Antepartum Medications

Question 1

Hydroxyprogesterone (Makena)

Answer 1

Synthetic progestin
Reduces preterm labor.
Initiate between the 16th and 20th week of gestation and ending at the 37th week of gestation or birth.
Pregnancy Category: B

Question 2

Hydralazine hydrochloride (Apresoline)

Answer 2

Direct vasodilator; dilates arterioles with little effect on vein; decreases systemic resistance, which subsequently decreases blood pressure.
Pregnancy category: C
Lactation: Excreted in breast milk; use caution

Question 3

Methyldopa (Aldomet)

Answer 3

Methyldopa may lower blood pressure by stimulating central inhibitory alpha-adrenergic receptors, false neurotransmission, and/or reduction of plasma renin activity.
Pregnancy Category: B
Lactation: distributed in breast milk but not in clinically significant amounts; compatible w/ breastfeeding

Question 4

Calcium gluconate

Answer 4

Bone mineral component; cofoactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways
Pregnancy category: C
Lactation: Calcium enters human milk; use with caution

Question 5

Betamethasone (Celestone)

Answer 5

Potent glucocorticoid with minimal to no mineralocorticoid activity.
RA/OA
Pregnancy Category: C
Lactation: systemically administered corticosteroids enter breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other effects; use with caution

Question 6

Misoprostol (Cytotec)

Answer 6

Synthetic prostaglandin E analogue parent drug that is rapidly deesterified to misoprostol acid (active metabolite) and replaces protective prostaglandins consumed with therapies that inhibit prostaglandin synthesis
Pregnancy category: X

Question 7

Magnesium sulfate

Answer 7

Indicated to prevent seizures associated with pre-eclampsia, and for control of seizures with eclampsia.
Depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects; decreases amount of acetylcholine released at end-plate by motor nerve impulse.
Pregnancy category: D
Lactation: Safe

Question 8

Methotrexate

Answer 8

Cancer drug, will terminate pregnancy

Question 9

Labetolol (Normodyne)

Answer 9

Action: Produces falls in B/P
Use: severe pre-eclampsia when delivery imminent
Precautions:
Pregnancy - class C
Contraindicated CHF

Question 10

Nifedipine (Procardia)

Answer 10

Calcium-channel blocker.Vasodilation with decreased peripheral resistance and increased heart rate.
Pregnancy category: C

Question 11

Ritrodrine hydrochloride (Yutopar)

Answer 11

Intravenous ritodrine is indicated in the treatment of preterm labor in patients with a pregnancy of 20 or more weeks’ gestation.
beta-2–adrenergic agonist, relaxes the uterus

Question 12

Terbutaline (Brethine)

Answer 12

Beta adrenergic agonist

Premature labor-action relaxes uterine muscle