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Chief Complaint

Are my new medications okay to use with my old ones?

History of Present Illness

Patient recently suffered a broken foot, post-surgery, and developed an infection. She is being discharged from the hospital on antibiotics, pain medications and her oral contraceptive and GERD medication that she was taking prior to admission.

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Missing Information?


Patient Database

Drug Therapy Problems

Care Plan (by Problem)


  1. What hormonal contraceptive drug interactions are present in this patient?

    Hint: See Table 49-5 in PPP

  2. What alternative contraceptive products may be used for this patient?

    Hint: See Treatment in PPP

  3. If the patient wants to continue her oral contraceptive, how long will the patient need to use an alternative contraceptive method?

    Hint: See Table 49-5 in PPP

  4. What risks and adverse effects of hormonal contraceptives would you discuss with this patient?

    Hint: See Table 49-4 in PPP

  5. How do the patient’s needs influence the choice of hormonal contraceptive agents?

    Hint: See Clinical Presentation and Diagnosis in PPP


Patient presents 4 weeks later. How is your ankle pain? How is your contraceptive working for you?

Hint: See Chapter 35 and Outcome Evaluation in PPP


Global Perspective

Unintended pregnancy continues throughout the world. From 2015 to 2019, approximately 121 million unintended pregnancies occurred each year globally. Of these, 61% resulted in abortion. Overall, compared to 1990 to 1994, unintended pregnancies have decreased from 79 to 64 per 1,000 women ages 15-49 years, however abortion has increased from 51% to 61%. Contraceptive access and proper use are very important particularly in lower income countries where unintended pregnancy is higher compared to middle and high-income countries.

1. +
Bearak  J, Popinchalk  A, Ganatra  B, Moller  AB, Tunçalp  Ö, Beavin  C, Kwok  L, Alkema  L. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019. Lancet Glob Health. 2020 Sep;8(9):e1152–e1161. doi: 10.1016/S2214-109X(20)30315-6. Epub 2020 Jul 22. PMID: 32710833. 
2. +
Unintended Pregnancy and Abortion Worldwide | Guttmacher Institute March 2022 Fact Sheet, Accessed June 15, 2022.

Key References

1. +
Curtis  KM, Tepper  NK, Jatlaoui  TC,  et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(No. RR-3):1–104. DOI:

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