Repro 1 Flashcards
(29 cards)
Name the drugs for induction of labor/control of post pardum bleeding
- Misoprostol
- Dinoprostone
- Carboprost
- Oxytocin
- Ergot alkaloids
Name the drugs for patent ductus arteriosos
Maintain - alprostadil
Close - indomethacin, Ibuprofen
Name corticosteroids used
- Cortisol
- Betamethasone
- Dexamethasone
Drugs for newborns (given right after birth)
- Erythromycin ointment
- Vitamin K
- Hepatitis B vaccine
Delaying labor drugs
- Indomethacin
- Nifedipine
- Terbutaline
- MgSO4
- Atosiban
Antihypertensives for pregnancy
- A-methyldopa (a2 agonist)
- Labetalol (a/b blocker)
- Nifedipine (CCB)
- Hydralazine (for severe, given IV)
What are the teratogen risk categories
A- low chance of fetal harm
D- evidence of fetal harm but benifits may outweigh negatives in some instances
X- contraindicated in pregnancy or in women who may become pregnant
What stops prostaglandins from acting on maternal tissue during pregnancy?
Enzyme PGDH inactivated amnion prositiglandins but it decreases during labor
What feedforward cascade is created in late gestation
Placental CRH stimulates fetal adrenal production of DHEA and cortisol
What is the role of connections and gap junctions in pregnancy
The allow for interconnectivity and extensive waves of depolarization over the large uterus
What changes do the cervix undergo doing ripening?
Collagen fibrils become disorganized and loosely packed
What drug is used for termination of pregnancy if less than 77 days and off label cervical ripening
Misoprostol. A prostaglandin E1 analog. This will also maintain the ductus arteriosus
What drug comes in a gel, vaginal insert, and suppository but it’s very expensive and needs refrigeration. What is an adverse effect
Dinoprostone. Mostly used for cervical ripening. Suppository will terminate pregnancy if before 20 weeks. Can cause fever unresponsive to NSAIDs
What drug can induced abortion but is mostly used for refractory bleeding after delivery
Carboprost. Prostaglandin F2a analog. Given by deep intramuscular injection
What drug causes prolonged tonic uterine contractions and constricts arterials and veins. What is its adverse effect
Ergot Alkaloids. Causes Saint Anthony’s fire, mania psychosis vomiting and gangrene of digits
What management for preterm premature rupture of membranes happens at 34 weeks
Group B strep prophylaxis’ and single corticosteroids. If less than 34 weeks ad antimicrobials to prolong latency
What management of pre-term rupture of membranes happens before 32 weeks
Magnesium sulfate for Nuro protection, antimicrobials, corticosteroid course, Group B strep prophylaxis and possibly tocolytics
What do corticosteroids do in order to increase surfactant production
Induces transcription of proteins in alveolar type two pneumocytes
Why is cortisol not administered to pregnant women
The placenta will metabolize Cortizone. Adding an OH at carbon 11 will allow the corticosteroid to pass
What drug blocks synthesis of PGF2a in order to prevent contractions
Indomethacin. Agent of choice from 24 to 32 weeks. After 32 weeks can close ductus arteriosus
What drug delays contractions by blocking calcium influx
Nifedipine. First choice from 32 to 34 weeks when NSAIDs are contraindicated
What drug delays contractions by increasing CAMP and potassium channel mediated hyper polarization, dephosphorylation of myosin light chains
Terbutaline. Should not be used for more than 2 to 3 days in injectable form, should not be used orally to prevent labor
What drug is used to prevent eclamptic seizures and has Neuro protection
Magnesium sulfate. Competes with calcium at channels
What drug blocks oxytocin
Atosaban 
