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Flashcards in Meds used in labour Deck (23)
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1
Q

Oxytocin drug class

Oxytocin production and release site

A

Oxytoxic hormones

Produced in the hypothalamus and travels to the posterior pituitary before being released into general circulation

2
Q

Oxytocin MOA

SE of oxytocin

A

stimulates the ripening of the cervix and contractions of the uterus during labour and delivery. It also plays a role in lactation during breastfeeding

Has a similar structure to vasopressin
Excessive quantities or prolonged use of oxytocin can therefore result in anti-diuretic effects with resulting water intoxication and hyponatraemia. This is due to water being absorbed in greater quantities from the kidneys. Oxytocin can also lead to uterine hyperstimulation.

3
Q

Oxytocin clinical indications

What is syntocinon

A

Induce labour
Progress labour
Improve the frequency and strength of uterine contractions
Prevent or treat postpartum haemorrhage

Syntocinon: brand name for oxytocin

4
Q

Oxytocin contraindications

Oxytocin route of administration

A

evidence of fetal distress, fetal prematurity, abnormal fetal position (including unengaged head), placenta previa, uterine prolapse, vasa previa, cephalopelvic disproportion, cervical cancer

Given by slow intra-venous infusion using an infusion pump. Uterine activity must be monitored carefully and hyperstimulation avoided. Oxytocin can also be given intramuscularly.

5
Q

Ergometrine clinical indications

MOA?

A

Derived form ergot plants
For delivery of placenta
To reduce postpartum bleeding in PPH. Only used after the delivery of the baby

Stimulates SM contraction both in uterus and blood vessels

6
Q

Ergometrine SEs?

Contraindications

A

Hypertension
Diarrhoea
Vomiting
Angina

Avoid in eclampsia and use only in patients with significant HTN

7
Q

What is syntometrine

A

A combination drug containing oxytocin (Syntocinon) and ergometrine. It can be used for prevention or treatment of postpartum haemorrhage.

8
Q

Dinoprostone drug class

Clinical indication

MOA?

A

Prostaglandin E2

For the induction of labour: To stimulate contraction of the uterine muscles
To ripen the cervix before delivery

Act as vasodilators and lower blood pressure

9
Q

Dinopristone forms for IOL?

A
Vaginal pessaries (Propess)
Vaginal tablets (Prostin tablets)
Vaginal gel (Prostin gel)
10
Q

Misoprostol drug class

Clinical indications

A

Prostaglandin analogue

Medical management of miscarriage
Misoprostol is used alongside mifepristone for abortions, and induction of labour after intrauterine fetal death

11
Q

Mifepristone drug class

Clinicall indications

MOA

A

Anti-progestogen medication- prostaglandin analog

Induction of labour after intrauterine death or for abortions

Competitive progesterone receptor antagonist
It sensitises the myometrium to prostaglandin-induced contractions.
Mifepristone is used alongside misoprostol. It is not used during pregnancy with a healthy living foetus

12
Q

Nifedipine drug class and MOA

Clinical indications in pregnancy

A

Calcium channel blocker

Acts to reduce smooth muscle contractions in blood vessels and uterus

Reduce blood pressure in hypertension and pre-eclampsia
Tocolysis in premature labour, where it suppresses uterine activity and delays the onset of labour

13
Q

Nifedipine SEs

Nifedipine contraindications

A

Flushing
Headache
Ankle swelling

Cardiac disease such as severe hypotension or heart failure

14
Q

Terbutaline drug class ?

MOA ?

A

Beta-2 agonist: stimulates beta 2 adrenergic receptors

It acts on the smooth muscle of the uterus to suppress uterine contractions

15
Q

Terbutaline clinical indications

A

Used for tocolysis in uterine hyperstimulation, notably when the uterine contractions become excessive during induction of labour

16
Q

Contraindications to tocolysis

A

Greater than 34 weeks gestation

Non-reassuring cardiotocograph, fatal foetal anomaly or intrauterine death

Intrauterine growth restriction or placental insufficiency

Cervical dilation greater than 4cm

Chorioamnionitis

Maternal factors such as pre-eclampsia, ante-partum haemorrhage, haemodynamic instability

17
Q

Carboprost drug class?

MOA?

A

synthetic prostaglandin analogue, meaning it binds to prostaglandin receptors

Stimulates uterine contraction

18
Q

Clinical indication and route of administration of Carboprost

A

PPH where ergometrine and oxytocin have been inadequate

Given as a deep IM injection

19
Q

Contraindications to Carboprost?

A

Patients with asthma: can cause life threatening exacerbation

20
Q

TXA drug class

MOA?

A

Synthetic derivative of lysine
Antifibrinolytic that rversibly binds to lysine receptor sites on plasminogen: reduces bleeding

It binds to plasminogen and prevents it from converting to plasmin. Plasmin is an enzyme that works to dissolve the fibrin within blood clots. Fibrin is a protein that helps hold blood clots together. Therefore, by decreasing the activity of the enzyme plasmin, tranexamic acid helps prevent the breakdown of blood clots.

21
Q

TXA Clinical indications

A

Prevention and treatment of PPH
menorrhagia
Beneficial in the trauma in the first 3 hours of bleeding

22
Q

Mefanemic acid drug class and clin ind

MOA?

A

NSAID used to treat mild to moderate pain for no more than a week and primary dysmenorrhoea

Cyclo-oxegenase inhibito (COX 1 AND 2)

23
Q

Mefanemic acid side effects:

A
Diarrhoea 
Constipation 
Gassy or bloating 
Headache 
Dizziness 
Gastric ulcers