Gynaecology Mcqs Postgraduation entrance preparation
Friday, September 18, 2009
30 - Drugs that May Reduce Combined Hormonal Contraceptive Efficacy
Interacting Drug
Documentation
Antituberculous
Rifampin
Established; reduced efficacy if 50 microg EE
Antifungals
Griseofulvin
Strongly suspected
Anticonvulsants and sedatives
Phenytoin, mephenytoin, phenobarbital, primidone, carbamzepine, ethosuximide
Strongly suspected; reduced efficacy if 50 microg EE; trials lacking
Antibiotics
Tetracycline, doxycycline
Two small studies find no association
Penicillins
No association documented
Ciprofloxacin
No effect on efficacy of a 30 microg EE + desogestrel pill
Ofloxacin
No effect on efficacy of a 30 microg EE + levonorgestrel pill
Antiretrovirals
Variable effects; see manufacturer or other
EE = ethinyl estradiol.
29 - Drugs Whose Effectiveness Is Influenced by Combination Oral Contraceptives
Interacting Drug
Documentation
Management
Analgesics
Acetaminophen
Adequate
Larger doses of analgesic may be required
Aspirin
Probable
Larger doses of analgesic may be required
Meperidine
Suspected
Smaller doses of analgesic may be required
Morphine
Probable
Larger doses of analgesic may be required
Anticoagulants
Dicumarol, warfarin
Controversial
Antidepressants
Imipramine
Suspected
Decrease dosage about a third
Tranquilizers
Diazepam, alprazolam
Suspected
Decrease dose
Temazepam
Possible
May need to increase dose
Other benzodiazepines
Suspected
Observe for increased effect
Anti-inflammatories
Corticosteroids
Adequate
Watch for potentiation of effects, decrease dose accordingly
Bronchodilators
Aminophylline, theophylline, caffeine
Adequate
Reduce starting dose by a third
Antihypertensives
Cyclopenthiazide
Adequate
Increase dose
Metoprolol
Suspected
May need to lower dose
Other
Troleandomycin
Suspected liver damage
Avoid
Cyclosporine
Possible
May use smaller dose
Antiretrovirals
Variable
See manufacturer or other
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