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Spring Pharmacology > Labor & Delivery > Flashcards

Labor & Delivery Flashcards

1
Q

PLLR

A

Pregnancy & Lactation Labeling Rule

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2
Q

Medications used to stop uterine contractions and delay preterm birth

A

Tocolytic agents

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3
Q

EGA

A

Gestational age

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4
Q

Preterm labor window

A

20-37 weeks

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5
Q

Tocolytic agents are used up to what week?

A

34

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6
Q

Requirements for tocolytic use

A

20-34 weeks
Documented preterm labor (regular contractions and cervical change)
Maternal consent

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7
Q

Benefit of tocolytic use

A

Decreased neonatal morbidity and mortality

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8
Q

Fetal resuscitation, neuroprotection, hospital transport, and delivery delay to administer glucocorticoids would indicate the use of

A

Short course tocolytic therapy

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9
Q

Two relative contraindications to tocolytic therapy

A

Cervical dilation > 4 cm

Ruptured membranes

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10
Q

Labor is inevitable past what point?

A

4 cm cervical dilation

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11
Q

IUFD

A

Intrauterine fetal demise

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12
Q

Inflammation of the fetal membranes due to a bacterial infection

A

Chorioamnionitis

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13
Q

Absolute contraindications to tocolytic therapy

A 
Fetal death
Fetal anomalies incompatible with life
Fetal compromise warranting immediate delivery
Chorioamnionitis
Severe hemorrhage
Severe chronic HTN and/or preeclampsia
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14
Q

4 tocolytic agents

A

Magnesium sulfate
Terbutaline
Indomethacin
Nifedipine

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15
Q

Terbutaline classification

A

Beta agonist

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16
Q

Indomethacin inhibits

A

Prostaglandin synthetase

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17
Q

Nifedipine classification

A

Calcium channel blocker

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18
Q

Magnesium sulfate works by

A

Inhibiting the release of acetylcholine in neuromuscular junctions

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19
Q

This drug may decrease the incidence and severity of

A

Cerebral palsy

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20
Q

Target lab for magnesium sulfate

A

4-5.5 mg/dL of Mg

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21
Q

Two types of magnesium sulfate dosage

A

Loading and maintenance

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22
Q

Magnesium sulfate excretion

A

Renal

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23
Q

Flushing, nausea, vomiting, blurred vision, headache, lethargy, and diplopia are non life threatening maternal effects of

A

Magnesium sulfate

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24
Q

Maternal adverse effects of magnesium sulfate

A 
Muscle weakness/tendon rupture
Loss of DTRs
Pulmonary edema
Atelectasis
Respiratory arrest
Ileus
Hypocalcemia
Cardiac arrest
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25
Q

Fetal side effects of magnesium sulfate

A

Hypotonia
Lethargy
Hypocalcemia

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26
Q

Antidote for magnesium sulfate

A

Calcium gluconate

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27
Q

Frequent monitoring of vitals, LOC, and DTRs is required with

A

Calcium gluconate

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28
Q

This drug may depress fetal activity and decrease baseline FHR variability

A

Magnesium sulfate

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29
Q

Treatment for muscle weakness in patients on magnesium sulfate

A

Bed rest

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30
Q

Utero-placental blood and oxygen flow is decreased at

A

> 35 mmHg intrauterine pressure

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31
Q

Utero-placental blood and oxygen flow ceases at

A

50-60 mmHg intrauterine pressure

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32
Q

More than 5 contractions in 10 minutes over a 30 minute period is called

A

Tachysystole

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33
Q

Uterine resting tone between contractions > 20 mmHg or firm to palpation is called

A

Hypertonus

34
Q

FHR prolonged deceleration, tetanic uterine contraction, and increased uterine resting tone are the three requirements for

A

Terbutaline

35
Q

This drug allows a baby to clear acidosis that occurs during hypoxia

A

Terbutaline

36
Q

This drug promotes binding of intracellular calcium, inhibits actin and myosin chain, and relaxes uterine muscle

A

Terbutaline

37
Q

Maternal adverse effects of terbutaline

A 
Hyperglycemia
Hypokalemia
Tachycardia
Palpitations
Hypotension
Chest pain
Pulmonary edema
Nervousness
Nausea
Vomiting
Oliguria
38
Q

Fetal adverse effects of terbutaline

A

Tachycardia
Hyperinsulinemia
Hyperglycemia

39
Q

Neonatal adverse effects of terbutaline

A

Hypoglycemia
Hypocalcemia
Hypotension
Ileus

40
Q

Cardiac disease, hyperthyroidism, diabetes, and convulsive disorders are contraindications for

A

Terbutaline

41
Q

Hold terbutaline for

A

HR > 120 BPM

BP < 90/60

42
Q

S/s of pulmonary edema

A 
Dyspnea
Coughing
Crackles
Wheezing
Decreased SaO2
43
Q

This drug blocks production of prostaglandins leading to smooth muscle relaxation

A

Indomethacin

44
Q

Two prostaglandins blocked by indomethacin

A

Prostacyclin, thromboxane

45
Q

This drug is only given prior to 32 weeks

A

Indomethacin

46
Q

Duration of indomethacin

A

72 hours

47
Q

This drug can close the ductus arterioles prematurely

A

Indomethacin

48
Q

Maternal adverse effects of indomethacin

A 
N &amp; v
Dizziness
Skin rash
Decreased renal blood flow
Postpartum hemorrhage
Oliguria
49
Q

Neonatal adverse effects of indomethacin

A

Ventricular hypertrophy
Premature closure of ductus arterioles
Oligohydramnios

50
Q

Fundal massage can be used for

A

Postpartum hemorrhage

51
Q

This drug relaxes smooth muscle by blocking calcium entry into the cell

A

Nifedipine

52
Q

Nifedipine maternal adverse effects

A 
Hypotension
Tachycardia
Facial flushing
Headache
Peripheral edema
Nausea
53
Q

Nifedipine neonatal adverse effects

A

No known adverse effects

54
Q

Betamethasone classification

A

Corticosteroid

55
Q

Mechanism of betamethasone

A

Enhances fetal lung maturity by promoting increased synthesis and release of surfactant

56
Q

This drug decreases the risk and severity of Respiratory Distress Syndrome (RDS)

A

Betamethasone

57
Q

This drug should be administered in 2 IM doses 24 hours apart

A

Betamethasone

58
Q

Betamethasone should be given to these women

A

23-34 weeks EGA at risk for preterm delivery within 7 days

59
Q

This drug is administered to preterm infants per endotracheal tube to decrease RDS

A

Synthetic surfactant

60
Q

This drug is a synthetic lipoprotein used to decrease surface tension of the pulmonary fluids in the alveoli to decrease atelectasis

A

Surfactant

61
Q

3 antihypertensive medications

A

Hydralazine
Methyldopa
Labetalol

62
Q

This medication is used as both a tocolytic and an anti-seizure medication

A

Magnesium sulfate

63
Q

This drug is thought to compete with intracellular calcium across cell membrane

A

Magnesium sulfate

64
Q

Seizures are a concern with this condition

A

Preeclampsia

65
Q

This drug is IV push every 20 minutes until max dose is reached or BP is controlled

A

Hydralazine hydrochloride

66
Q

This drug is IV push incrementally increased doses every 10 minutes until max dose reached or BP controlled

A

Labetalol

67
Q

Methyldopa route

A

IV push

PO

68
Q

These antibiotics are given to prevent GBS transmission

A

Penicillin G

Ampicillin

69
Q

A one time dose of this antibiotic is given 60 minutes before a C-section

A

Cephalosporin 1st gen

70
Q

If a mom has a penicillin allergy, these two antibiotics are substituted for cephalosporin

A

Clindamycin and gentamycin

Can add azithromycin

71
Q

A stitch in the cervix if it is opening early

A

Cerclage

72
Q

These patients often require a higher dosage of antibiotics

A

Obese patients

73
Q

Dilation of the cervix is caused by

A

Degradation of collagen by proteolytic enzymes

74
Q

Rearrangement of collagen, elastin, and smooth muscle cells causes

A

Softening and effacement of the cervix

75
Q

These medications are rarely used now due to more efficient meds with fewer side effects and lower cost

A

Prostaglandins E2 medications

76
Q

Dinoprostone classification

A

Prostaglandin E2 cervical ripening agent

77
Q

This drug works via enzymatic dissolution of collagen fibrils, increasing H20 content, and causing chemical changes

A

Prostaglandin E2

78
Q

Dose related side effects of prostaglandin E2 meds

A 
Cramping
Painful contractions
N &amp; v
Diarrhea
Fever, chills
79
Q

Asthma, HTN, renal disease, liver disease, cardiac disease, seizure disorders, and diabetes require caution with this drug

A

Prostaglandin E2

80
Q

This drug can cause spontaneous abortion if given in the first trimester

A

Prostaglandin E1

81
Q

Misoprostol classification

A

Prostaglandin E1 cervical ripening agent

82
Q

This drug is administered either P.O. or per vagina

A

Misoprostol

Spring Pharmacology (1 decks)

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