Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Exam III > Drugs Acting on the Uterus > Flashcards

Drugs Acting on the Uterus Flashcards

1
Q

Hormones and chemical that contract uterus

A
  • Estrogens
  • Prostaglandins
  • Oxytocin
  • Stretching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hormones and chemicals that relax uterus

A
  • Beta adrenergic drugs
  • Progesterone
  • Alcohol
  • MgSO4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the primary cause of all PPHs?

A

Uterine atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

1st line treatment PPH

A

Massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Oxytoxin (Pitocin, Syntocin)

A

-Cyclic octapeptide stored in posterior pituitary normally released in response to suckling and cervical pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Oxytocin Indications/therapeutic effects

A
  • DOC to induce labor at term if indicated**
  • For prevention of hemorrhage (IM preferred)**
  • For stimulation of milk let down reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Oxytocin to induce labor

A
  • Augment labor in selected patients w/uterine dysfunctional inertia
  • Causes timed contractions (on then off)
  • IV infusion is preferred for these
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Oxytocin adverse effects

A
  • Water intoxication w/convulsions*
  • Uterine rupture w/large dose*
  • Allergy
  • Anaphylaxis*
  • Sinus bradycardia of the fetus*

(premature ventricular contractions and other arrhythmias of the fetus and fetal death due to extreme uterine contractions, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why does water intoxication occur?

A
  • Because of the ADH like effect of oxytocin
  • Serious complication that may occur
  • If doses are large and infused for a prolonged period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Oxytocin pharmacokinetics

A
  • Very short half life: 1-6 minutes

- Inactivated by liver and kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oxytocin contraindications/precautions

A
  • Malpresentation
  • Cephalopelvic disproportion
  • Complete placenta previa
  • Uterine scar from previous C-section
  • Unengaged head
  • Cervical scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ergot alkaloids (ergonovine maleate, methylergonovine maleate) MOA

A

-Contraction of uterine smooth muscle through activation of serotonin and alpha-adrenergic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ergot alkaloids indications/therapeutic effects

A
  • After completion of labor and the delivery of the placenta* to produce firm uterine contractions and to decrease uterine bleeding
  • 2nd line after massage and oxytocin have failed
  • For the same reason following suction abortion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ergot alkaloids pharmacokinetics

A
  • Rapid action
  • 30-40 seconds after IV
  • 10 min after oral use
  • Action lasts several hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ergot alkaloids adverse effects

A
  • Transient HTN (contracts ALL smooth muscle)

- Angina, MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ergot alkaloids contraindications/precautions

A
  • Should NEVER be used to induce labor* (the contractions are strong, non-physiological, continuous and will cause fetal hypoxia)
  • Obliterative vascular or coronary artery disease*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prostaglandins (dinoprostone; synthetic prostaglandin E2) Indications/therapeutic effects

A
  • Expulsion of uterine contents (intrauterine fetal death, missed abortion [miscarriage], elective abortion)
  • Cervical ripening prior to delivery at term
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dinoprostone pharmacokinetics

A
  • For abortion: one suppository inserted in the vagina. Subsequent suppositories inserted at 3-5 hour intervals until abortion occurs
  • For cervical ripening: apply gel to cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dinoprostone adverse effects

A
  • GI disturbances, vomiting, diarrhea***
  • Black box**
  • Fever, chills, HA
20
Q

Dinoprostone contraindications/precautions

A
  • For cervical ripening, problems w/mother or fetus (fetal distress, etc.; hx of difficult deliveries or C-section)
  • For abortions-should NOT be used in patients with: acute pelvic inflammation; acute cardiac, pulmonary, renal, or hepatic diseases; asthma, HTN, anemia, jaundice, or epilepsy
21
Q

Prostaglandins-Carboprost tromethamine (Prostin/M15, Hemabate)

A

-This is a derivative (15-methyl) of PGF2 alpha

22
Q

Carboprost tromethamine indications/therapeutic effects

A
  • Induce abortion in 13th and 20th week (2nd trimester; time of abortion is 16 hrs)
  • Postpartum bleeding due to uterine atony (3rd line after massage, oxytocin, and ergots)
23
Q

