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O&G MRCOG PART 1 > Pharmacology > Flashcards

Pharmacology Flashcards

(74 cards)

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1
Q

POST PARTUM HEMORRAGE

A

POST PARTUM HEMORRAGE

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2
Q

What is the half life of oxytocin?

A

Oxytocin half life is 5 minutes

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3
Q

What is the half life of misoprostal?

A

Misoprostal half life is 20 to 40 minutes

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4
Q

What is the half life of Ergometrine ?

A

Ergometrine half life is 30 to 120 minutes

1/2 half to 2 hours

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5
Q

What drug is considered 1st choice for preventing PPH or postpartum hemorrhage?

A

Oxytocin is 1st choice for preventing post partum hemorrhage

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6
Q

Which nuclei in the hypothalamus is oxytocin synthesized?

A

Oxytocin is synthesized in the supraoptic and paraventricular nuclei

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7
Q

Where is oxytocin stored?

A

Oxytocin is stored in the posterior pituitary

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8
Q

How many aminoacids make up oxytocin?

A

Oxytocin is a nanopeptide made up of 9 aminoacids

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9
Q

Describe the oxytocin receptor

A

The oxytocin receptor is a G protein coupled receptor requiring Mg2+ and cholesterol.

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10
Q

What type of prostaglandin is misoprostal?

A

Misoprostal is a synthetic prostaglandin E1 analogue

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11
Q

What type of prostaglandin is carboprost?

A

Carboprost is a synthetic prostaglandin F2 analogue

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12
Q

What type of prostaglandin is Dinoprostone?

A

Dinoprostone is a naturally occuring prostaglandin E2

Mnemonic DinoprostonE for PG E2

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13
Q

What type of prostaglandin is dinoprost?

A

Dinoprost is a naturally occuring prostaglandin F2 alpha

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14
Q

How does ergometrine cause smooth muscle contraction?

A

The moa is not fully understood

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15
Q

When ergometrine is combined with oxytocin, what is that drug called?

A

Syntometrine
Synto - syntocinon
Metrine- ergometrine

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16
Q

By what percentage does prophylactic oxytocics reduce risk of postpartum hemorrhage?

A

Prophylactic oxytocics reduce risk of postpartum hemorrhage by 60%

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17
Q

If uterine atony is the caused of PPH what drug with dosage is given FIRST?

A

Syntocinon 5 units by slow IV injection

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18
Q

If uterine atony is the caused of PPH what drug with dosage is given SECOND?

A

Ergometrine 0.5mg by slow IV or IM injection
C/I in hypertension

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19
Q

If uterine atony is the caused of PPH what drug with dosage is given THIRD?

A

Syntocinon infusion
C/I fluid restricted patient

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20
Q

If uterine atony is the caused of PPH what drug with dosage is given FOURTH line?

A

Carboprost 0.25mg IM
Maximum of eight doses
C/I Asthmatics

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21
Q

If uterine atony is the caused of PPH what drug with dosage is given FIFTH line?

A

Carboprost 0.5mg direct intramyometrial injection

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22
Q

If uterine atony is the caused of PPH what drug with dosage is given SIXTH line?

A

Misoprostal 1000 micrograms rectally

or 1mg

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23
Q

What illicit drug can be maufactured from ergometrine?

A

LDS a hallucinogen can be manufactured by ergometrine

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24
Q

What is ergometrine?

