Kg - Pharm 2 Exam 3, Uterine Drugs Flashcards
(46 cards)
types of drugs used for uterine contraction?
- estrogens
- prostaglandins
- oxytocin
- stretching
types of drugs used for uterine relaxation?
- beta adrenergic drugs (b2 relax all smooth muscle)
- progesterone
- alcohol
- MgSO4
DOC for inducing labor at term? (and why?)
oxytocin
- NUMBER AND SENSITIVITY OF OXYTOCIN RECEPTORS in uterus increase just prior to delivery
what is useful to induce abortions during second trimester? (and why?)
prostaglandins
- uterus gen resistant to stimulation during 2nd trimester, but prostaglandins can CAUSE STRONG LABOR LIKE CONTRACTIONS at this stage
in postpartum hemorrhage, why is uterine massage 1st line treatment?
physical stretching stimulates uterine muscle contractions
how/when is oxytocin usu released?
in response to suckling/cervical pressure
oxytocin - indications/therapeutic effects?
DOC to INDUCE LABOR AT TERM IF INDICATED
- causes timed contractions
- IV infusion preferred
- augment labor in pts w/ uterine dysfunctional inertia
FOR PREVENTION OF HEMORRHAGE
- IM route preferred
STIMULATION OF MILK LET DOWN REFLEX
- nasal application method preferred
oxytocin - adverse effects
- WATER INTOXICATION w/ convulsions
- -> bc of ADH like effect (only if doses large/prolonged infusion)
- UTERINE RUPTURE w/ large dose
- allergy
- ANAPHYLAXIS
- SINUS BRADYCARDIA of fetus
oxytocin - pharmacokinetics?
- very short half life 1-6 min
- inactivated by liver/kidneys
oxytocin - contraindications/precautions?
anything that prevents vaginal delivery
- malpresentation
- cephalopelvic disproportion
- placenta previa
- uterine scar
- unengaged head
- cervical scarring
Ergot alkaloids - MOA
- contraction of uterine smooth muscle via activation of serotonin and alpha adrenergic receptors
ergot alkaloids - indications/therapeutic effects
- AFTER COMPLETION OF LABOR/DELIVERY OF PLACENTA to produce firm uterine contraction to decrease uterine bleeding
–> 2nd line after massage and oxytocin have failed
(for same reasons following suction abortion)
ergot alkaloids - pharmacokinetics
- rapid action (30-40 sec after IV, 10 min after oral use)
- lasts several hours
ergot alkaloids - adverse effects
- transient hypertension (contracts all smooth muscle)
- angina, MI
ergot alkaloids - contraindications/precautions?
- NEVER USED TO INDUCE LABOR (would cause fetal hypoxia)
- OBLITERATIVE VASCULAR/CAD
dinoprostone - indications/therapeutic effects
- expulsion of uterine contents (intrauterine fetal death, miscarriage, elective abortion)
- cervical ripening prior to delivery at term
dinoprostone - pharmacokinetics
abortion:
- one suppository in vagina (subsequent q 3-5 hrs until abortion occurs)
for cervical ripening:
- apply gel to cervix
dinoprostone - adverse effects
- GI, VOMITING, DIARRHEA***
- fever, chills, HA
dinoprostone - contraindications/precautions
abortion - NOT TO BE USED w/:
- acute pelvic inflammation
- ACUTE CARDIAC, PULMONARY, RENAL, HEPATIC DZ
- ASTHMA, HTN, ANEMIA, JAUNDICE, EPILEPSY
for cervical ripening:
- fetal distress
- hx difficult deliveries or c-section
carboprost tromethamine - indications/therapeutic effects?
- induce abortion in 13th/20th wk
- postpartum bleeding due to uterine atony
- -> 3rd like after massage, oxytocin, ergots
dinoprostone - info?
synthetic prostaglandin E2
carboprost tromethamine - info?
derivative of PGF2
carboprost tromethamine - pharmacokinetics?
- IM
- methylation increases half life from 15 sec to 8 min
carboprost tromethamine - adverse effects?
- not serious if used properly
- systemic PG actions often diagnosed as anaphylactic shock
- VOMITING, DIARRHEA
- fever, rash
