Fatima O. Mohammed Drug Study Name of Drug: Protec Drug Order Generic Name: Levonorgestrel + Ethinyl Estradiol Route, Dosage, Frequency Dosage: 150 mcg/ 30 mcg Route: Oral Brand Name: Ferrous fumarate Classification: Hormonal contraceptives Frequency: OD Mechanism Of Action Indication Contraindication Drug Effects Nursing Responsibilities When LNG (or another progestin) is used in combination with EE, the primary mechanism of action is prevention of the surge of luteinizing hormone thereby preventing ovulation; but progestins also thicken the cervical mucus and alter the endometrial lining to help prevent fertilization or implantation. A combination of 2 hormones: levonorgestrel (a progestin) and ethinyl estradiol (an estrogen) used to prevent pregnancy. This birth control pills make periods more regular, decrease blood loss and painful periods, decrease risk of ovarian cysts, and also treat acne. Using this medication does not protect an individual against sexually transmitted diseases (such as HIV, gonorrhea, chlamydia). levonorgestrel/ethinyl estradiol may contain inactive ingredients that can cause allergic reactions. It is contraindicated to an individual with allergies to any estrogens (such as ethinyl estradiol, mestranol); or to any progestins (such as norethindrone, desogestrel). Side effects: Nausea, vomiting, headache, abdominal cramps/bloating, breast tenderness, swelling of the ankles/feet (retaining fluid), or weight change may occur. Increased blood pressure & vaginal bleeding/ spotting. •Note for allergic reactions including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. •Do not allow this medication if the client smokes cigarettes/use tobacco and is over 35 years old. •Smoking raises risk of stroke, heart attack, blood clots, and high blood pressure • Medical history, especially of: DVT, blood clotting disorders, high blood pressure, abnormal breast exam, endometrial and breast cancer), high cholesterol or triglyceride, depression, diabetes, thyroid problems, edema, Adverse effects: lumps in the breast, mental/mood changes (such as new/worsening depression), unusual changes in vaginal bleeding (such as continuous spotting, sudden heavy bleeding), severe pain in the stomach/abdomen/pelvis, dark urine, yellowing eyes/skin. •Inform the client to continue taking the medication exactly as prescribed by the doctor. Start with the first tablet in the pack, and take them in the correct order. •Encourage the client to not skip any doses. Pregnancy is more likely if she miss pills, start a new pack late, or take pill at a different time of the day than usual. •Taking the medication after evening meal or at bedtime may help to relieve stomach upset or nausea with the medication. •Vomiting/diarrhea stop the tablet working. Follow can from the & others. The client may need to stop this medication for a time or take special precautions. •This medication should not be used during pregnancy instructions written as if the client missed dose. •Most women do not have regular periods while taking this medication. If there is bleeding or spotting, do not stop taking the pills. •If the doctor directs the client to start the medication on any other day, use an additional form of non-hormonal birth control (such as condoms, spermicide) for the first 7 days to prevent pregnancy. If started on the first day of period, back-up birth control is not necessary in the first week. • This medication may cause blotchy, dark areas on the face and skin (melasma). Sunlight may worsen this effect. Limit time in the sun. Use sunscreen and wear protective clothing when outdoors.