A

An ergot alkaloid

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25
What dose of thiamine supplement is given for hyperemesis gravidarum?
Thiamine 100mg po tds
26
What is an alternative for thiamine supplementation?
Pabrinex / Vitamin B complex given intravenously
27
NSAIDS
NSAIDS
28
Aspirin and other NSAIDs are often contraindicated in individuals with asthma. The activity of which enzyme can exacerbated airway inflammation in such individuals? (Sizer and Neil)
Lipoxygenase
29
How does NSAIDs trigger bronchospasm in people with asthma
Inhibition of COX enzyme lead to the shunting of arachidonic acid to leukotriene by enzyme lipoxygenase
30
In the arachidonic acid cascade how is arachidonic acid formed?
Phospholipids from cell membrane is coverted to arachidonic acid via enzyme phospholipase
31
In the arachidonic acid cascade how is PGH2 formed?
Arachidonic acid is converted to PGH2 via enzyme cycloxygenase
32
In the arachidonic acid cascade how is PGH2 produces prostacyclin. What is its function?
1. Inhibits platelet aggregation 2. Causes vasodilation
33
In the arachidonic acid cascade how is PGH2 produces thromboxane A2. What is its function?
1. Promote platelet aggregation
34
TOCOLYTICS
TOCOLYTICS
35
According to NICE guidelines what is the FIRST line tocolytic?
Nifedipine
36
According to NICE guidelines what is the SECOND line tocolytic?
Oxytocin receptor antagonist such as atosiban
37
CONTRACEPTION
CONTRACEPTION
38
What is the moa of how the emergency contraceptive levonelle works?
1. Prevents or delay ovulation 2. Thins the lining of the uterus making implantation unfavourable 2. Affects fertilization
39
What drugs reduce the effectiveness of levenogestrel?
Enzyme inducers such as phenytoin
40
What are the options for emergency contraception if a patient is taking an enzyme inducer such as phenytoin?
1. copper IUD 2. High dose levenogestrel 3grams stat
41
In terms of emergency contraceptive within what time frame can copper IUD used?
Within 5 days of unprotected sex
42
What dose of ulipristal is given for emergency contraceptive?
30mg po stat
43
What is ulipristal and how does it function as an emeregency contraceptive
Ulipristal is a selective progesterone receptor modulator MOA 1. Delays or prevents ovulation 2. Thins endometrium making implantation unfavourable
44
In terms of emergency contraceptive within what time frame can ulipristal used?
within 5 days of unprotected sex
45
In terms of emergency contraceptive within what time frame can levenogestrel be used?
within 3 days of unprotected sex
46
Within what time line is a repeat dose of ulipristal given for emergency contraception
within 3 hours
47
Within what time line is a repeat dose of levenogestrel given for emergency contraception
within 2 hours
48
What is levenogestrel
A synthetic progesterone
49
What dose of levenogestrel is given for emergency contraception?
1.5mg po stat
50
Which antiepileptics are cytochrome P450 inducers?
Carbemazepine Phenytoin Phenobarbitone
51
Which antibiotic is a cytochrome P450 inducers?
Rifampicin
52
Which antifungal are cytochrome P450 inducers?
Griseofluvin
53
Which diabetic medication is cytochrome P450 inducers?
Sulphonylurea
54
Which beverage that is consumed socially can act as a cytochrome P450 inducers?
Alcohol
55
What is the concern with cytochrome P450 inducers and contraception
Cytochrome P450 inducers reduce the effective of some hormonal contraception
56
ANTIBIOTICS
ANTIBIOTICS
57
What is beta lactamase?
Beta lactamase is an enzyme produced by bacteria which breaks down the beta lactam ring found in certain antibiotics such as penincillin and cephalosporin. This cause bacterial reisistance.
58
What is clavulanic acid?
Clavulanic acid is a beta lactamase inhibitor Prevents bacteria from breaking down the beta lactam ring found in penincillin, making the antibiotic more effective.
59
What is the moa of penicillins?
Simply put - they interup the bacteria cell wall Beta lactam works by inhibiting the peptidoglycan cross links in bacterial cell wall
60
What is the moa of cephalosporins?
Simply put - they interup the bacteria cell wall Beta lactam works by inhibiting the peptidoglycan cross links in bacterial cell wall
61
What is peptidyltransferase?
This is the enzyme that binds amino acids together at the ribosome causing polypeptide chain.
62
What is the moa of macrolide?
1. Stop protein synthesis in bacteria 2. Peptidyltransferase inhibitor 3. Macrolides inhibit the enzyme peptidyltransferase which joins aminoacids together at the ribsomes
63
What is the moa of quinolones?
1. Inhibits DNA replication in bacteria 2. Inhibits the enzyme DNA gyrase 3. DNA gyrase works to uncoil DNA in bacteria to aide DNA replication
64
What is the moa of tetracyclines?
1. Interupts protein synthesis in bacteria 2. Binds to the 30S subunit of microbial ribosome blocking the attachment of aminoacyl tRNA to the A site of the ribosome
65
What is the A site of the ribosome?
The A site of the ribsome is where the tRNA carrying the new amino acid to be attached to the polypeptide chain comes to be. A site or aminoacyl site
66
What is the moa of nitrofurantoin?
Damages bacteria DNA
67
What is the moa of trimethroprim
1. Antifolate 2. Interrupts DNA synthesis and cell growth 3. Dihydrofolate reductase inhibitor, this enzyme is essential for DNA synthesis and cell growth
68
What is the risk of cross reactivity to cephalosporins in penicillin allergic patients?
0.5 - 6.5% Meta analysis performed in 2007 supported this theory and in 2008 the BNF revised the quoted figure to 0.5 to 6.5%
69
ANTIEMETICS
ANTIEMETICS
70
Why is the antiemetic odansetron 2nd line in the treatment of nausea and vomiting associated with hyperemesis gravidarum
Ondansetron carries a small risk of orofacial clefting
71
Why is the antiemetic metoclopromide 2nd line in the treatment of nausea and vomiting associated with hyperemesis gravidarum
Metoclopromide has an increase risk of extrapyramidal side effects
72
Regarding methotrexate which blood test are done for monitoring
1. Full blood count 2. LFTs 3. U&Es
73
What is the BNF advice regarding frequency of full blood count monitoring for patient whose therapy is not yet stabilized
Repeated every 1 - 2 weeks
74
What is the BNF advice regarding frequency of full blood count monitoring for patients established on treatment
Repeated every 2 to 3 months

O&G MRCOG PART 1 (14 decks)

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