Flashcards in Repro pharm Deck (27)
After delivery of a healthy infant, a young woman begins to bleed extensively because her uterus has failed to contract. What can you give her?
contracts uterine smooth muscle
- also used to control post partum hemorrhage
Increased by oxytocin
increased by beta 2 - relaxes
B2 agonist --> increases Gs --> increases cAMP --> decreases MLCK
*myosin light chain kinase
PGE2, PGF2a, and oxytocin all activate Gq, which increase Ca2+ and causes myometrial contraction, What is their receptors?
these receptors do what?
activate Gq and cause increase in Ca2+ (thru L type Ca2+ channels) and cause myometrial contraction
PGE and EPI increase Gs and have what effects?
PGE --> Ep2-4 --> Gs --> increase cAMP --> cervic ripening-dilation
EPI --> B2 --> Gs --> increase cAMP --> myometrial relaxation
Cervical dilatation is dependent upon ______
Oxytocic --> contract
Tocolytic --> relax
Uterin sm also expresses B2-adrenergic receptors that mediate _____
Epi --> B2 --> Gs --> Increase cAMP --> myometrial relaxation
Elevated Liver enzymes
Low Platelet count
Leading cause of infant mortality
Preventing preterm labor
Adverse drug rxns of oxytocin
Higher doses --> water intoxication --> coma, convulsions, death
Impaired fetal oxygenation
- given orally to induce uterine contractions
Nifedipine increases HR
act via a1 and 5HT2 receptors --> direct contraction of vascular and uterine sm
- ONLY used for control of LATE uterine bleeding (if oxytocin doesnt work)
- reduce bleeding by causing sustained contraction of the uterus
A pregnant women presents at term for induction of labor, what to give her?
Admin of PGE2 vaginal gel until cervix has ripened followed in 6 hrs by admin of IC oxytocin thru an infusion pump if active labor has not occured
Wen are tocolytic agents indicated?
when delay in delivery for 48 hours will provide benefit to newborn
- reduce prematurity problems
Prostaglandin synthesis inhibitors (NSAIDS)
Most potent and widely used in suppressing labor in first 24-32 weeks gestation
Choice of inhibition of labor (tocolytic agent) if NSAIDS are contraindicated
(platelet disorders, renal dysfxn, GI ulcer disease, asthma)
- a vascular sm dilation
- potential concern is that fall in maternal BP may have negative fx on blood flow betwen uterus and placenta
b2 adrenergic agonist
- tocolytic agent
- inhibition of labor
- less effective if cervix has dilated and membranes have ruptured
- higher relative incidence of maternal side effects
(risk of maternal hyperglycemia, and fetal hypoglycemia)
decreases Ca2+ --> decreases MLCK
- indicated for pre-eclampsia and eclampsia
drug class that will cause uterine contractions and deliver the products of conception following interruption of an established pregnancy with mifepristone is:
prostaglandin analogs (misoprostol)
*note: prostaglandin analogs have Prost in the name
What drug interacts with nitroglycerin by inhibiting metabolism of cGMP?
1st line for ED
*blocks cGMP breakdown --> increases cGMP --> enhance vasodilation --> increase blood flow
*enhance fx of nitric oxide
Adverse rxns of sildenafil
1. "hot and sweaty"
5. Cyanopsia (blue-tinted vision)
"fils" that fill the penis
Inhibit PDE-5 --> increase cGMP -->
sm relaxation in corpus cavernosum --> increase BF --> erection
*enhance NO effect