L11 Pharmacist prescribing of the ECP and OC

Pharmacists can sell up to 6 months’ OC supply to a woman who: (select ALL)

You cannot switch between OCs except in cases where the patient may be from overseas and their usual formulation is not available.

If a patient is breastfeeding & wanting postpartum contraception, they can be supplied a COC & are to be referred to their medical practitioner.

Which of these is NOT an absolute contraindication for OCs?

Under section 44(m) of the Med Regs, pharmacists can supply a prescription medication at the request of a patient in an emergency. It must have been previously prescribed by a NZ prescriber in last [blank_start]3[blank_end] months. It can be 72 hours worth or the minimum [blank_start]pack[blank_end] size ie 1 month's for COC.

Which of these is not a common early side effect of OCs?

Women can access funded ECP without a prescription from their pharmacist.

Fertility: • Sperm survival – maximum [blank_start]7 days[blank_end] • Egg survival – [blank_start]12 – 24 hours[blank_end] • Full suppression of ovulation with COC, if the hormone free week is extended – risk of ovulation after about [blank_start]8 or 9 days[blank_end]

Copper intrauterine device (IUD) • The copper IUD is the most [blank_start]effective[blank_end] form of emergency contraception (almost 100% effective) • Works up to [blank_start]five[blank_end] days after unprotected intercourse • Efficacy is not affected by body mass index or [blank_start]weight[blank_end] • Copper IUD has [blank_start]few[blank_end] contraindications • Can be left in situ to provide future contraception • Must be fitted by an expert (GP or family planning clinic)

Emergency contraceptive pill (ECP) • Postinor-1 is the funded brand – contains [blank_start]levonorgestrel[blank_end] • Does not provide [blank_start]future[blank_end] contraception • may delay next period • can cause [blank_start]nausea and vomiting[blank_end] in some users (rare) • Efficacy is similar up to day for but only registered up to [blank_start]72 hours[blank_end]

Pharmacists are prevented by law from supplying the ECP, nor providing contraceptive advice, to people under the age of 16 years.

ECP Counselling… • If adverse effects occur, generally [blank_start]mild[blank_end] & will subside within 24 hrs. • Repeat the dose if [blank_start]vomiting[blank_end] within 3 hrs of taking ECP. • Next period may be early or late. • Increased pregnancy [blank_start]risk[blank_end] post-ECP as it can delay ovulation. • Seek medical attention ASAP if any lower abdominal pain occurs b/c this could be an ectopic pregnancy. • Perform a pregnancy test in [blank_start]3 - 4[blank_end] wks, if the next menstrual bleed is abnormally light, heavy or brief, or is absent, or if she is otherwise concerned. • Refer for STI counselling, continuous contraception, sexual assault?