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

Question 1

what is neostigmine and what is it’s function?

Answer 1

acetylcholine- esterase inhibitor

smooth muscle contraction

Question 2

when do we give neostigmine?

Answer 2

non-obstructive ileus (postoperative)

urinary retention

Question 3

duration of action of neostigmine

Answer 3

2-4 hours

Question 4

does neostigmine enter the CNS?

Answer 4

no, it’s a quaternary amine

Question 5

what is Butyl-scopolamine

Answer 5

cholinergic receptor blocker (non-selective)

Question 6

what are Solifenacin and Oxybutynin

Answer 6

cholinergic receptor blockers (modest selectivity for M₃)

Question 7

list the agents that cause smooth muscle relaxation

Answer 7

butyl-scopolamine
solifenacin 
oxybutynin
papaverine
drotaverine

Question 8

what are Papaverine and Drotaverine

Answer 8

Ca²⁺-channel blocker 
PDE inhibitor (non-selective) 
opioid alkaloid derivative

Question 9

how are papaverine and drotaverine given?

Answer 9

oral or parenteral

Question 10

what is the use of drotaverine?

Answer 10

enhance cervical dilation during childbirth

Question 11

what are the side effects of papaverine

Answer 11

cardiac–> negative ionotropic, arrhythmia, hypotension
hepatotoxicity
GI irritation
Priapism

Question 12

what is papaverine used for?

Answer 12

gastrointestinal and genitourinary spasm

Question 13

what is butyl-scopolamine used for?

Answer 13

GI spasm

abdominal pain, menstrual cramps, biliary/renal colic

Question 14

what are Solifenacin and Oxybutynin used for?

Answer 14

bladder spasm (post-operative)
urinary incontinence

Question 15

what is Atosiban?

Answer 15

Oxytocin receptor antagonist

Question 16

list the tocolytic agents

Answer 16

Atosiban
Terbutaline
Mg²⁺-sulphate
Ethanol

Question 17

how are Atosiban, Mg²⁺-sulphate and Ethanol given?

Answer 17

IV

Question 18

what is Terbutaline?

Answer 18

β₂-selective agonist (SABA)

Question 19

how is Terbutaline given

Answer 19

aerosol inhalation, parenteral, oral

Question 20

what is Atosiban used for?

Answer 20

Tocolytic agent (suppress preterm labor) –> effective from gestational week 24

Question 21

SE of Atosiban

Answer 21

increased rates of infant death

Question 22

when is Terbutaline used as a Tocolytic agent?

Answer 22

from gestational week 16

Question 23

side effects of terbutaline

Answer 23

arrhythmias (may affect both mother and fetus)

Question 24

what are the indications for Mg²⁺-sulphate

Answer 24

1. tocolytic agent
2. seizure prevention in preeclampsia/eclampsia
3. protective role in fetal brain

Question 25

what are the SE of giving Mg²⁺-sulphate

Answer 25

maternal–> flushing, lethargy, pulmonary edema, cardiac arrest
neonatal–> hypotension, respiratory depression

Question 26

what is Oxytocin (pitocin)?

Answer 26

Oxytocin receptor agonist

induces uterine contraction

Question 27

how is Oxytocin given?

Answer 27

IV or intranasal

Question 28

when is Oxytocin given?

Answer 28

1. induction and augmentation of labor
2. control of postpartum uterine hemorrhage (high doses)
3. induction of lactation (intranasal preparation)

Question 29

side effects of Oxytocin

Answer 29

fetal distress
placental abruption
uterine rapture

Question 30

what is Ergotamine and how is it given

Answer 30

Ergot alkaloid derivatives

parenteral

Question 31

what does Ergotamine do?

Answer 31

induces vasoconstriction and uterine contraction

Question 32

when do we give ergotamine

Answer 32

control of postpartum uterine hemorrhage

*must not be given before delivery of the placenta

Question 33

what is Misoprostol

Answer 33

PGE₁ analogue

Question 34

what is Misoprostol used for?

Answer 34

Abortifacient, in combination with Mifepristone (progesterone antagonist)

*effective up to 60 days into pregnancy

Question 35

what are the agents contracting the pregnant uterus

Answer 35

Oxytocin
ergotamine
Misoprostol