obs and gynae drugs Flashcards
(22 cards)
What does oxytocin do in labour?
Stimulates ripening of the cervix and contractions of the uterus during labour & delivery.
Plays a role in lactation during breastfeeding.
What can oxytocin infusions be used for?
Induce labour, progress labour, improve frequency & strength of uterine contractions, prevent or treat postpartum haemorrhage.
What is syntocinon?
Brand name for oxytocin.
What is atosiban?
Oxytocin receptor antagonist which can be used as an alternative to nifedipine & tocolysis.
What does ergometrine do?
Stimulates smooth muscle contraction, both in uterus & in blood vessels which makes it useful for placental delivery and helps to reduce postpartum haemorrhage.
When is ergometrine used?
Only ever used during the third stage (delivery of placenta) and postpartum.
What are side effects of ergometrine?
Hypertension, diarrhoea, vomiting & angina and needs to be avoided in eclampsia.
What is a combination drug containing oxytocin & ergometrine?
Syntometrine.
What do prostaglandins do?
Stimulate uterine contractions and ripen the cervix before delivery.
What prostaglandin is used for induction of labour?
Dinoprostone which is prostaglandin E2 which comes as a pessary (Propess), tablet (Prostin) or vaginal gel (Prostin gel).
What inhibits the action of prostaglandins?
NSAIDs as prostaglandins decrease blood pressure whereas NSAIDs increase blood pressure hence why you can’t take them in pregnancy.
What does misoprostol do?
Prostaglandin analogue so activates prostaglandin receptors so can be used as medical management in miscarriage to help complete the miscarriage.
When is misoprostol used alongside mifepristone?
Abortions & induction of labour after intrauterine fetal death.
What is mifepristone?
Anti-progesterone medication that blocks the action of progesterone, halting the pregnancy & ripening the cervix. It enhances the effects of prostaglandins to stimulate uterine contraction.
What is nifedipine?
CCB which reduces smooth muscle contraction in uterus.
When do you use nifedipine in pregnancy?
Reduce blood pressure in pre-eclampsia, tocolysis in premature labour, where it suppresses uterine activity and delays onset of labour.
What does terbutaline do?
Beta 2 agonist so stimulates beta 2 adrenergic receptors and acts on smooth muscle of uterus to suppress uterine contractions. Used for tocolysis in uterine hyperstimulation.
What does carboprost do?
Synthetic prostaglandin analogue so binds to prostaglandin receptors and stimulates uterine contraction. Given as IM in postpartum haemorrhage if ergometrine and oxytocin has been inadequate.
When can you not use carboprost?
Asthma - can lead to life threatening exacerbation.
What does tranexamic acid do?
Antifibrinolytic medication which reduces bleeding by binding to plasminogen and preventing it from converting to plasmin. Decreases plasmin activity, preventing bleeding.
When is tranexamic acid used?
Prevention & treatment of PPH.
