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Flashcards in Uterine Deck (43):
1

What are the Oxytocics

Stimulants
Oxytocin
Ergonovine
Methylergonovine
Carboprost tromethamine
Dinoprostone
Misoprostol

2

What are the Tocolytics

Relaxants
Mg sulfate
Indomethacin
Nifedipine
Atosiban
Terbutaline (beta 2 agonists)

3

How does Oxytocin work

Activate Gq - SM contraction
Increase PG synthesis

4

When is the uterus more sensitive to Oxytocin

2nd half of pregnancy

5

DOC for induction of labor

Oxytocin

6

When do you give oxytocin

Augment dysfunctional labor
Limit post-partum hemorrhage (1st line)
Induce abortion

7

What is the Oxytocin challenge test

Measure HR to check for fetal hypoxia

8

What are the AE for Oxytocin

Fetal distress
Placental abruption
Uterine rupture
Activate vasopressin receptors

9

What are partial alpha agonists and have some 5HT activity

Ergonovine
Methylergonovine

10

Sensitivity to what increases in pregnancy

Ergot alkaloids

11

2nd line for post-partum hemorrhage

Ergonovine
Methylergonovine

12

What is found in breast milk

Ergonovine
Methylergonovine

13

What can cause gangrene in nursing infant

Ergonovine
Methylergonovine

14

Contraindication for Ergot Alkaloids

Angina
MI
Pregnancy
CVA
HTN

15

Which is a PGF2 alpha analog

Carboprost tromethamine

16

Give if pt has benign hydatiform mole

Dinoprostone

17

Used to induce abortion in 2nd trimester

Carboprost tromethamine
Dinoprostone

18

3rd line for post-partum hemorrhage

Carboprost tromethamine

19

Used to evacuate uterus after missed abortion

Dinoprostone

20

Used to ripen the cervix

Dinoprostone
Misoprostone

21

Which is a PGE1 analog

Misoprostol

22

What is the only FDA approved use of Misoprostol

NSAID induced gastric ulcers

23

What else can Misoprostol be used for

Induce labor
Post-partum hemorrhage

24

What is the leading cause of neonatal mortality

Preterm birth (< 37wks)

25

What is the most popular tocolytic

Mg sulfate

26

Which tocolytic has similar efficacy to terbutaline but with better tolerance

Mg sulfate

27

Which tocolytics cross the placenta

Mg sulfate
Indomethacin

28

How does Mg sulfate work

Uncouples excitation-contraction in myometrium

29

Mg sulfate AE

Resp depression
Cardiac arrest

30

How does Indomethacin act

Inhibit PG synthesis (NSAID)

31

When do you give Indomethacin

To delay preterm labor

32

Indomethacin AE

Oligohydramnios (decreased fetal RBF)
Premature closure of ductus arteriosus

33

Contraindications for Indomethacin

> 32 weeks

34

What is the Ca channel blocking tocolytic

Nifedipine

35

How does Nifedipine work

Inhibit contractility
Decreased Ca = Decreased MLCK

36

What is more successful than Indomethacin at prolonging preterm labor

Nifedipine

37

Nifedipine AE

Maternal tachycardia
Palpitations
Flushing, nausea
HA, dizziness

38

Which tocolytic is a competitive oxytocin receptor antagonist

Atosiban (NOT USA)

39

How does Terbutaline act

Activate Gs = Increase cAMP, PKA
Decreased SM-MLCK affinity for Ca-calmodulin
SM relax

40

What should not be used to treat preterm labor

Oral Terbutaline

41

When should injectable Terbutaline be given

72hrs or less

42

Which tocolytic has a black box warning

Terbutaline

43

Terbutaline AE

Palpitation, tremor
N/V
Anxiety  
Chest pain & dyspnea
Hyperglycemia
Hypokalemia
Hypotension
Pulmonary edema
Cardiac Insufficiency
Arrhythmia, MI
Maternal death