My roll number is bp1650169 and i am here to present my topic that is on the drug ethenyl easter diol with norethysterone first of all we will be discussing the indication and the rational use of this drug that for which purpose we are basically using this drug basically this drug is a combination of two hormones that is estrogen and the progesterone which is used
To prevent pregnancy these are also called as birth control pills it is a most common type of oral contraceptive method these preparations are highly effective in achieving contraception basically by using this drug we are preventing pregnancy now the mechanism action of this drug as we know this drug is a combination of two hormones estrogen in the progesterone
So each hormone will individually show its effect or its mechanism of action and helping and contraception in this combination estrogen provide negative feedback on the release of lh which is luteinizing hormone and fsh which is physically stimulating hormone by the pituitary gland thus preventing the release of an egg during menstrual cycle which is a process
Of ovulation now the progesterone it shows its effect by thicken the cervical mucus thus hampering the transport of sperm the withdrawal of the progesterone stimulates menstrual bleeding during the placebo week it also changes the lining of the uterus to prevent attachment of a fertilized egg hence preventing pregnancy following oral contraception now the side
Effects of this drug there are different side effects there can be different side effects of this drug depending upon the lady which is taking this contraception pills and the incidence of the side effects with the oral contraceptives is determined by specific compounds and the combination used means as we know this drug is a combination of two hormones so each
Hormone will show different types of side effects uh depending upon the lady but both of these hormones will perform its function so all both of these show different types of side effects according to this combination we will have side effects like because of the estrogen we can have the side effects like breast tenderness fluid retention headache nausea increased
Blood pressure and swelling and because of the progesterone it may associate it with depression changes in the libido historism and acne the another side effects can be incidence of cervical sensor can may also be increased with oral contraceptives because women are less likely to use additional barrier methods for contraception the another side effects can
Be abnormal or unusable with vaginal bleeding now the dose variation in the adjustments for this contraception pills in the adults and the teenager one tablet daily containing drug for consecutive 21 days followed by one week without drug means in this there is no drug and these are called as placebo tablets because they are basically the iron tablets in the
Pediatric this medication may be used for birth control in teenage patients in teenage females but should not be used before the start of menstruation this drug is basically contraindicated in the um in the children in the pediatric before menstruation and also in the in the women after the post manipul time now drug drug interaction means this drug can be
Interact with different types of drug if the person is taking before because of any reason so we have we will have we have different types of exam examples like first we have rafael persin and if we are using this contraceptive uh therapy with refimbracion then it can increase estrogen metabolism which will uh cause reduction in oral contraceptive efficacy means
By using a drug with rifampicin can lead to decrease contraceptive efficacy and there will be no contraception it will lead to pregnancy the another example can be ampicillin which lead to interruption of entire haptic circulation of estrogen causes reduction of oral contraceptive efficacy and then some other antibiotics may also have similar effect leading to
Pregnancy and there will be no contraception some other products may interact with this drug includes aromatase inhibitors such as anestrosol eczema stain finite one can also be used if used then this can occur all or corticosteroids etc now the contraception of the drug oral contraceptives are contraindicated basically in the presence of cerebrovascular and
Thromboembolic disorders and estrogen depending nucleus neuroplasm liver diseases and pregnancy now the combination oral contraceptives should not be used in the patients over the age of 35 who are heavy smokers this drug is also contraindicated for the patients of hypertension and hyper glycemia in all these condition this drug should not be used now the drug
Toxicity means by using this drug okay we can have different types of toxicity in our body so what are these toxicities these are evidence for carcinogenicity means there can be chance of cancerous formation in the cancer like uterus cancer ovarian cancer in the female so there is sufficient evidence in human for the carcinogenicity of post-menopausal estrogen
Therapy second direct toxicity can be concurrent use of calcium supplement with estrogen may increase calcium absorption means by using this drug there will be calcium absorption in our body and if there will be calcium absorption then there will be thromboembolic disorders thrombus will be formed emboli will be formed then there if these conditions occur then
There will be myocardial infarction as we know uh we can have this condition and because of calcium absorption they can also be the kidneys transformation in our body and they can be excess or bad nephrolithiasis in susceptible individuals the other toxicity is that female patients experiencing and overdose may present with in withdrawal bleeding nausea vomiting
Breast tenderness abdominal pain drowsiness and fatigue these all can be dropped toxicity by using this contraception pills now the dosage form this dosage form is available in usually two phases means we can have two faces of this drug the first is monophesic in the monophysic it contains a constant dose of estrogen and the progesterone given over 21 to 24 days
The other phase can be triphasic triphasic oral contraceptives products attempts to mimic the natural female cycle and most contain a constant dose of estrogen with increasing dosing of progesterone given over three successive seven days period now the availability of this these draw this form the product of the contraception can be available in different following
Dosage forms like tablet chewable dosage form and the capsule liquid form now the availability of different types of brands the there can be many modern brands but here we are discussing only three types of the brands the first brand is geogynone and there are different types of manufacturers for each brand like geogynone is prepared it’s manufactured in the
German pharma and the second is gyneric which is manufactured in the the fire of aromatic and the third is hydrate and which is manufactured in the hygeia which have different trade price each and every drug each and every brand has different rate price for in our country and in different countries now for the contraception we are discussing a case study for our
Understanding and the caste study which i have chosen is a patient is 19 year old mother of two the younger of which is nine months old and her last pregnancy was a difficult one and she doesn’t want another child for several years she came to the clinic for the contraception therapy the woman is obese the woman is obese and diabetic patient for which she uses
Metformin before meal now which contraception therapy would you recommend so for this case study we have a soap node in the top note we have first subject in the subject the gender is female whose age is 19 years old she visited hospital for the contraception therapy as she is the mother of two and obviously doesn’t want another child now uh and as her younger one
Is nine months old so she doesn’t want any pregnancy and in the history her medical condition is obese and diabetic patient and for the diabetes she uses metformin which is control so the diabetes is controlled by the metformin and her diet thus assessment of art softnote in the assessment first before given therapy the pelvic ultrasound should be performed for
If there is any complication so we can know before the giving the contraception otherwise there will be further complication if we didn’t do the ultrasound of the female so we should perform the pelvic ultrasound if there will be any problem in the patients in the ladies body in the lady body so uh we can have further conditions like and also we should perform
Different types of testing like blood tests so if there will be complication we will know about that then medication should be prescribed for contraception now in the plan according to the case the patient wants contraception so for the contraception of the drug of the lady the drug is which is recommended is we have different types of the drug but here we are
Using gynorate as the dose of the dynalite is that it will contain 28 tablets and with 21 tablets are active pills with medication in which the medication is present and seven reminder pills with no medication and the seven reminder pills will be used during the menstrual cycle now this medication should be used after your evening meal or at bedtime it is very
Important that you take this medication at the same time each day 24 hours apart means each medication will be used after every 24 hours at the same time daily if we do not have gynerate then the norcept can also be used used for this condition now something we should be considered by during using this contraception that the medication should not be escaped for
A day otherwise there will there can be chance of pregnancy so inhibiting the contraception and the other thing is that the lady should use different supplements like iron supplements multi vitamins and should assure the healthy diet good sleep and avoid stress then the contraception therapy will be perfect for a lady or will work for a lady thank you
Transcribed from video
Ethinyl estradiol and Norethesterone combinations By Pharmacy by Dr. Shahana wahid