Carboprost tromethamine pharmacokinetics

A
  • IM administration

- Methylation increases half life from 15 seconds to 8 minutes

24
Q

Carboprost tromethamine adverse effects

A
  • Not serious if used properly
  • Systemic PG actions often diagnosed as anaphylactic shock
  • Vomiting and diarrhea**
  • Fever and rashes
25
Q

Carboprost tromethamine contraindications/precautions

A

-Should NOT be used in patients with-acute pelvic inflammation; acute cardiac, pulmonary, renal, or hepatic diseases; asthma, HTN, anemia, jaundice, or epilepsy

26
Q

Uterine relaxants (tocolytics) goal

A

To prevent premature labor or delay premature labor until term or until the fetus has matured sufficiently for survival (37th week)

27
Q

What happens if delivery happens before the 37th week?

A

-If the fetal lungs are developed–>corticosteroids

28
Q

Tocolytics other info

A
  • No option is FDA approved, or a DOC**
  • Doesn’t look like their use improves perinatal outcome
  • May prolong enough to give corticosteroids (2-7 days)
29
Q

Magnesium sulfate (MgSO4) MOA

A

-Unknown (relaxes the uterus probably by a direct effect)

30
Q

MgSO4 indications/therapeutic effects

A
  • Considered 1st line drug

- Can prevent convulsions in pre-eclampsia and treat eclampsia (FDA approved)

31
Q

MgSO4 pharmacokinetics

A

-IV, administered slowly (significant hypotension or asystole if too fast)

32
Q

MgSO4 adverse effects

A
  • Flushing, diaphoresis, hypotension
  • Depressed deep tendon reflexes, muscle paralysis, weakness, lethargy, hypothermia
  • Circulatory collapse, and cardiac, CNS, or respiratory depression
33
Q

Nifedipine (Procardia) MOA

A
  • L type calcium channel blocker

- Inhibits Calcium influx (smooth muscle contractions)

34
Q

Nifedipine indications/therapeutic effects

A

-Becoming 1st line agent (considering beta 2 agonists problem)

35
Q

Indomethacin

A
  • Has been investigated for its ability to delay preterm labor
  • 1st-2nd line drug
36
Q

Indomethacin MOA

A

-Strong inhibitor of COX enzyme–>reduction of prostaglandin synthesis

37
Q

Indomethacin adverse effects

A
  • Maternal GI irritation, peptic ulceration, thrombocytopenia, allergic reactions, HA, and dizziness
  • Reports about partial closure of the fetal ductus arteriosus** (also impaired fetal renal function, bronchopulmonary dysplasia, and persistent pulmonary HTN in the neonatal period)
38
Q

Progesterone

A

“recommended” by the American College of Obstretricians and Gynecologists

39
Q

Progesterone indications/therapeutic effects

A
  • More effective than placebo in maintaining the length of pregnancy when given prophylactically* from the 16th-37th week of pregnancy or until delivery
  • Not effective for acute treatment**
  • Recommended for high risk women with a hx of preterm birth
  • Approved for use in ART to maintain the luteal phase following IVF or ICSI
40
Q

Nitroglycerin

A

-Emergency use only**-in case of uterine rupture

41
Q

Nitroglycerin indications/therapeutic uses

A

-Case reports have shown that when given IV bolus intravenous nitroglycerin, there is a sudden transient cervicouterine relaxation within 45-90 seconds, lasting about 1 minute

42
Q

Nitroglycerin contraindications/precautions

A
  • Uncorrected hypovolemia
  • Severe anemia
  • Increased intracranial pressure
  • Constrictive pericarditis/pericardial tamponade
  • Hypersensitivity
43
Q

Ethanol

A

-Historically used in rural areas

44
Q

Ethanol MOA

A

-Direct relaxant effect on the myometrium and inhibition of oxytocin release

45
Q

Ethanol indications/therapeutic effects

A

Inhibit premature labor

46
Q

Ethanol Pharmacokinetics

A

-Loading dose (10% injection): 7.5 ml/kg/hr IV for 2 hours w/a maintenance infusion rate of 1.5 ml/kg/hr IV for put to 10 hrs.

47
Q

Beta 2 adrenergic agents-terbutaline (brethine)

A

-FDA black box warning against its use in tocolysis

Pharm Exam III (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions