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pharm II, exam 3 > Uterine drugs > Flashcards

Uterine drugs Flashcards

1
Q

DOC for inducing labor at term

A

oxytocin (Pitocin, Syntocin)

  • IV infusion
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2
Q

what happens to uterine receptors prior to labor and deliverty

A
  • number and sensitivity of oxytocin receptors in the uterus increase
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3
Q

uterus is generally resistant to stimulation during 2nd trimester but what can cause strong labor like contractions at this stage

A

prostaglandins

  • useful in inducing abortions at this time
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4
Q

1st line treatment for postpartum hemorrhage

A

massage

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5
Q

indications for use for oxytocin

A
  1. induce labor at term if indicated: IV route
  2. prevention of hemorrhage: IM route
  3. stimulation of milk let-down reflex: nasal application
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6
Q

adverse effects of oxytocin

A
  • water intoxication: due to ADH like effect
  • uterine rupture with large doses
  • anaphylaxis
  • sinus bradycardia of fetus
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7
Q

CI to oxytocin

A

when you can’t deliver vaginally

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8
Q

List the Ergot Alkaloids

A
  • Ergonovine maleate
  • Methylergonovine Maleate
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9
Q

MOA of Ergot Alkaloids

A

contraction of uterine smooth muscle through activation of serotonin and alpha adrenergic receptors

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10
Q

when are Ergot Alkaloids used

A
  • after completion of labor and the delivery of the placenta to produce firm uterine contractions and to decrease uterine bleeding
    • 2nd line after massage and oxytocin have failed
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11
Q

Contraindications to use Ergot Alkaloids

A
  • should never be used to induce labor
  • obliterative vascular or coronary artery disease
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12
Q

List the Prostaglandin drugs

A
  • Dinoprostone (Prostin E2)
  • Carboprost tromethamine (derivative of PGF2a)
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13
Q

when is Dinoprostone (Prostin E2) used

A
  • expulsion of uterine contents
    • intrauterine fetal death
    • missed abortions
    • elective abortions
  • cervical ripening prior to delivery at term
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14
Q

adverse effects of Dinoprostone (Prostin E2)

A
  • GI disturbances, vomiting, diarrhea - black box
    • ​top 5 diarrhea producing drugs
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15
Q

list the top 5 diarrhea drugs

A
  • “Many quality Drugs Expel Crap”
  • Metformin
  • Quinidine
  • Dinoprostone
  • Erythromycin
  • Colchicine
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16
Q

when is use of Dinoprostone contraindicated

A
  • for abortions, shoud not be used in patients with
    • acute cardiac, pulmonary, renal, or hepatic diseases
    • asthma, HTN, anemia, jaundice, or epilepsy
17
Q

when is Carboprost tromethamine used

A
  • induced abortion in 13th and 20th week
  • postpartum bleeding due to uterine atony
    • 3rd line after massage, oxytocin, and ergots
18
Q

adverse effects of Carboprost tromethamine

A
  • vomiting and diarrhea
19
Q

when is use of Carboprost tromethamine contraindicated

A
  • should not be used in patients with
    • acute cardiac, pulmonary, renal, or hepatic diseases
    • asthma, HTN, anemia, jaundice, or epilepsy
20
Q

define premature labor

A

labor before the fetus has matured sufficiently for survival (37th week)

21
Q

primary risk factor for premature labor

A

previous preterm labor or preterm birth

22
Q

what can be given if delivery will happen before 37th week

A

corticosteroids: develop fetal lungs
* no option for stopping preterm labor is FDA approved

23
Q

MOA of Magnesium sulfate

A

relaxes the uterus probably by a direct effect

24
Q

1st line drug (prefernce) for stopping preterm labor

A

Magnesium sulfate

25
Q

use of Magnesium sulfate

A
  1. 1st line to relax the uterus and prevent preterm labor
  2. can prevent convulsions in pre-eclampsia and treat eclampsia
26
Q

route of administration of Magnesium sulfate

A

IV

27
Q

adverse effects of Magnesium sulfate

A

flu-like symptoms

28
Q

MOA of Nifedipine

A
  • L type calcium channel blockers
  • inhibits Ca2+ influx (smooth muscle contractions)
29
Q

use of Nifedipine in labor

A

becoming 1st line agent for preventing preterm labor

30
Q

MOA of Indomethacin

A
  • strong inhibitor of COX enzymes -> reduce prostaglandin synthesis
31
Q

Use of Indomethacin in labor

A
  • 2nd line drug for preventing preterm labor
32
Q

adverse effects of Indomethacin

A
  • partial closure of fetal ductus arteriosus
33
Q

Indications for use of Progesterone in preventing perterm labor

A
  • maintains length of pregnancy when given prophylactically from the 16th -37th weeks of pregnancy or until delivery
    • not effective for acute treatment
    • recommended for high risk women with a h/o preterm birth
34
Q

Indications for use of Nitroglycerin during labor

A
  • Emergency use only
  • in case of uterine rupture

pharm II, exam 3 (8 decks)

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