A/35. Smooth muscle relaxants used for relief GI and UG spasms. Drugs influencing uterus functions.

Question 1

Drugs need to know in this topic

Answer 1

papaverine

drotaverine

butylscopolamine

misoprostol

oxytocin

ergotamine

terbutaline

atosiban

Mg++

ethanol

solifenacin

Question 2

Drugs acting on the gastrointestinal and genitourinary tracts
Smooth muscle contraction

Answer 2

Bethanechol

Neostigmine

Question 3

Drugs acting on the gastrointestinal and genitourinary tracts
Smooth muscle relaxation

Answer 3

Butyl- scopolamine

Solifenacin
Oxybutynin

Papaverine

Drotaverine

Question 4

Drugs acting on the female reproductive system
Tocolytic drugs – Agents relaxing the pregnant uterus

Answer 4

Atosiban

Terbutaline

Mg2+-sulphate

Ethanol

Question 5

Agents relaxing the non-pregnant uterus

Answer 5

NSAID’s

1. Ibuprofen
2. Naproxen

Question 6

Agents contracting the pregnant uterus

Answer 6

Oxytocin

Ergotamine

Misoprostol

Question 7

Drugs acting on the male reproductive system
Agents acting on the male reproductive system

Answer 7

Tamsulosin

Question 8

Butyl- scopolamine

Answer 8

Cholinergic receptor blocker (nonselective)

1. Oral
2. No CNS effects
3. GI spasm
4. Management of abdominal pain and discomfort
   caused by GI cramps, menstrual cramps, biliary colic, renal colic

Question 9

Solifenacin
Oxybutynin

Answer 9

Cholinergic receptor blockers

1. Oral, transdermal patch
2. No CNS effects
3. Bladder spasm (post-operative, neurogenic)
4. Urinary incontinence

(modest selectivity for M3)

Question 10

Papaverine

Drotaverine

Answer 10

Papaverine: Ca2+-channel blocker

PDE inhibitor (non-selective): Drotaverine

1. Opioid alkaloid derivative
2. Oral, parenteral
3. Gastrointestinal and genitourinary spasm

Side effects:
1. Cardiac → negative ionotropic, arrhythmia,
hypotension
2. Hepatotoxicity
3. GI irritation
4. Priapism
5. Used to enhance cervical dilation during childbirth

Question 11

Atosiban

Answer 11

Oxytocin receptor antagonist

1. IV

1. Tocolytic agent (suppress preterm labor)
 #effective from gestational week 24

• *Side effects:**
  1. Increased rates of infant death

Question 12

Terbutaline

Answer 12

β2-selective agonist (SABA)

1. Aerosol inhalation, parenteral, oral
2. Rapid onset of action
3. Tocolytic agent #effective from gestational week 16
   Side effects:
4. Cardiac stimulant effect with arrhythmias (may affect both
   mother and fetus)

Question 13

Mg2+-sulphate

Answer 13

1. IV
2. Tocolytic agent
3. Seizure prevention in preeclampsia/eclampsia
4. Protective role on fetal brain
   Side effects:
5. Maternal → flushing, lethargy, headache, weakness, pulmonary edema,
   cardiac arrest
6. Neonatal → hypotension, respiratory depression

Question 14

Ethanol

Answer 14

1. IV
2. Tocolytic agent

Question 15

Oxytocin

Answer 15

Oxytocin receptor agonist

1. IV, intranasal
2. Induction and augmentation of labor
3. Control of postpartum uterine hemorrhage (high doses)
4. Induction of lactation (intranasal preparation)

• *Side effects:**
  1. Fetal distress
  2. Placental abruption
  3. Uterine rupture

(induces uterine contraction)

Question 16

Ergotamine

Answer 16

Induces vasoconstriction and uterine contraction

1. Ergot alkaloid derivatives
2. Parentera

1. Control of postpartum uterine hemorrhage
#must not be given before delivery of the placenta

Question 17

Misoprostol

Answer 17

PGE1 analogue

1. Oral

1. Abortifacient, in combination with mifepristone (progesterone antagonist)
#effective up to 60 days into pregnancy

Question 18

Tamsulosin

Answer 18

‘Uroselective’ α-blocker

1. Oral 1. Hypertension
2. Benign prostatic hyperplasia (BPH) → relax the muscle of the prostate
   and bladder neck, which allows urine to flow more easily

(inhibits α1A sparing α1B receptors→ no hypotension)