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Reprouctive Pharmacology Flashcards

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1
Q

Rhogam (Rho(D) immune globulin)

A

Rh antibodies that are injected within 72 hours after birth to prevent sensitization in the rh- mother who has had a fetal maternal transfusion of rh+ fetal blood. Prevent hemolytic disease in next newborn

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2
Q

Indications. For rhogam

A

At 28 weeks rh_ mom to prevent sensitization. Can be give phorpholactically, or after any type of exposure risk that occurs after 28 weeks of gestation (amniocentesis, second trimester, miscarriage or abortion

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3
Q

What does rhogam do

A

Suppres antibody production in mom. Following delivery, preg termination, any abdominal trauma, ectopic preg, version, or after procedures such as amniocentesis or chorionic Billy’s sampling

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4
Q

MOE rhogam

A

Causes lysis of the fetal RBS from a rh-positive infant that may have entered the rh negative mothers bloodstream. By destroying the fetal RBC the mother does not form antibodies against them. Protect from becoming sensitized in future pregnancies

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5
Q

Side effects rhogam

A

Myalgia and lethargy

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6
Q

Coombs test

A

Blood test indicates the whether the mother has already been sensitized and has the presence of antibodies

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7
Q

Positive Coombs test

A

Mom sensitized

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8
Q

Negative Coombs est

A

Mom hasn’t been sensitized so can give rhogam

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9
Q

Does of rhogam 300 mcg given to mom. Not infant.

A

Standard

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10
Q

Microdose 50 mcg coombs

A

After 1st trimester miscarriage or abortion, ectopic preg or following chorionic villus sampling

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11
Q

Why need to watch for allergic responses with rhogam

A

Considered a blood product

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12
Q

Magnesium sulfate

A

CNS depressant inhibits the release of acetylcholine at neuromuscular junctions . Preventing skeletal and uterine muscle contraction.

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13
Q

Indication for magnesium sulfate

A

Preterm labor contractions and the treatment of pressclampsia

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14
Q

Side effects magnesium sulfate

A

Warm feeling, hypotension, decreased DTR, decreased respiratoy rate, decreased urine output, paralytic ileus

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15
Q

Antidote for magnesium sulfate

A

Calcium gluconate

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16
Q

MOS magnesium sulfate

A

Muscle relaxant and depresses CNS by stopping the release of ach
Decreased neuromuscular irritability and cardiac conduction
Also decrease hyperreflexia and preven t onset of seizure from eclampsia

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17
Q

Indications for magnesium sulfate

A

Preterm labor contractions and preeclampsia

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18
Q

Side effects magnesium sulfate

A

Warn feeling, hypotension, DTrS decreased respiratory rebate, decreased urine output, paralytic ileus,

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19
Q

Why get warm feeling with magnesium sulfate

A

Vasodilator

Get flushing

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20
Q

Why get hypotension from magnesium sulfate

A

Vasodilator

Can get pulmonary edema or headache

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21
Q

Why get decreased DTR with magnesium sulfate

A

Relaxes the CNS

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22
Q

Why get decreased urine output with magnesium sulfate

A

Renal perfusion decreases as a result of lowered bp and cardiac output.

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23
Q

Antidote to magnesium sulfate

A

Calcium gluconate

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24
Q

Magnesium toxicity

A

Cardiac arrest and respiratory depression.

