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Practice exam 4: Answers
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
Three disadvantages of LARC include the possibility of irregular bleeding with Mirena (in the first six months) and Implanon; persistent bleeding may occur with Depo-Provera and heavier menstrual blood loss is common with CulUDs (1). A second disadvantage of LARC is that some, e.g. Mirena, Implanon and CulUDs, require a small operation or outpatient procedure to insert and remove them (1). A third disadvantage specific to Depo-Provera is the potential long ‘carry-over’ effect following discontinuation – resumption of ovulation may take up to a year (1). [There is no delay in return of fertility with CulUDs, Mirena or Implanon.]
Injectable contraception
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Subsequent injections of Depo-Provera should be given every 12 weeks and Noristerat at eight-week intervals. Observations of blood pressure and weight should be performed. Regular weight checks can be useful as often clients complain that their weight has increased, yet when weighed there is no change.
Medical treatment of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
Intramuscular Depo-Provera® is an alternative to oral medroxyprogesterone acetate. It is more often used for contraception, but has been shown to be effective in inducing amenorrhoea and improving endometriosis-associated pelvic pain. Depo-Provera is as effective as low-dose danazol combined with an oral contraceptive pill, but has far fewer side-effects11. The major side-effects of Depo-Provera include weight gain, breast tenderness. There may be prolonged amenorrhoea following termination of treatment. It is this last side-effect that limits use for women wishing to seek fertility in the short term.
Can behaviour support interventions successfully treat inappropriate sexual behaviour after acquired brain injury in community settings? A case series (N = 24)
Published in Neuropsychological Rehabilitation, 2022
Glenn Kelly, Suzanne Brown, Lauren Gillett, Joseph Descallar, Grahame K. Simpson
No medication was prescribed to target the ISX behaviours, and a minority of the sample were prescribed other classes of medication, limiting the likelihood that medication played a role in the reductions of ISX behaviours. Depo-Provera (medroxyprogesterone acetate) is a common agent employed by forensic services to treat sex offenders in general (Nair, 2016). The treatment of sexual aggression using Depo-Provera among an uncontrolled case series of clients with ABI (n = 8) has been reported (Emory et al., 1995). Those behaviours included instances of paedophilia or rape, whereas the behaviours in the current case series were not as severe. The results of the current case series suggest that behaviour support interventions can be considered as an alternative to medication as a treatment option for most ISX behaviours after ABI.
Access to contraception: A nonprofit’s community strategy
Published in Women's Reproductive Health, 2019
Lynda M. Sagrestano, Joy Clay, Ruthbeth Finerman, Amy F. Madjlesi, Nikole Gettings, Sydney Ashby
An additional barrier to availability related to the stocking of LARC. As they are somewhat expensive medical devices, most clinics did not keep stocks of LARC on hand, but instead ordered them as needed. This resulted in patients needing at least two appointments (one to choose a LARC and one for the insertion) with time in between for acquisition of the device, which served as an additional barrier to choosing LARC or to implementing the choice of a LARC. Similarly, patients who used Depo-Provera had to obtain a prescription from their doctor, fill the prescription at a pharmacy, and then return to their provider to have the shot administered. The nonprofit discovered that TennCare (the state Medicaid program) required patient-specific ordering of LARC and Depo-Provera. That is, each device ordered through TennCare was specified for a particular patient and had to be ordered after initial consultation; if the patient later decided not to have it inserted, the device could not be reallocated for another patient, as it had already been paid for by the insurance of the first patient. The nonprofit successfully lobbied TennCare to have patient-specific ordering of LARC and Depo-Provera removed, thus allowing providers to keep them in stock and removing this barrier to usage. The nonprofit was then able to fund the stocking of LARC in their partner clinics to ensure that patients who chose LARC did not need to return for a second appointment for insertion.
Phase 1 study to investigate the pharmacokinetic properties of dacomitinib in healthy adult Chinese subjects genotyped for CYP2D6
Published in Xenobiotica, 2018
Xia Chen, Ji Jiang, Nagdeep Giri, Pei Hu
Eligible subjects had no evidence or history of clinically significant dermatologic, haematologic, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurologic, or allergic disease. Subjects were excluded if they had any condition possibly affecting drug absorption (e.g. gastrectomy), a history or evidence of drug dependency, a positive urine cotinine test at screening, a history of or regular alcohol consumption exceeding seven drinks/week for women or 14 drinks/week for men, or were unwilling to avoid beverages containing caffeine and/or alcohol or abstain from smoking. Prior use of an investigational drug or biologic within the three months preceding the first dose of study medication was not allowed. Concomitant treatment with prescription or nonprescription drugs and dietary supplements within 14 days or five half-lives, whichever was longer, before the first dose of study medication was not allowed. Herbal medication and hormone replacement therapy had to be discontinued at least 28 days before the first dose of study medication. In addition, Depo-Provera® had to be discontinued at least six months before the first dose of study medication.