Go Back   Just Us Nurses! A Forum for Nurses. Learn, Share, Discuss, Conversate. The Choice is Yours. Join Us Today! > Nursing Today > Nursing in the News

User Tag List

Reply
 
LinkBack Thread Tools Rate Thread Display Modes
  #1  
Old 01-20-2009, 02:36 AM
DutchgirlRN's Avatar
Owner/Administrator
 
Join Date: May 2008
Location: USA
Posts: 7,923
Thanks: 3,899
Thanked 7,713 Times in 4,409 Posts
My Mood:
Mentioned: 2 Post(s)
Tagged: 2 Thread(s)
Default Plan B the morning after pill, now available without a prescription

The was obviously written before it went over the counter. I saw a commercial for it last night.


What is Plan B?
Plan B is a new emergency contraceptive (morning after pill) that was approved by the FDA in July 1999. It is made up of two progestin-only pills containing levonorgestrel.

Progestins are the "pregnancy" hormone. Levonorgestrel is used in regular birth control methods, such as Norplant. Previous formulations had used progestins in combination with estrogens, the "female" hormone. It is the first progestin-only pill that has been approved in the U.S. for emergency contraception after either unprotected sex or a contraceptive accident, such as a condom breaking.
Why do we care? Is Plan B better?
A common side effect of the morning after pills is nausea. Plan B causes nausea much less often than the next best formulation, which is called the Yuzpe method. Plan B causes nausea in about 23 % of those who take vs. about 50% of those on Yuzpe. It is also more effective. Plan B's pregnancy rate was only 1% vs. about 3% for Yuzpe.

This one-two punch of decreased side effects and increased effectiveness may have a hidden advantage. More eligible women may decide take it, because it is less life disrupting. Then, the unwanted pregnancy rate for reproductive age women as a group could be improved beyond the extra 2% drop in pregnancies due to the drugs themselves.However, progestin tends to be more expensive. It is likely that Plan B will cost more than Yuzpe.

Step By Step Guide for Plan B

1. Find Out Who to Contact to Get Plan B

In the U.S.: Since Plan B is a prescription medication, you must get it from a doctor. The doctor may require you to have an appointment. Since it is new medication, it may take time to obtain. The only providers currently giving it are those listed on the Planned Parenthood (1-888-NOT-2-LATE), or found through the Emergency Contraceptive website at Princeton.

There are plans to make it available through pharmacists in Washington State. Hopefully, this will spread.

In the UK, the two pill pack is not available. Following the regimen is done by taking about 25 separate levonorgestrel pills that add up to the total required dosage.

2. Get on the Phone Right Away--Effectiveness Drops with Each Passing Day

When a woman needs Plan B, she will have to get it very quickly. She can only start it within 72 hours (three days) after intercourse. But, sooner is better than later. On day one, 95% of pregnancies are prevented, compared with 85% on the second day, and 60% for those starting on the third day.

Be assertive on the phone. Let the staff know that there are time constraints.

3. Talk with a Health Professional about Eligibility for Plan B

Plan B should not be used by anyone who is or suspects she is pregnant. It should also not be used if the woman has been experiencing abnormal vaginal bleeding for an undetermined reason. If a woman has had an allergic reaction to any part of the pill, they should not use it. A past reaction to Norplant, would be an example.

Chinese women experience a higher pregnancy rate with Plan B (which is the true with the Yuzpe method). While the reason is not known in this case, typically racial/ethnic group related decreases in drug effectiveness are due to a genetic tendency to metabolize the drug faster. This means that those of Chinese descent will be affected, no matter where they live. Typically, such differences are dealt with by increasing the dose or simply using a drug regiment that doesn't show this difference.

4. Talk with a Health Professional about Medical History and Medications

Plan B may throw off blood sugar control a bit in diabetic women, so they should be monitored by a doctor. Plan B interacts with anti-convulsants like phenytoin, carbamazepine, and barbituates, as well as rifampin, a drug used to treat tuberculosis. However, no interactions have been found with antibiotics. Breastfeeding mothers don't need to worry.

5. Taking Plan B

Plan B can be taken at any time during the menstrual cycle, and should be taken as soon after unprotected sex as is possible. It must be started within 72 hours (three days). A second dose is taken 12 hours after the first. If a woman vomits within an hour after taking either of the two doses of Plan B, she should talk to your doctor to find out if she should repeat the dose.

6. The Immediate Experience

While the chance of nausea is dropped in half, it still afflicts about a fourth of its patients. This may cause a woman to take some time off of work or school in order to deal with this side effect. Some doctors suggest adding an anti-nausea medication to combat this. The woman may need to speak up and ask for it. Many anti-nausea medications cause drowsiness.

