drugs used in pregnancy

Question 1

what is an oxytocic

Answer 1

this is any agent that stimulates the uterus to contract

Question 2

what are oxytocics used for

Answer 2

used for the induction or augmentation of labour

Question 3

what can be used to control postpartum hemorrhage

Answer 3

oxytocics

Question 4

tocolytics

Answer 4

this is an agent that inhibits uterine contraction

Question 5

describe the role of calcium and smooth muscle contraction

Answer 5

the more calcium present, the more vigourous a contraction is going to be

Question 6

what is oxytocin

Answer 6

this is a hormone produced during labour

Question 7

what does oxytocin do?

Answer 7

increases the force and frequency of uterine contractions

Question 8

what increases the force and frequency of uterine contractions

Answer 8

oxytocin

Question 9

what are the agonist drugs for oxytocin

Answer 9

pitocin and syntocinon

Question 10

pitocin and syntocinon are what

Answer 10

the proper name for oxytocin, and agonist drugs

Question 11

if you administer pitocin via iv, how quickly do uterine induction and augmentation occur?

Answer 11

response is almost immediately and subsides in one hour

Question 12

if you administer pitocin and syntocinon via IM how quickly is the response and how long does it persist for?

Answer 12

3-5 min and persists for 2-3 hours

Question 13

what is the goal of IM injection of oxytocin

Answer 13

to encourage robust contractions to reduce post partum hemmorhage

Question 14

what is the biological effect of oxytocin?

Answer 14

¡ Oxytocin from the fetus and mothers posterior pituitary stimulates the uterus to contract, stimulating the placenta to make prostaglandins which then stimulate more vigorous contractions of the uterus – positive feedback

Question 15

Oxytocin from the fetus and mothers posterior pituitary stimulates the uterus to contract, stimulating the placenta to make prostaglandins which then stimulate more vigorous contractions of the uterus – positive feedback
what is this describing?

Answer 15

this is describing the biological effect of oxytocin

Question 16

how is oxytocin administered for the induction of labour?

Answer 16

IV - dose is increased every 15-60 minutes

Question 17

what happens when too much oxytocin is given via IV?

Answer 17

the body will hold onto fluids

Question 18

why does the body hold onto alot of fluids when given too much oxytocin

Answer 18

because oxytocin binds to an ADH receptor, this will stimulate the body to conserve water, possessing an antidiuretic affect

Question 19

uterine hypertonus is a result of what?

Answer 19

too much oxytocin administered, binding to ADH receptor gives antidiuretic affect

Question 20

when should oxytocin infusion be d/c

Answer 20

if contractions are less than 2 min apart and last longer than 90 seconds

Question 21

if contractions are less than 2 min apart and last longer than 90 seconds what should be discontinued

Answer 21

oxytocin adminsteration

Question 22

what will happen to the uterus if there is too much over stimulation

Answer 22

it will begin to seize

Question 23

dinoprostone

Answer 23

this is a oxytocic agent, works to ripen the cervix and initiate labour

Question 24

what oxytocic agent causes cervical ripening and initiates labour

Answer 24

dinoprostone

Question 25

what prostagladin agonist is used to control post partum hemorrhage in cases that are not responding to oxytocin

Answer 25

carborprost

Question 26

what might prostagaldins cause?

Answer 26

nausea, vomiting, diarrhea, headache, hypertension, and bronchiospasm

Question 27

ergot alkaloid

Answer 27

causes contractions within 1-5 minutes that persist for 3 hours, we dont use much because of increase of blood pressure

Question 28

why shouldn't ergot alkaloids be used to induce labour?

Answer 28

since it raises blood pressure, it can raise the chances of uterine hypertonus

Question 29

why should ergot alkaloids not be used for induction or augmentation and prostagladins not be used to augmentate labour

Answer 29

because of the increased risk of uterine hypertonus

Question 30

what drug decreases the intracellular calcium levels and reduces the strength of uterine contractions

Answer 30

tocolytic drugs

Question 31

when are tocolytic drugs commonly administered

Answer 31

pre term labour, cephalic version, uterine hypertonus

Question 32

what does the administration of tocolytic drugs 48 hours before preterm labour allow for

Answer 32

administration of gluccocorticoids, delivery at same facility, prolonged pregnancy

Question 33

what does the administration of glucocorticoids in pre term pregnancy allow for

Answer 33

they speed up the lung maturation in the fetus, increasing outcomes

Question 34

glucocorticoid therapy is recommended for who

Answer 34

women between 24 and 34 weeks of pregnancy that are likely to deliver a premature baby

Question 35

glucocorticoid therapy reduces the risk of what complications by 50%

Answer 35

respiriatory distress syndrome bleeding in the brain necrotizing enterocolitis spesis

Question 36

when should tocolytic drugs be administered?

Answer 36

between 24-34 weeks of pregnancy, chance of pre term | when pt is experiencing contractions that last longer than 45 seconds occurring 2-10 min apart

Question 37

what should be administered when the pt is experiencing 45 secong contractions 2-10 mins apart

Answer 37

tocolytic drug;

Question 38

tocolytic prostaglandin inhibitors

Answer 38

inhibit prostaglandin synthesis via inhibiton of COX1 and COX2 enzymes

Question 39

what are the side effects of giving NSAIDs after 32 weeks gestation?

Answer 39

premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurugitation and renal failure

Question 40

Premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurgitation and renal failure are what?

Answer 40

side effects of adminsitering NSAIDs after 32 weeks gestation

Question 41

tocolytic drugs; calcium channel blockers

Answer 41

what we know; calcium plays a huge role in smooth muscle contraction, so if calcium is inhibited, there will be no action on the myometrium thus causing no contraction

Question 42

role of beta2 adrenergic antagonists

Answer 42

stimulate gs protien coupled b2-adrenergic receptors thus inducing phosphorylation and sequestration of CA

Question 43

what induces phosphorylation and sequestration of Ca

Answer 43

beta2 adrenergic agonists

Question 44

when would beta2-adrenergic agonists be used?

Answer 44

may be used when attempting cephaic version

Question 45

oxytocin receptor antagonists are

Answer 45

not effective

Question 46

how does atosiban (oxytocin receptor antagonist) work

Answer 46

it inhibits the binding of oxytocin at its receptor site

Question 47

tocolytic drugs - indomethacin

Answer 47

first time therapy for labor inhibition in women between 24-32 weeks of labour

Question 48

tocolytic drugs; nifedipine

Answer 48

between 32-34 week, recommended for initial treatment for preterm labour