Upload
bharani-soundhar
View
17
Download
0
Embed Size (px)
Citation preview
hormonal contraceptives - 2 M.S.SOUNDHARRAJAN
OTHER TYPES : 1.INJECTABLES 2.IMPLANTS 3.VAGINAL RINGS 4.TRANSDERMAL CONTRACEPTIVE PATCH
INJECTABLES :CLASSIFICATIONPROGESTERONE CONTAINING injectables :1.DEPOT MEDROXYPROGESTERONE ACETATE:
◦ - DOSE: 150mg IM every 3 months (microcrystal aqus.suspn)◦ - given within first 7 days of menstrual cycle
SIDE EFFECTS:1st 3 months – irregular bleeding , prolonged bleedingat 1 year - amenorrhea ,infrequent bleeding , irregular
bleeding
2.NORETHINDRONE ENANTHATE: - 200 mg IM every 2 months
SIDE EFFECTS: Weight gain , Abdominal bloating and discomfort
Headache , Mood changes , less sex drive, Loss of bone density
Dizziness
ADVANTAGES OF PROGESTERONE ONLY INJECTABLES :Its long acting, reversible method
DMPA is least androgenic
Side effects of lipids and carbohydrate metabolism are low
Suited to lactating women
Avoids estrogenic side effects
Incidence of PID, ECTOPIC PREGNANCY, FUNCTIONAL OVARIAN CYST , ENDOMETRIAL CANCER are low
ESTROGEN AND PROGESTRONE CONTAINING INJECTABLES :
CYCLO-PROVERA or CYCLOFEM
◦ 25mg DMPA & 5mg estradiol cypionate◦ Once a month ,deep IM
ADVANTAGES :
Less menstrual irregularitiesEasily reversible
MESIGYNA :50mg NET +5mg estradiol valerate
IMPLANTS Subdermal drug delivery system ADV: - long acting , reversible, progesterone only TYPES OF IMPLANTS 1.Norplant – has 6 rods 2.Jadella & Norplant 2 – has 2 rods 3.Implanon – has 1 rod
NORPLANT DOSAGE:
Contains 6 capsules or rodsEach containing 36mg of levonorgestrel (totally 216 mg)Length – 34mm , 2.4mmg diameterDuration – 5 years
Under LA ,medial aspect of upper arm , capsule has to be removed
NORPLANT -2 (Jadelle) DOSAGE:
◦ 75 mg of levonorgestrel◦ Has two rods, each of length 43mm & 2.5mm in
diameter◦ Inserted on medial aspect of upper arm
ADVANTAGE : Easy to administer than norplant1
IMPLANON Long acting single rod subdermal implant Length – 4 cm ,2mm diameter
DOSAGE: 68mg of crystalline etonogetrel in ethylene vinyl acetate copolymer
DURATION : 3 years
Effects are reversible with in a month of removal
ADVANTAGES :
Long acting sustainable contraceptive Low systemic side effects Can be used by lactating mothers
DISADVANTAGES :
Ectopic pregnancy- 1.3% Local infection EXPENSIVE Has to insert & remove the capsules
CONTRACEPTIVE VAGINAL RINGS They were tried and abandoned. TYPES: Combined progesterone estrogen rings, progesterone ring, 3- keto desogestrel rings DOSE: 120 microgram of etonogestrel & 15 micrograms of ethinyl estriol DURATION : Used for 3 weeks with one week gap
CONTRACEPTIVE VAGINAL RINGS
TRANSDERMAL CONTRACEPTIVE PATCH DOSAGE : 150 micrograms of progestogen norelgestromin + 20 micrograms of ethinyl estriol. DURATION : 7 Days. FAILURE RATE :0.7 PER 100 Woman years. ADVERSE EFFECTS : nausea and/or vomiting , application site reaction , breast discomfort, engorgement or pain , headache , and emotional liability , spotting ,breakthrough bleeding.
RECENT ADVANCES UNDER DEVELOPMENT
VACCINES :
Research is on to produce vaccines which can be manufactured at relatively low cost with long lasting reversible contraceptive effects
Vaccines researched at present :
Anti HCG vaccine
Anti zona – pellucida vaccine
Anti sperm vaccine
OTHER METHODS UNDER DEVELOPMENT : Gene therapy , Regulatory peptides