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    Norgestrel

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    api-3797941
    Norgestrel is a progestin hormone used as a contraceptive. It works primarily by altering cervical mucus and the endometrium to prevent implantation. It is less effective than combination estrogen/progestin contraceptives at preventing pregnancy. It is contraindicated in pregnancy, breastfeeding, history of thrombosis, and liver or breast disease. Common side effects include headaches, mood changes, breast tenderness, irregular bleeding. Rare but serious risks include blood clots, stroke, and loss of vision.

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    Norgestrel

    Uploaded by

    api-3797941
    90 views3 pages
    Norgestrel is a progestin hormone used as a contraceptive. It works primarily by altering cervical mucus and the endometrium to prevent implantation. It is less effective than combination estrogen/progestin contraceptives at preventing pregnancy. It is contraindicated in pregnancy, breastfeeding, history of thrombosis, and liver or breast disease. Common side effects include headaches, mood changes, breast tenderness, irregular bleeding. Rare but serious risks include blood clots, stroke, and loss of vision.

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    norgestrel

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    Norgestrel is a progestin hormone used as a contraceptive. It works primarily by altering cervical mucus and the endometrium to prevent implantation. It is less effective than combination estrogen/progestin contraceptives at preventing pregnancy. It is contraindicated in pregnancy, breastfeeding, history of thrombosis, and liver or breast disease. Common side effects include headaches, mood changes, breast tenderness, irregular bleeding. Rare but serious risks include blood clots, stroke, and loss of vision.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    90 views3 pages

    Norgestrel

    Uploaded by

    api-3797941
    Norgestrel is a progestin hormone used as a contraceptive. It works primarily by altering cervical mucus and the endometrium to prevent implantation. It is less effective than combination estrogen/progestin contraceptives at preventing pregnancy. It is contraindicated in pregnancy, breastfeeding, history of thrombosis, and liver or breast disease. Common side effects include headaches, mood changes, breast tenderness, irregular bleeding. Rare but serious risks include blood clots, stroke, and loss of vision.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3

    norgestrel

    (nor jess' trel)


    Ovrette

    Pregnancy Category X

    Drug classes
    Hormone
    Progestin
    Hormonal contraceptive

    Therapeutic actions
    Progestational agent; the endogenous female progestin, progesterone, transforms
    proliferative endometrium into secretory endometrium; inhibits the secretion of pituitary
    gonadotropins, which prevents follicular maturation and ovulation; and inhibits
    spontaneous uterine contractions. The primary mechanism by which norgestrel prevents
    conception is not known, but progestin-only hormonal contraceptives alter the cervical
    mucus, exert a progestional effect on the endometrium that interferes with implantation,
    and in some patients, suppress ovulation.

    Indication
    • Prevention of pregnancy using hormonal contraceptives; somewhat less
    efficacious (3 pregnancies per 100 woman years) than the combined
    estrogen/progestin hormonal contraceptives (about 1 pregnancy per 100 woman
    years, depending on formulation)

    Contraindications and cautions


    • Contraindicated with allergy to progestins, tartrazine; thrombophlebitis,
    thromboembolic disorders, cerebral hemorrhage, or history of these conditions;
    CAD; hepatic disease, carcinoma of the breast or genital organs, undiagnosed
    vaginal bleeding, missed abortion; as a diagnostic test for pregnancy; pregnancy
    (fetal abnormalities—masculinization of the female fetus, congenital heart
    defects, and limb reduction defects); lactation.
    • Use cautiously with epilepsy, migraine, asthma, cardiac or renal dysfunction.

    Available forms
    Tablets—0.075 mg

    Dosages
    ADULTS
    Administer daily, starting on the first day of menstruation. Take 1 tablet, PO, at the same
    time each day, every day of the year. Missed dose: 1 tablet—take as soon as remembered,
    then take the next tablet at regular time; 2 consecutive tablets—take 1 of the missed
    tablets, discard the other, and take daily tablet at usual time; 3 consecutive tablets—
    discontinue immediately and use additional form of birth control until menses or
    pregnancy is ruled out.
    Pharmacokinetics
    Route Onset
    Oral Varies

