{"id":1545,"date":"2013-10-11T09:26:55","date_gmt":"2013-10-11T09:26:55","guid":{"rendered":"http:\/\/jacobimed.org\/NS\/?page_id=1545"},"modified":"2013-10-11T09:26:55","modified_gmt":"2013-10-11T09:26:55","slug":"ec-question-2","status":"publish","type":"page","link":"https:\/\/jacobimed.org\/old\/ambulatory\/mlove\/curriculumwomengeri-2\/emergency-contraception\/ec-question-2\/","title":{"rendered":"EC question 2"},"content":{"rendered":"<p>&nbsp;<\/p>\n<div class=\"Section1\">\n<h1>Question #2<\/h1>\n<p class=\"MsoNormal\"><span style=\"text-decoration: underline;\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">Emergency contraception and HIV prophylaxis should be offered.<span>&nbsp; <\/span>Emergency contraception options include<br \/>\nestrogen\/progestin combination regimen (Yupze method), progestin alone (Plan B),<br \/>\nmifepristone (RU-486), or copper IUD insertion would be effective.<span>&nbsp; <\/span>The estrogen\/progestin combinations,<br \/>\nprogestin alone or mifepristone are best administered within 72 hours.<span>&nbsp; <\/span>There is some evidence that there may be<br \/>\nefficacy up to 120 hours.<span>&nbsp; <\/span>However, only<br \/>\nIUD insertion is recommended for up to 120 hours.<span>&nbsp; <\/span>These methods work by preventing ovulation, preventing<br \/>\nimplantation, or causing regression of the corpus luteum and are not considered<br \/>\nequivalent to therapeutic abortion.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">The Yupze method requires 100 micrograms ethinyl estradiol and 0.5 mg<br \/>\nof levonorgestrel taken twice 12 hours apart. Preven is a prepackaged<br \/>\nestrogen\/progestin.<span>&nbsp; <\/span>Standard birth<br \/>\ncontrol pills can also be used with dosing adjustments.<span>&nbsp; <\/span>This methods is felt to be about 80%<br \/>\neffective.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">Levonorgestrel alone is more efficacious.<span>&nbsp; <\/span>It can be taken as a 0.75 mg 12 hours apart or 1.5 mg once.<span>&nbsp; <\/span>This is felt to be about 85% effective.<span>&nbsp; <\/span>Plan B, containing 2 0.75 mg levonorgestrel<br \/>\ntablets, has been marketed for this purpose.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">High dose estrogens, 5 mg of ethinyl estradiol daily for five days has<br \/>\nsimilar efficacy to the Yupze regimen.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">Mifepristone, an antiprogestin, works by preventing ovulation and<br \/>\nimplantation.<span>&nbsp; <\/span>600 mg once works 100% of<br \/>\nthe time if given within 72 hours.<span>&nbsp;<br \/>\n<\/span>Doses as low as 10 mg have been equally efficacious.<span>&nbsp; <\/span>Mifepristone appears to be efficacious even<br \/>\nup to 120 hours.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">A copper IUD can be inserted within 120 hours.<span>&nbsp; <\/span>The IUD will disrupt implantation.<span>&nbsp; <\/span>It will also provide ongoing contraception<br \/>\nafter the initial situation.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\">Other situations where emergency contraceptives should be considered<br \/>\ninclude intercourse where there was failure of the primary form of<br \/>\ncontraception.<span>&nbsp; <\/span>Examples are broken<br \/>\ncondoms, missed oral contraceptives, lack of contraceptives, missed or late<br \/>\ninjection of injectable contraceptives, dislodging of diaphragm or cervical<br \/>\ncap, and failure of coitus interruptus.<\/span><\/p>\n<p class=\"MsoNormal\"><span style=\"font-size: 14pt; font-family: Arial;\"><!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--><\/span><\/p>\n<p class=\"MsoNormal\"><!--[if !supportEmptyParas]--> <!--[endif]--><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Question #2 &nbsp; Emergency contraception and HIV prophylaxis should be offered.&nbsp; Emergency contraception options include estrogen\/progestin combination regimen (Yupze method), progestin alone (Plan B), mifepristone (RU-486), or copper IUD insertion would be effective.&nbsp; The estrogen\/progestin combinations, progestin alone or mifepristone are best administered within 72 hours.&nbsp; There is some evidence that there may be&#8230;.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1539,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"class_list":["post-1545","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1545","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/comments?post=1545"}],"version-history":[{"count":1,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1545\/revisions"}],"predecessor-version":[{"id":1547,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1545\/revisions\/1547"}],"up":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1539"}],"wp:attachment":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/media?parent=1545"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}