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GU II > Pharm > Flashcards

Pharm Flashcards

1
Q

what medication is used to induce ovulation?

A

clomiphene citrate

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2
Q

what is the MOA of clomiphene?

A

induces ovulation as its a selective estrogen receptor modulator
it blocks estrogen’s negative effects on the hypothalamus leading to inc. GnRH

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3
Q

what pharmicokinetic changes of drugs cause higher fetal concentrations?

A

lipophilic, low molecular wt, high Pka, not affected by protein binding

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4
Q

what drug can cause significant renal failure in infants?

A

ACEIs

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5
Q

what drugs can cause neonatal abstinence syndrome

A

opiods

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6
Q

what can cause spina bifida?

A

dec. folic acid in diet

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7
Q

what does thalidomide do to a fetus? when are they most at risk?

A

causes limb malformations (phocomelia)

4-7 weeks gestation

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8
Q

what shows the following symptoms: low nasal bridge, small head and jaw, thin upper lip, epicanthal folds, poor growth, heart defects, delayed development?

A

fetal alcohol syndrome

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9
Q

what causes intrauterine growth retardation, stillbirth, risk for SIDs, neurobehavioral def?

A

tobacco use/nicotine`

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10
Q

what is the first line treatment for GBS?

A

penicillin

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11
Q

what is the second line treatment for GBS if there is no significant reaction to penicilin?

A

cefazolin

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12
Q

what do you treat GBS with if a patient is highly allergic to penicillin?

A

clindamycin and vacnomycin

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13
Q

what is used for a 1st trimester abortion?

A

misoprostol + mifepristone

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14
Q

what is the moa of mifepristone?

A

progesterone receptor antagonist

leads to endometrial decay

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15
Q

what is the MOA of misoprostol?

A

PGE1 analogue that causes uterine contractions

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16
Q

what do you use for a missed abortion/intrauterine fetal death?

A

dinoprostone (PGE2 analogue)

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17
Q

what is used for PPH due to uterine antony?

A

carboprost (hemabate)

PGF2 alpha analogue

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18
Q

what are the various obstetrical uses for misoprostol?

A

abortificant, ripen cervix, induce labor, treat PPH

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19
Q

what HTN drugs do you avoid in pregnancy?

A

prils and sartans

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20
Q

what drugs do you use for acute and chronic control of HTN in pregnancy?

A

methyldopa, hydralazine, labetalol, nifedipine

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21
Q

MOA of methyldopa

A

stimulates the central inhibitory alpha-2-adrenergic receptors, leading to a reduction in sympathetic tone, total peripheral resistance, and blood pressure

22
Q

moa of hydralazine

A

Direct acting arterial vasodilator

23
Q

moa of labetalol

A

Selective Alpha-1- blocker = vasodilate

Non selective Beta-1 block = decreased CO

24
Q

moa of nifedipine

A

Calcium Channel Blocker = arterial vasodilator

Fast release gel caps for acute, slow release tabs for chronic

25
Q

Explain the rationale for using magnesium sulfate in treating preeclampsia and eclampsia

A

prevents seizures with eclampsia

26
Q

Describe how magnesium sulfate is administered

A

Given as an IV loading dose followed by a constant IV infusion

27
Q

Explain the mechanisms of action of magnesium sulfate’s anticonvulsant effects

A

Unique calcium antagonist, an anticonvulsant: It inhibits calcium movement through its channels in a variety of tissues
Relaxes smooth muscle, also has the ability to decrease platelet aggregation and increase release of NO.
Increase the seizure threshold by inhibiting NMDA receptors, thereby limiting the effect of glutamate

28
Q

Recognize the signs of magnesium toxicity

A

N, warmth, flushing, somnolence, double vision, slurred speech, weakness, loss of patellar reflexes muscular paralysis, respiratory arrest, cardiac arrest

29
Q

identify a magnesium antidote

A

calcium gluconate

30
Q

Therapeutic use of misoprostol

A

cervical ripening
induction of labor
abortificient
PPH (prevent/treat)

31
Q

ADRs of misprostol

A

Diarrhea

shivering

32
Q

MOA of methylergonovine

A

ergot alkaloid

alpha 1 adrenergic, dopaminergic, agonist at serotonin receptors. induces uteronic effect and dec. blood loss

33
Q

MOA of oxytocin

A

stimulates uterine contractions

stimulates PG release

34
Q

therapeutic use of methylergonovine

A

prevent and treat PPH, not inducement of labor

35
Q

ADRs of methylergonovine

A

diarrhea
N/V
*hallucinations, abortifacient vasospasm for toxicity

36
Q

Treatments for PPH

A

Oxytocin
methylergonovine
carboprost
dinoprostone

37
Q

therapeutic use of oxytocin

A

Dilute: IOL after ripening via PGs

PPH

38
Q

ADRs of oxytocin

A

hyperstimulation of uterine contractions

activation of vasopressin receptors -> excessive fluid retention (hyponatremia, HF, seizures, or death)

39
Q

MOA of dinoprostone, misoprostol, and carboprost

A

bind PG receptors and inc. intracellular Ca leading to inc. adenylyl cyclase

40
Q

ADRs of carboprost

A

N/V

diarrhea

41
Q

therapeutic use of carboprost

A

PPH due to uterine atony

42
Q

therapeutic use of dinoprostone

A

cervical ripening (most common)
IOL
cervidil is sustained release

43
Q

contraindication to misoprostol use

A

women attempting vaginal birth w/ prior C/S

44
Q

what PG analogue is misoprostol

A

PG E1

45
Q

what PG analogue is dinoprost

A

PGE2

46
Q

what PG analogue is carboprost

A

PGF2alpha

47
Q

contraindications for dinoprostone

A

HTN, hepatic and renal dysfunction, glaucoma

48
Q

ADRs for dinoprostone

A

uterine hyperstimulation

uterine rupture w/wo fetal heart rate changes

49
Q

contraindications to carboprost

A

hypersensitivity

active renal, hepatic, or cardiac dz

50
Q

contraindications to methylergonovine

A

obstructive vascular dz

collagen dz

51
Q

contraindications for oxytocin

A

fetal distress
premi
abnormal fetal presentation

GU II (3 decks)

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