ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS
ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS
复制标题
澳大利亚皇家全科医生学院
DOI：
--
复制
发表时间：
1973
期刊：
影响因子：
--
通讯作者：
F. Farrar
中科院分区：
文献类型：
--
作者：
F. Farrar
首次咨询·获得病史：在发病后72小时内无保护性交？·在同一月经周期内有无保护性交的既往事件？·使用孕激素的禁忌症？·尿妊娠试验阴性，如果认为有必要测试·检查BP。血压升高不是禁忌症，但需要进一步调查·如果没有性传播感染（STI）的症状，延迟盆腔检查，直到随访·审查ECP的疗效，安全性和使用说明。·提到虽然非常有效，但ECP不是100%有效。·考虑成本。目前，开两剂仅含孕酮的口服避孕药（Microval®或Microlut®）更便宜，但必须在药房出示当前的医疗保险卡和医疗保健卡（如适用）。Postinor-2®可以通过私人处方（约20 - 25美元）提供，无需唯一的患者身份证明。·告知患者，如果她在服药后2小时内呕吐，她需要返回GP。·协助患者安排时间，以便在方便的时候给予第二剂。·讨论副作用（恶心，呕吐和乳房疼痛，头晕，疲劳，局部出血等不常见的副作用）。这些都是药物起作用的证据。
Initial Consultation • Obtain history: unprotected intercourse within 72 hours of presentation? • Prior episode(s) of unprotected intercourse in same menstrual cycle? • Any contraindications to progestogen use? • Negative urine pregnancy test if considered necessary to test • Check BP. Elevated BP is not a contraindication but requires further investigation • If no symptoms of sexually transmitted infection (STI), delay pelvic examination until followup • Review ECP efficacy, safety and instructions for use. • Mention that although highly effective, the ECP is not 100% effective. • Consider the cost. Currently it is cheaper to prescribe the progesterone-only oral contraceptive pill (Microval® or Microlut®) for two doses, however a current Medicare card and health care card (if applicable) must be shown at the pharmacy. Postinor-2® can be supplied via private prescription (~$20-$25), obviating the need for unique patient identification. • Inform the patient that she needs to return to the GP if she vomits within 2 hours of a dose. • Assist the patient to work out the timing so that the second dose is given at a convenient time. • Discuss side effects (nausea, vomiting and less common side effects of breast pain, dizziness, tiredness, spot bleeding). These are evidence that the medication is working.