Common drugs in Obstetrics Flashcards

1
Q

What are the indications for Oxytocin ?

A
  1. Induction and augmentation of labor
  2. Control and prevention of PPH
  3. Controls bleeding after: abortion or D & C for molar pregnancies
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2
Q

What are the contraindications for Oxytocin?

A
  1. Uterine scar
  2. Multiple pregnancies
  3. Fetal distress
  4. Malpresentation
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3
Q

What are the side effects of Oxytocin?

A
  1. Uterine Hyperstimulation
  2. Uterine rupture
  3. Maternal hypotension
  4. Fetal hypoxia and death
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4
Q

What are the MOA of Oxytocin?

MOA - Mechanism of action

A

In the Uterus: promotes uterine contractions by binding to oxytocin receptors in the myometrium → depolarization of muscle fibers and influx of Ca 2+ ions. Concentration of oxytocin receptors increases significantly in the 3rd trimester

In the Breast: facilitates milk ejection reflex via myoepithelial cell contraction

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5
Q

what is the brand name for Oxytocin?

A

Pitocin

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6
Q

What is Misoprostol?

A

A Prostaglandin E1 (PGE1) analog

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7
Q

What is the brand name of Misoprostol?

A

Cytotec

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8
Q

What is the MOA for Misoprostol?

MOA - Mechanism of action

A

Promotes uterine contractions & cervical ripening

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9
Q

What are the indications for Misoprostol?

A
  1. Control PPH
  2. Cervical ripening & induction
  3. Medical abortions
  4. Prophylaxis for NSAID-induced gastric ulcers (contraindicated during pregnancy)
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10
Q

What are the contraindications of Misoprostol?

A
  1. Treating of gastric ulcers while pregnant
  2. Uterine scar
  3. Hypersensitivity reaction
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11
Q

What are the side effects of Misoprostol?

A
  1. Nausea & Vomiting
  2. Diarrhea
  3. Uterine Hypertimulation
  4. Meconium stained liqour
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12
Q

What is the brand name of Methylergometrine?

A

Methergine

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13
Q

What is the MOA of Methylergometrine?

A

induces rapid and sustained tetanic uterine contractions by binding to Dopamine D1 receptors

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14
Q

What are the indications of Methylergometrine?

A
  1. Prevention & control of PPH
  2. Facilitate uterine contractions after C-section
  3. Control bleeding after: abortion and D & C for molar pregnancy
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15
Q

What are the contraindications for Methylergometrine?

A
  1. Administration after delivery of 1st twin (→ entrapment of 2nd twin)
  2. Heart disease (causes pulmonary edema due to sequestration of blood from uterine circulation into systemic circulation)
  3. Pre-eclampsia & Eclampsia (causes a sudden rise in BP)
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16
Q

What is the brand name for Carbopost tromethamine?

A

Hemabate

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17
Q

What is the MOA for Carbopost tromethamine?

A

Promotes uterine contraction

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18
Q

What are the indications for Carbopost tromethamine?

A
  1. Treat PPH 2° Uterine Atony
  2. 2nd Trimester termination
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19
Q

What are the contraindications to Carbopost tromethamine?

A

Use with caution in patients with:
* Asthma
* HTN
* Hepatic or Renal disease

20
Q

What are the side effects to Carbopost tromethamine?

A
  • Nausea & Vomiting
  • Diarrhea
  • Bronchoconstriction
  • HTN
  • Headache
  • Flushing
  • Pyrexia
21
Q

What is Mifeprestone?

A

An antiprogesterone (i.e., progesterone) & glucocorticoid antagonist

22
Q

What is the MOA for Mifeprestone

A

Because of it’s antiprogesterone effect it:
1. Prevents implantation of zygote
2. Prevents further development of implanted embryo

23
Q

What are the indications Mifeprestone?

A
  1. Medical abortion
  2. Emergency contrception
  3. Treat Fibroids & Endometriosis
24
Q

What are the contraindications for Mifeprestone?

A
  1. Ectopic pregnancy
  2. Bleeding disorders
  3. Anticoagualnt thereapy
  4. Long term corticosteroid therapy
  5. Adrenal failure
  6. Inherited porphyrias
25
Q

What are the side effects of Mifeprestone?

A
  1. Nausea & Vomiting
  2. Bleeding & Lower abdominal cramps
26
Q

What is MgSO4

Magnesium sulfate (MgSO4)

A

A Tocolytic

27
Q

What is the MOA for MgSO4

Magnesium sulfate (MgSO4)

A
  1. MgSO4 is a tocolytic, competes with Ca2+ ions for entry into the myometrium
  2. Blocks NMDA receptors in the brain
  3. reduces:
    * motor end plate sensitivity to ACh
    * the release of ACh from nerve endings

N-methyl-D-aspartate (NMDA)
Acetylcholine (ACh)

28
Q

What are the indications for MgSO4?

A
  1. Prevent convulsions in severe Pre-eclampsia & imminent eclampsia
  2. Anticonvulsant in eclampsia
  3. Preterm labor
  4. Neuroprotective effect on fetus
29
Q

What are the contraindications of MgSO4?

A
  1. Myasthenia gravis
  2. Maternal renal disease
30
Q

What are the side effects of MgSO4?

A
  1. Respiratory depression
  2. Respiratory & neuromuscular depression of newborn if mother recieved MgSO4 for prolonged periods prior to delivery
  3. Muscle weakness
  4. reduced FHR variability
31
Q

What is the antitode for MgSO4?

A

Calcium gluconate:10mL in 10% solution IV slow push

32
Q

What is the brand name for Methyldopa?

A

Aldomet

33
Q

What are the indications for Methyldopa?

A

BP control in Pre-eclampsia & Eclampsia

34
Q

What are the side effects of Methyldopa?

A

Maternal:
1. Postural hypotension
2. Bradycardia
3. Sedation
4. Headache
5. Depression
6. Hemolytic anemia
7. Hepatitis

Fetal: Intestinal illeus

35
Q

What is the brand name for Labetalol?

A

Trandate

36
Q

What is Labetalol?

A

A combined Alpa & Beta adrenergic receptor blocker

37
Q

What is the MOA of Labetalol?

A

Reduces peripheral vascular resistance & lowers BP

38
Q

What are the indications for Labetalol?

A
  1. Pre - eclampsia
  2. Eclampsia
  3. HTN ° Pheochromocytoma
  4. Clonidine withdrawal
39
Q

What are the contradications of Labetalol

A
  1. Asthma
  2. Heart block
  3. CHF
  4. Cardiogenic shock
40
Q

what are the side effects of Labetalol?

A
  1. Postural HTN
  2. Bronchospasm
  3. CHF
  4. Tremors
  5. Headache
40
Q

What is the MOA for Nifedipine

A

inhibits the voltage gated L-type calcium channels on vascular smooth muscle & myocardial cells → arteriolar vasodilation

41
Q

What are the indications for Nifedepine?

A
  1. Pre - eclampsia
  2. Tocolysis in Preterm Labor
42
Q

What are the side effects of Nifedipine

A
  1. Hypotension
  2. Tachycardia
  3. Headache
  4. Tocolysis
  5. DO NOT use with MgSO4
43
Q

What is the brand name for Butylscopolamine?

A

Buscopan

44
Q

What is another name for Butylscopolamine?

A

Hyoscine butylbromide