Contraceptives: Birth controls, Side Efeects

CONTRACEPTIVES

Description 

• These medications contain a  combination of estrogen and progestin or progestin alone.
• Estrogen-progestin combinations suppress ovulation and change the cervical, mucus making it difficult for sperm to enter. 
• Medication that contains only progestins is less effective then the combined medication. 
• Contraceptive usually are taken for 21 consecutive days and stopped for 7 days; the administration cycle is then repeated. 
• Contraceptives are useful in controlling irregular or excessive menstrual cycle. 
• Contraceptives provide reversible prevention of pregnancy. 
• Risk factors associated with the development of complications related to the use of contraceptives including smoking, obesity, and hypertension. 
• Contraceptives are contraindicated in women with hypertension, thromboembolic disease, cerebrovascular or coronary artery disease, estrogen-dependent cancers, and pregnancy.
• Contraceptives should be avoided with the use of hepatotoxic medications. 
• Contraceptives interfere with the activity of bromocriptine mesylate ( Parlodel) and anticoagulants and increase the toxicity of tricyclic antidepressants. 
• Contraceptives may alter blood glucose level. 
• Antibiotics may decrease the absorption and effectiveness of oral contraceptives. 

Side effects 

• Breakthrough bleeding 
• Excessive cervical mucous formation 
• Breast tenderness 
• Hypertension 
• Nausea, vomiting 

Intervention 

• Monitor vital signs and weight 
• Instruct the client in the administration of the medication. ( it may take up to 1 week for full contraceptives effect to occur when the medication is begun)
• Instruct the client with diabetes mellitus monitor blood glucose levels carefully. 
• Instruct the client to report signs of thromboembolic complications 
• Instruct the client to notify the physician if vaginal bleeding or menstrual irregularities occur or if pregnancy is suspected. 
• Advise the client to use an alternative method of birth control when taking antibiotics because these may decrease absorption of the oral contraceptive. 
• Instruct the client to perform breast self-examination monthly and about the importance of annual physical examination. 
• If the client decides to discontinue contraceptives to become pregnant, recommended that the client use an alternative form of birth control for 2 months after discontinuation to ensure more complete excretion of hormonal agents before conception.

Contraceptive patches 

• Designed to be worn for 3 weeks and for a 1 week period. 
• Applied on clean, dry, intact skin on the buttocks, abdomen, upper outer arm, or upper torso.
• Instruct the client to peel away half of backing on patch, apply the sticky surface to the skin, remove the other half of the backing, and then press down on the patch with the palm for 10 seconds. 
• Instruct the client to change the patch weekly, using a new location for each patch. 
• If the patch falls off and remains off for less than 24 hours ( such as when the client is sleeping or is unaware that it has fallen off), it can be reapplied if still sticky, or it can be replaced with a new patch. 
• If the patch is off for more than 24 hours, a new 4 week cycle must be started immediately. 

Vaginal ring

• Inserted into the vagina by the client, left in place for 3 weeks, and remove for 1 week
• The medication is absorbed through mucous membranes of the vagina. 
• Removed rings should be wrapped in a foil pouch and discarded, not flushed down the toilet.

Implant and depot injections provide long-acting forms of birth control, from 3 months to 5 years duration.