication works well, the patient must have an annual history, and physical examination conducted. Physical examination is inclusive of blood pressure, abdomen, pelvic organs, breasts, and cervical cytology. Question 8 Should this option fail, alternative treatment plans include vaginal ring, diaphragm, cap, contraceptive implant, IUD, progestogen-only pill, natural family planning, IUS, condoms, contraceptive patch, emergency contraception, and contraceptive injection. Question 9 This medication falls under pregnancy category X.
This drug is dangerous to the fetus therefore it must be taken no matter the circumstance.
Edelman A, Micks E, Gallo MF, Jensen JT, Grimes DA. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD004695. DOI: 10.1002/14651858.CD004695.pub3.
Greenstein, B., & Greenstein, A. (2007). Concise clinical pharmacology. London: Pharmaceutical Press.
Hatcher, R. A. (2008). Contraceptive technology. New York, N.Y: Ardent Media.
Nelson, A. (2007). Combined oral contraceptives. Contraceptive technology. 19th ed. New York, NY: Ardent Media, Inc, 193-270.