Uterine

Question 1

What are the Oxytocics

Answer 1

Stimulants
Oxytocin
Ergonovine
Methylergonovine
Carboprost tromethamine
Dinoprostone
Misoprostol

Question 2

What are the Tocolytics

Answer 2

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

Question 3

How does Oxytocin work

Answer 3

Activate Gq - SM contraction

Increase PG synthesis

Question 4

When is the uterus more sensitive to Oxytocin

Answer 4

2nd half of pregnancy

Question 5

DOC for induction of labor

Answer 5

Oxytocin

Question 6

When do you give oxytocin

Answer 6

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

Question 7

What is the Oxytocin challenge test

Answer 7

Measure HR to check for fetal hypoxia

Question 8

What are the AE for Oxytocin

Answer 8

Fetal distress
Placental abruption
Uterine rupture
Activate vasopressin receptors

Question 9

What are partial alpha agonists and have some 5HT activity

Answer 9

Ergonovine

Methylergonovine

Question 10

Sensitivity to what increases in pregnancy

Answer 10

Ergot alkaloids

Question 11

2nd line for post-partum hemorrhage

Answer 11

Ergonovine

Methylergonovine

Question 12

What is found in breast milk

Answer 12

Ergonovine

Methylergonovine

Question 13

What can cause gangrene in nursing infant

Answer 13

Ergonovine

Methylergonovine

Question 14

Contraindication for Ergot Alkaloids

Answer 14

Angina
MI
Pregnancy
CVA
HTN

Question 15

Which is a PGF2 alpha analog

Answer 15

Carboprost tromethamine

Question 16

Give if pt has benign hydatiform mole

Answer 16

Dinoprostone

Question 17

Used to induce abortion in 2nd trimester

Answer 17

Carboprost tromethamine

Dinoprostone

Question 18

3rd line for post-partum hemorrhage

Answer 18

Carboprost tromethamine

Question 19

Used to evacuate uterus after missed abortion

Answer 19

Dinoprostone

Question 20

Used to ripen the cervix

Answer 20

Dinoprostone

Misoprostone

Question 21

Which is a PGE1 analog

Answer 21

Misoprostol

Question 22

What is the only FDA approved use of Misoprostol

Answer 22

NSAID induced gastric ulcers

Question 23

What else can Misoprostol be used for

Answer 23

Induce labor

Post-partum hemorrhage

Question 24

What is the leading cause of neonatal mortality

Answer 24

Preterm birth (< 37wks)

Question 25

What is the most popular tocolytic

Answer 25

Mg sulfate

Question 26

Which tocolytic has similar efficacy to terbutaline but with better tolerance

Answer 26

Mg sulfate

Question 27

Which tocolytics cross the placenta

Answer 27

Mg sulfate | Indomethacin

Question 28

How does Mg sulfate work

Answer 28

Uncouples excitation-contraction in myometrium

Question 29

Mg sulfate AE

Answer 29

Resp depression | Cardiac arrest

Question 30

How does Indomethacin act

Answer 30

Inhibit PG synthesis (NSAID)

Question 31

When do you give Indomethacin

Answer 31

To delay preterm labor

Question 32

Indomethacin AE

Answer 32

Oligohydramnios (decreased fetal RBF) | Premature closure of ductus arteriosus

Question 33

Contraindications for Indomethacin

Answer 33

> 32 weeks

Question 34

What is the Ca channel blocking tocolytic

Answer 34

Nifedipine

Question 35

How does Nifedipine work

Answer 35

Inhibit contractility | Decreased Ca = Decreased MLCK

Question 36

What is more successful than Indomethacin at prolonging preterm labor

Answer 36

Nifedipine

Question 37

Nifedipine AE

Answer 37

Maternal tachycardia Palpitations Flushing, nausea HA, dizziness

Question 38

Which tocolytic is a competitive oxytocin receptor antagonist

Answer 38

Atosiban (NOT USA)

Question 39

How does Terbutaline act

Answer 39

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

Question 40

What should not be used to treat preterm labor

Answer 40

Oral Terbutaline

Question 41

When should injectable Terbutaline be given

Answer 41

72hrs or less

Question 42

Which tocolytic has a black box warning

Answer 42

Terbutaline

Question 43

Terbutaline AE

Answer 43

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