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ENRP > Ante/Perinatal Pharmacology cont. > Flashcards

Ante/Perinatal Pharmacology cont. Flashcards

1
Q

Uterotonics are used for uterine stimulation. What 3 things can they do?

A
  1. Cervical ripening
  2. Induction of contractions
  3. Control postpartum bleed
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2
Q

What does cervical ripening involve?

A

Collagen and glycosaminoglycans broken down

=> cervix is thinned and dilated

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3
Q

What is Misoprostol?

A

PGE1 Analog

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4
Q

How should Misoprostol be stored? How long does it take for onset?

A

Stable at room temperature

– 30 minutes for onset

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5
Q

What are some maternal adverse effects seen with Misoprostol?

A

N/V, pain, chills, shivering

- Abnormal uterine contractions

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6
Q

What is a fetal adverse effect that can occur with Misoprostol in response to it causing abnormal uterine contractions?

A

Hypoxia

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7
Q

Prostaglandin E1 Analog that can terminate pregnancy if within 77 days

A

Misoprostol

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8
Q

What is Dinoprostone?

A

PGE2 Analog

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9
Q

How should Dinoprostone be stored? Time to onset?

A

Needs to be refrigerated

– onset is within minutes

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10
Q

When Dinoprostone is given for abortions, what adverse effect can occur?

A

Fever that is unresponsive to NSAIDs and lasts for about 6 hours

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11
Q

What is a contraindication for giving Misoprostol or Dinoprostone?

A

Prior C-section

– can rupture uterine scar!

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12
Q

What is a possible fetal adverse effect that can occur with Dinoprostone?

A

Hypoxia

– due to abnormal uterine contractions

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13
Q

What drug can cause a fever that is unresponsive to NSAIDs for 6 hours?

A

Dinoprostone

– seen with abortion

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14
Q

What is Carboprost?

A

Prostaglandin F2alpha analog

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15
Q

What is Carboprost and how is it given?

A

Prostaglandin F2alpha Analog

– IM injection

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16
Q

What are 2 contraindications for giving Carboprost?

A

PID

Active organ disease

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17
Q

What is Oxytocin?

A

Posterior pituitary hormone

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18
Q

What are 2 contraindications for use of Oxytocin?

A

If cervix is not ripe

If fetal lungs are not mature

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19
Q

What is a possible maternal adverse effect that can occur with Oxytocin?

A 
Water intoxication
(hyponatremia)
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20
Q

If water intoxication occurs, what drug was given to control a postpartum bleed?

A

Oxytocin

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21
Q

What is a contraindication for Ergot Alkaloids?

A

HTN

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22
Q

What drugs are constrictors from rye fungus and thus constrict arterioles/veins?

A

Ergot alkaloids

23
Q

What is a possible adverse effect of Ergot Alkaloids that are used to control a postpartum bleed?

A

St. Anthony’s fire

= mania, psychosis, dry gangrene

24
Q

Mania, psychosis and dry gangrene is seen with what drug?

A

Ergot alkaloids

– St. Anthony’s Fire

25
What is a common reason that Tocolytics are used?
Need time for corticosteroids to trigger surfactant production and brain maturation
26
What is a risk factor for RDS and what is it?
Preterm birth usually before 32 weeks | -- deficient surfactant production from type 2 pneumocytes
27
What are Corticosteroids used for?
Promote lung maturation and surfactant production
28
What are corticosteroids used for?
Promote lung maturation and surfactant production
29
When are corticosteroids indicated?
Between 24-36 weeks with any sign of: - preterm labor, hemorrhage, membrane rupture - preeclampsia/HELLP c-section conditions
30
How is Betamethasone given?
2 doses via IM injection at 24 hour intervals
31
How is Dexamethasone given?
4 doses via IM injection at 12 hour intervals
32
With the treatment of RDS, what is done first?
CPAP
33
With the treatment of RDS, after CPAP, the FiO2 is measured. If it is greater than 0.4, what is done?
Surfactant therapy and intubate
34
With the treatment of RDS, after CPAP, FiO2 is measured. If it is less than 0.4, what is done?
CPAP and ABG
35
If an ABG is obtained on a neonate with RDS, with what pH level will you consider surfactant therapy and intubation?
< 7.2
36
What can Magnesium Sulfate do?
Neuroprotection of fetus | -- decreases risk of cerebral palsy
37
MOA for Magnesium sulfate?
Unknown -- competes with calcium
38
Terbutaline is a? What does it do molecularly?
Beta2 agonist | -- increases cAMP, hyperpolarization and dephosphorylation
39
What are contraindications for Terbutaline and why?
Cardiac/Thyroid disease and DM | --> Hyperinsulinemia and heart events
40
What is Nifedipine?
Calcium Channel Blocker
41
MOA for Indomethacin?
Blocks synthesis of prostaglandin F2alpha
42
What drug blocks synthesis fo PGF2alpha?
Indomethacin
43
MOA for Atosiban?
(-) Oxytocin
44
What drug blocks Oxytocin?
Atosiban
45
Tocolytics may be able to delay labor but can they stop it? Other things to know?
NO | -- Do NOT combine them and treat for less than 72 hours
46
What is Erythromycin used for?
Prophylaxis against gonococcal conjunctivitis
47
What is Alprostadil and what does it do?
Synthetic PGE1 for parenteral admin | = maintains PDA
48
What is a possible side effect of Alprostadil?
Pyrexia
49
What is a possible side effect of Indomethacin and Ibuprofen that are used to close PDA?
Decreased kidney function
50
Decreased levels of ____ cause the PDA to close
PGE2
51
Alpha 2 agonist used for HTN in pregnancy?
Methyldopa
52
Alpha/Beta Blocker used for HTN in pregnancy?
Labetalol
53
Arterial vasodilator used for HTN in pregnancy?
Hydralazine
54
Arterial and Venous Vasodilator for HTN in pregnancy?
Sodium Nitroprusside

ENRP (45 decks)

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