Other immediate common side effects reported by women taking Plan B include abdominal pain (17.6%), fatigue (16.9%), and headache (16.8%). Women will need to consider these factors in planning activities the two days after starting the medication.

Some women may find that they experience some spotting for a few days after taking Plan B. Wearing a pantyliner for two to three days is a good idea.

7. Afterwards

Fertility returns within a cycle or two after a course of Plan B. A significant percentage notice differences in their next period. Some notice heavier (13.8% of all users) and some lighter (12.5%) menstrual bleeding.

8. Follow-up and If Pregnancy Occurs Anyway

Women do not need to go for a routine follow-up physical exam after using Plan B. A visit for birth control is appropriate in many cases.

If a woman does become pregnant, it is more likely to be an ectopic pregnancy. Plan B doesn't cause ectopics per se. But since the uterus is not very receptive to the eggs that wind up there, by process of elimination, the tubal pregnancies become a higher percentage of the ones left. A woman should see a doctor right away if suspects she is pregnant, has pelvic pain, or any other concerns about her health.

The good news is that if a post-Plan B pregnancy goes to term, there hasn't been any adverse effects on the babies reported.

http://www.estronaut.com/a/Plan_B_Mo...traceptive.htm
__________________
Send a private message to DutchgirlRN


Joanna MSN, APRN, FNP-BC

Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #2  
Old 01-20-2009, 06:34 AM
BlueRidge's Avatar
Senior Member
 
Join Date: Jun 2008
Location: Blue Ridge Mountains
Posts: 1,682
Thanks: 2,227
Thanked 2,810 Times in 1,347 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Default

I only hope it doesn't lead to lowered use of appropriate contraception. At the health dept, we had some girls coming in for Plan B (by RX) every other month....but refused to be on BCP's regularly 'cuz they didn't like the hormones and didn't want it to look like they were PLANNING on intercourse!!
__________________

There is a God-Shaped hole in every human being that only He can fill.
Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #3  
Old 01-20-2009, 07:10 AM
DutchgirlRN's Avatar
Owner/Administrator
 
Join Date: May 2008
Location: USA
Posts: 7,923
Thanks: 3,899
Thanked 7,713 Times in 4,409 Posts
My Mood:
Mentioned: 2 Post(s)
Tagged: 2 Thread(s)
Default

I agree Pat. I think its a bad move to make it OTC. I mean why make it OTC? Just asking for people to abuse it.
__________________
Send a private message to DutchgirlRN


Joanna MSN, APRN, FNP-BC

Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #4  
Old 01-20-2009, 07:40 AM
HhRNhhr
Guest
 
Posts: n/a
Mentioned: Post(s)
Tagged: Thread(s)
Default

Oh, this is scary........
Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #5  
Old 01-20-2009, 10:52 AM
Poliopioneer's Avatar
Senior Member
 
Join Date: Jun 2008
Posts: 7,477
Thanks: 5,417
Thanked 5,786 Times in 3,765 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 2 Thread(s)
Default

Quote:
Originally Posted by HhRNhhr View Post
Oh, this is scary........
You bet it's scary! It scares me because I respect life. It scares me because I have never wanted to live in a civilization that goes to hell around me, while I'm minding my own business. It scares me because my next thought is, embryos now; who's next?

And I don't scare that easily any more.
Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #6  
Old 01-20-2009, 01:58 PM
momx3lvn's Avatar
Senior Member
 
Join Date: Jun 2008
Location: Contemplating what path to take.
Posts: 3,232
Thanks: 1,146
Thanked 2,571 Times in 1,725 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Default

There may just an increase in the number of unwanted pregnancie due to failure to follow directions properly and or thinking it is a substitute for BC. Not to mention the rate of STD's may increase if female use this as standard BC.
__________________
LVN on my way to RN.
Down 23.6 lbs since Jan 1st.
Reply With Quote Go to top
The Following User Says Thank You to momx3lvn For This Useful Post:
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #7  
Old 01-20-2009, 02:08 PM
TheBeeKeeper's Avatar
Senior Member
 
Join Date: Jun 2008
Location: The Portal to Hades
Posts: 735
Thanks: 1,356
Thanked 975 Times in 541 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Default

Is it possible that Plan B will not available in the quantitites that we are assuming?

For instance in my area Mucinex D is OTC however you can't get all you want thanks to the meth heads who were chopping them up to mix with other substances. We have to ask the pharmacist for it, we must be 18 and our driver's licenses are not just glanced at but scanned into their system because there are black strips on the backs of them here.

If your driver's license shows that you are attempting to buy more than a certain amount, (no more then 4 boxes in a week for an individual and not to exceed whatever in a month) it flags and the cops are called on you and you get a felony charge of "Doctor shopping" times however many boxes you tried to get. So if you tried to get 8 boxes and you're already over the limit then you would get 8 counts of doctor shopping.