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25
Effect of calcium glucoronate
Increases muscle contraction
26
Leuprolide
Gonadotropin releasing hormone agonist
27
MOA leuprolide when given in a pulsating manor
Stimulates GnRH receptors in the anterior pituitary resulting ins timulation of LH and FSh which then stimulate the ovaries and testes to produce sex steroids
28
MOA of leuprolide when given in a Continuous manor
Potent inhibitor of gonadotropin secretion when administered continuously resulting in suppression of ovarian and testicular production of sex steroids Down regulation LH FSH
29
What is pulsation use of leuprolide used o treat
Infertility
30
What is continuous leuprolide used to treat
Prostate cancer, precocious puberty, uterine fibroids, and endometriosis
31
Side effects of continuous leuprolide
*inhibit sex steroid-antiandrogenic | Decreased libido, nausea/vomiting and symptoms of menopause like amenorrhea and hot flashes
32
Upregulation of FSH LH
Bind to receptors on the Sertoli cells (males) and the leydig cells (females) and granula cells and theca internal cells in females
33
Downregulatoin FSH LH
Constant stimulation of GnRH receptors in anterior pituitary
34
How does pulsating leuprolide help fertility
Increase FSH LH. Stimulates leydig cells to produce testosterone and increases sperm production
35
Indications for continuous leuprolide
Palliative treatment of advanced prostate cancer, breast cancer
36
Uterine fibroids and leuprolide
Continuous Decrease e and p which temporarily puts patient in a postmenopausal state. Shrinks fibroids and the cessation of menstruation
37
Endometriosis and continuous leuprolide
(Cells lining the uterus appear to flourish outside the uterine cavity0in membrane lining the abdominal cavity, peritoneum) Decrease in e Helps control symptoms in endometriosis
38
Side effects leuprolide
Antiandrogenic effects such as decreasing testosterone in men andesterogen in women. Manifests as decreased libido, nausea/vomiting, as well as hot flashes and amenorrhea
39
Methylegonovine (methergine) and ergotamine (ergot alkaloids) examples
Methylergovine, ergotamine, dihydroergotamine
40
What do ergot alkaloids do
Produce strong powerful contractions and are used to control postpartum hemorrhage and treat migraine
41
Indication for ergot alkaloids
Migraine, postpartum hemorrhage, as second line after treatment with oxytocin
42
MOA ergot alkaloids
Smooth muscle contraction-causes uterine contractions Vasoconstriction-treat migraines but can cause hypertension
43
Side effects ergot alkaloids
Nausea, vomiting, severe hypertension, tachycardia
44
Why are ergot alkaloids used as second line treatment
Effects are often delayed
45
Why are ergot alkaloids not recommended for inducing labor
Delayed onset of contractions and should only be used for postpartum hemorrhage after the use of oxytocin
46
Why do ergot alkaloids help migrain
Constrict dilated blood vessels
47
Oxytocin
Synthetic analog of the hormone produced in the hypothalamus that is stored and released int he posterior pituitary
48
Function of oxytocin
Stimulate uterine contractions and initiate milk ejects from the nipple during breastfeeding
49
Indication for oxytocin
Induce labor and control hemorrhage after delivery
50
Why should oxytocin be give in lowest possible dose
Increased risk of side effects
51
When cant u administer oxytocin
Alone or without confirming cervical ripening in a pregnant patient
52
MOA oxytocin (pitocin)
Increased uterine contractions by stimulating receptors on the uterine muscle wall. Also stimulates milk ejection from nipple
53
Indications for oxytocin
Labor induction | Control postpartum hemorrhage
54
Side effects oxytocin
Uterine rupture, water intoxication
55
Why risk of rupturing uterine wall with oxytocin
Strength of muscle contractions | *higher risk if have previous uterine scarring (multi parity) bc weakened uterine walls
56
Contradictions to oxytocin
Fetal lung immaturity*before 20 was gestation Cervix not ripened *may cause fetal or maternal injuries Active genital herpes infection *TORCH need cesarean
57
Why must give oxytocin in IV
GI system destroys it
58
Carboprost (hemabate)
Synthetic prostaglandin used to treat postpartum hemorrhage by inducing uterine contractions.
59
What is postpartum hemorrhage
When after birth uterus doesn’t contract and stop bleeding
60
Indications for carboprost (hemabate)
Post partum hemorrhage | Abortion
61
Side effects carboprost
Hypertension, fever, bronchoconstriction, nausea, vomiting, diarrhea
62
MOA carboprost
Prostaglandin F2 alpha analog Smooth muscle contraction-cause intense uterine contractions to stop. Postpartum bleeding
63
Side effects carboprost (hemabate)
GI distress (SM contraction), hypertension (vasoconstrict), fever, bronchioconstriction (caution with asthma history)
64
Consideration carboprost with fever
Fever common cause of fever must be identified (drug induced or other, such as endometriosis)
65
Dinoprostone and misoprostol
Prostaglandin medications tat both act to ripen the cervix.
66
Dinoprostone (prepidil, cervidil)
Only used topically as a gel or vaginal insert Induce abortion or ripen the cervix to induce labor
67
Misoprostol (cytotoxic)
Also used as energy contraception and to prevent GI ulcers Also used topically as a gel or vaginal insert Induce abortion or ripen cervix to induce labor
68
MOA dinoprostone and misoprostol
Stimulate contraction and ripening of the cervix to stimulate induction of labor or the induction of abortion
69
MOA ddinprostons is also known as a ___, while misoprostol is a _____
``` Prostaglandin E2 (PGE2) Prostaglandin E1 (PGE1) ```
70
Indications for dinoprostone and misoprostol
Promote cervical ripening(breakdown of colalgen) Prevent GI ulcers(stimulates secretion of mucus and bicarbonate, maintains submucosal gastric perfusion and suppresses secretion of gastric acid) Protecting against NSAID induced ulcers (misoprostol serves as a replacement for endogenous prostagladins)medical abortion (stimulate uterine contractions to expel fetus)
71
Misoprostol emergency contraception
Yup
72
Side effects misoprostol and dinoprostone
Fetal distress | Hyperstimuation of uterus
73
Why give prostagladins before induction of labor or initiation of oxytocin
Softening and ripening of cervix which should occcur before the induction of labor or use of oxytocin

Pharmacology (52 decks)

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