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Flashcards in Drugs Y4 Deck (17)
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1

What's Ritodrine?

MoA, class, side effects

Ritodrine

MoA: A tocolytic → inhibits smooth muscle contraction in the uterus (delays labour)

 

Class: beta-agonist

SE: tachycardia, headache, palpitations and impaired glucose tolerance 

To avoid in cardiac disease and diabetes! 

2

Atosiban 

MoA, class

MoA: oxytocin antagonist/inhibitor →tocolytic 

(reduces labour within 48-hour period) 

*it is preferable to use rather than ritodrine

3

Examples of tocolytics (5)

Tocolytics → to reduce onset of labour

  • Ritodrine → beta-agonist
  • Atosiban → oxytocin inhibitor (preferable to Ritodrine in view of better SEs)
  • Nifedipine → CCB, often used as tocolytic (not yet licensed for use in the UK) 
  • magnesium sulphate
  • indometacin → NSAID (to close a hemodynamically significant patent ductus arteriosus, as indicated by clinical evidence, in premature infants)

4

Relative contraindications to tocolysis (3)

  • rupture of membranes
  • fetal distress
  • intrauterine infection

5

When and why are corticosteroids indicated in preterm gestation?

 

What corticosteroids?

Betamethasone and dexamethasone (corticosteroids)

  • between 24 - 34 weeks of gestation (in preterm labour and absence of infection)
  • Use: to promote pulmonary maturity and to stimulate surfactant production

 

  • Proven to reduce risk of: respiratory distress, intraventricular haemorrhage and necrotizing enterocolitis (in premature babies)

6

Antibiotic used for infection prophylaxis in premature rupture of membranes 

Erythromycin 

 

 

*Penicillin is given in addition if group B strep has been isolated)

7

Use of what drug in a pre-mature labour is associated with necrotising enterocolitis?

Co-amoxiclav

8

Can Gentamicin be given in pregnancy?

Not, it has been associated with auditory and vestibular damage (2nd and 3rd trimester)

9

Mnemonic to remember DMARDs

'CALM GASP'

 

  • Cyclophosphamide
  • Azathioprine
  • Leflunomide
  • Methotrexate
  • Gold
  • Anti-malarias
  • Sulfasalazine
  • Penicillamine

10

SEs of Cyclophosphamide (2)

Cyclophosphamide = DMARD

SEs: 

  • risk of malignancy
  • bone marrow supression

11

Side effects (2) of Azathioprine

Azathioprine = DMARD

  • GI upset 
  • bone marrow suppression

12

Side effects (2) of Leflunomide

Leflunomide = DMARD

  • hepatitis 
  • hypertension 

13

Side effects (2) of Methotrexate

Methotrexate = DMARD

  • worsening of rheumatoid nodules
  • liver/lung fibrosis 

14

Side effects of Gold (3)

Gold = DMARD

 

  • rash
  • proteinuria
  • bone marrow supression

15

Side effect of anti-malaria (1)

retinal damage 

16

Side effects of sulphasalazine (2)

Sulphasalazine = DMARD

 

- infertility in males

- bone marrow supression

17

Side effects of Penicillamine 

- rash 

- bone marrow suppression