It doesn't matter what drug store in the state you are in because it shows every mucinex d transaction made to that drivers license.

Plan B could have controls placed on it like this even if it is OTC.
__________________
"We barely have time to react in this world, let alone rehearse? Ani DiFranco


TheBeeKeeper, RN
Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #8  
Old 01-20-2009, 04:08 PM
Senior Member
 
Join Date: Jul 2008
Location: West Virginia
Posts: 326
Thanks: 139
Thanked 347 Times in 196 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Default

I think in many places it is considered under the counter meaning a pharmacist has to sell it to someone. There are multiple lawsuits right now over this. I can see both sides, a pharmacist shouldn't have to sell this if it is against their values but I also can see how much difficulty this could create for a patient who has limited means.

The abortion issue never changes. It still splits so many people. It is one issue that I truly an undecided on. I would never assist in one and I have that option but these pharmacist don't. But I also see the argument about this pill not being an abortion.

I don't like to hold other people to my morals or religious beliefs. Having said that I don't appreciate other groups forcing healthcare providers to perform morally offensive procedures such as dispensing this pill. So I do think pharmacist should not be forced to dispense this, otherwise as a voter I am inclined to tell my legislators this pill should just be outlawed.
__________________
"The username "Noryn" depicted in this post applies only to the poster on www.justusnurses.com.
Any similarity to "Noryn" on any other message board (living or dead) is merely coincidental."

~Noryn, RN
Reply With Quote Go to top
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #9  
Old 01-20-2009, 04:35 PM
Haunted
Guest
 
Posts: n/a
Mentioned: Post(s)
Tagged: Thread(s)
Default

3-4 years ago when I was getting started as a Sexual assault nurse examiner we had it in the drug box and offered it, along with ativan, valium, narcotics and antibiotics. There was no MD present at the time.

I thought it had been available for many years OTC from any pharmacist. Maybe it is now just starting to be advertised.

I have read everyone's comments about how it could "open the door" towards promiscuity, etc. One could also make that claim regarding Gardisil. Assuming your teen age daughter is going to be sexually active anyway, at least you can protect her from one STD.

I personally do not see the "morning after pill" as a type of abortion. And if it is available over the counter hopefully fewer women will have abortions. Now if we could get them to understand the need for contraception........
Reply With Quote Go to top
The Following User Says Thank You to For This Useful Post:
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
  #10  
Old 01-20-2009, 07:04 PM
TheBeeKeeper's Avatar
Senior Member
 
Join Date: Jun 2008
Location: The Portal to Hades
Posts: 735
Thanks: 1,356
Thanked 975 Times in 541 Posts
My Mood:
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Default

Everyone's posts have been very interesting. I can understand why some people find Plan B or the morning after pill offensive to their own belief system and if they don't want to administer it they should not have too, but are we all aware that this pill is not the same as RU-486 which is the medication that actually induces an abortion?

Plan B is a backup contraceptive and it's MOA is not effective on someone who is already pregnant.

I know everyone's a nurse here and knows their crap and I"m just a student but a correctional nurse down here got her butt in a sling for thinking Plan B and RU-486 were the same thing.

The jails here do dispense Plan B if the inmate requests it within 24 hours of being incarcerated but not RU-486. The nurse didn't do her med pass do to moral beliefs which was fine with the facility. Where she got in trouble is because she didn't know they were completely different from each other. No she was not fired but she was treated very negatively by the media and general public for not knowing something that a lot of lay people did know. I only bring this up because my pharm teacher last semester said a lot of very experienced medical people confuse RU-486 w/Plan B all the time.

Dutch and everyone else this board is the best we can discuss anything and it doesn't degenerate into nastiness.
__________________
"We barely have time to react in this world, let alone rehearse? Ani DiFranco


TheBeeKeeper, RN
Reply With Quote Go to top
The Following 3 Users Say Thank You to TheBeeKeeper For This Useful Post:
Nursing Forum, Nursing Education, Nursing School, Nursing Chat, Nursing Bulletin Board, Nursing Vent, RN, LPN
Reply

Bookmarks

Thread Tools
Display Modes Rate This Thread
Rate This Thread:

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On


All times are GMT -5. The time now is 05:37 PM.


Powered by vBulletin® Version 3.7.2
Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
Search Engine Optimization by vBSEO 3.6.0
User Alert System provided by Advanced User Tagging v3.2.4 (Lite) - vBulletin Mods & Addons Copyright © 2019 DragonByte Technologies Ltd.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.



Search only trustworthy HONcode health websites:

     
//-->