    Metabolism: Hepatic; T1/2: Unknown


    Distribution: Crosses placenta; enters breast milk
    Excretion: Urine

    Adverse effects
    • CNS: Neuro-ocular lesions, mental depression, migraine, changes in corneal
    curvature, contact lens intolerance
    • CV: Thrombophlebitis, thrombosis, pulmonary embolism, coronary thrombosis,
    MI, cerebral thrombosis, Raynaud's disease, arterial thromboembolism, renal
    artery thrombosis, cerebral hemorrhage, hypertension
    • Dermatologic: Rash with or without pruritus, acne, melasma
    • GI: Gallbladder disease, liver tumors, hepatic lesions, nausea, vomiting,
    abdominal cramps, bloating, cholestatic jaundice
    • GU: Breakthrough bleeding, spotting, change in menstrual flow, amenorrhea,
    changes in cervical erosion and cervical secretions, endocervical hyperplasia,
    vaginal candidiasis
    • Other: Breast tenderness and secretion, enlargement; fluid retention, edema,
    increase or decrease in weight

    Interactions
    Drug-drug
    • Decreased effectiveness of hormonal contraceptives with barbiturates, hydantoins,
    carbamazepine, rifampin, griseofulvin, penicillins, tetracyclines; use alternate
    form of birth control if these drugs are needed
    Drug-alternative therapy
    • Decreased effectiveness if taken with St. John's wort

    Nursing considerations
    Assessment
    • History: Allergy to progestins, tartrazine; thrombophlebitis, thromboembolic
    disorders, cerebral hemorrhage; CAD; hepatic disease, carcinoma of the breast or
    genital organs, undiagnosed vaginal bleeding, missed abortion; epilepsy,
    migraine, asthma, cardiac or renal dysfunction; pregnancy; lactation
    • Physical: Skin color, lesions, turgor; hair; breasts; pelvic exam; orientation,
    affect; ophthalmologic exam; P, auscultation, peripheral perfusion, edema; R,
    adventitious sounds; liver evaluation; liver and renal function tests, glucose
    tolerance, Pap smear, pregnancy test

    Interventions
    • Arrange for pretreatment and periodic (at least annual) history and physical,
    including BP, breasts, abdomen, pelvic organs, and a Pap smear.
    • Start no earlier than 4 wk postpartum for postpartum use.
    • Discontinue drug and consult physician if sudden partial or complete loss of
    vision occurs; if papilledema or retinal vascular lesions are present on exam,
    discontinue.
    • Discontinue drug and consult physician at any sign of thromboembolic disease—
    leg pain, swelling, peripheral perfusion changes, shortness of breath.

    Teaching points
    • Take exactly as prescribed at intervals not exceeding 24 hr. Take at bedtime or
    with a meal to establish a routine; medication must be taken daily for prevention
    of pregnancy; if you miss 1 tablet, take as soon as remembered, then take the next
    tablet at regular time. If you miss 2 consecutive tablets, take 1 of the missed
    tablets, discard the other, and take daily tablet at usual time. If you miss 3
    consecutive tablets, discontinue immediately, and use another method of birth
    control until your cycle starts again. It is a good idea to use an additional method
    of birth control if any tablets are missed.
    • Discontinue drug and consult your health care provider if you decide to become
    pregnant. It may be suggested that you use a nonhormonal form of birth control
    for a few months before becoming pregnant.
    • Do not take this drug during pregnancy; serious fetal abnormalities have been
    reported. If you think that you are pregnant consult physician immediately.
    • Tell your nurse, physician, or dentist that you take this drug. If other medications
    are prescribed, they may decrease the effectiveness of hormonal contraceptives
    and an additional method of birth control may be needed.
    • These side effects may occur: Sensitivity to light (avoid exposure to the sun; use
    sunscreen and protective clothing); dizziness, sleeplessness, depression (use
    caution driving or performing tasks that require alertness); rash, skin color
    changes, loss of hair; fever; nausea; breakthrough bleeding or spotting (transient);
    intolerance to contact lenses due to corneal changes.
    • Report pain or swelling and warmth in the calves, acute chest pain or shortness of
    breath, sudden severe headache or vomiting, dizziness or fainting, visual
    disturbances, numbness or tingling in the arm or leg, breakthrough bleeding or
    spotting that lasts into the second month of therapy.

    Adverse effects in Italic are most common; those in Bold are life-threatening.

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