Chemical components of MALA D are?

Appeared in: HPSSC Staff Nurse - 2021

Explanation

Mala-D is a low-dose combined oral contraceptive pill provided under India's National Family Welfare Programme.
It contains two active hormonal ingredients: a synthetic progestin and a synthetic estrogen.
The specific composition is 0.15 mg of Levonorgestrel (progestin) and 0.03 mg (30 mcg) of Ethinyl Estradiol (estrogen).
The pack also includes 7 iron (ferrous fumarate) tablets to be taken during the pill-free interval.

Option B: This option incorrectly pairs D-Norgestrel (another name for Levonorgestrel) with Progesterone. The estrogen component in Mala-D is Ethinyl Estradiol, a synthetic estrogen, not natural Progesterone.
Option C: This option is incorrect because Mala-D is a combined oral contraceptive, meaning it contains both a progestin and an estrogen. Pills containing only a progestin are known as 'mini-pills' or progestin-only pills (POPs).
Option D: Norethisterone Acetate is a different type of synthetic progestin. While it is used in other combined oral contraceptive formulations, it is not the progestin component found in Mala-D.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Composition of Combined Oral Contraceptive Pills (Mala-D) as background academic context rather than a clinical decision trigger.
Nurses must be knowledgeable about the composition of different contraceptives to provide accurate patient education on usage, side effects, and contraindications.
Understanding the difference between Mala-D (socially marketed) and Mala-N (free government supply) is crucial for counseling patients in the Indian healthcare system.
Patient counseling must include clear instructions on the 'missed pill' protocol to ensure contraceptive efficacy and prevent unintended pregnancies.

How to Approach the Question

First, identify the core of the question, which is asking for the specific chemical ingredients of 'Mala-D'.
Recognize 'Mala-D' as a specific brand name of an oral contraceptive pill distributed under India's national family planning program.
Recall or deduce that combined oral contraceptives contain both an estrogen and a progestin.
Evaluate the options by matching the specific drug names. 'Levonorgestrel' is a common progestin and 'Ethinyl Estradiol' is a common estrogen in these pills.
Eliminate other options: 'Progesterone' alone is incorrect for a combined pill. 'Norethisterone Acetate' is a different progestin. The combination with 'Progesterone' instead of 'Ethinyl Estradiol' is also incorrect.

Concept Tested & Keywords

QO0f98f3G_DLQhy8gHj7Sw

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 194-196

E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 375-377

Practise the full HPSSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.