QuestionSBA
QuestionChoice
Budesonide does not commonly interact with combined oral contraception
50381
c
Budesonide 400 micrograms INH BD
QuestionChoice
Carbamazepine is a PY450 enzyme inducer, this is the enzyme responsible for the metabolism of the combined oral contraceptive pills. Increased activity of said enzyme results in the combined oral contraceptive pill being metabolised quicker and therefore having a lower efficacy. Other PY450 inducers include phenytoin, phenobarbital, felbamate, topiramate, oxcarbazepine and primidone.
50379
a
Carbamazepine 200mg PO BD
QuestionChoice
Cetirizine does not commonly interact with combined oral contraception
50382
d
Cetirizine 10mg PO OD
QuestionChoice
Hydromol does not commonly interact with combined oral contraception
50383
e
Hydromol cream one application to affected area BD
QuestionChoice
Salbutamol does not commonly interact with combined oral contraception
50380
b
Salbutamol 200micrograms INH QDS
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3659
Taking the combined oral contraceptive pill and carbamazepine reduces the efficacy of the combined oral contraceptive pill
Topic
131
Obstetrics & Gynaecology/Paediatrics
10130
Case Presentation: A 18-year-old woman attends her GP asking for the combined oral contraceptive pill.  Her regular medicines are listed (below).


**PH** Asthma, Epilepsy, Eczema, Allergic rhinitis

**DH** Salbutamol 200micrograms INH QDS, Budesonide 400 micrograms INH BD, Carbamazepine 200mg PO BD, Cetirizine 10mg PO OD, Hydromol cream one application to affected area BD

Question: Select the prescription that is most likely to reduce the efficacy of the combined oral contraceptive pill.
a