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Pharmacology > Drugs of pregnancy, labour and post partum care > Flashcards

Drugs of pregnancy, labour and post partum care Flashcards

1
Q

What is the half life of oxytocin?

A

5 minutes

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2
Q

What is the half life of misoprostol?

A

20-40 minutes

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3
Q

What is the half life of ergometrine?

A

30-120 minutes

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4
Q

What is a uterotonic?

A

Drugs that cause uterine contraction

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5
Q

What drug causes St Anthony’s fire?

A

Ergometrine

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6
Q

What is St Anthony’s fire?

A

Otherwise referred to as ergotism or ergot poisoning - it is a potential toxic side effect of ergometrine - due to ergot alkaloid toxicity - it can cause dry gangrene and convulsions

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7
Q

What is oxytocin?

A

A nanopetide produced in the hypothalamus and released by the posterior pituitary gland- it is a uterotonic - it stimulates uterine contraction

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8
Q

What is misoprostol?

A

A synthetic prostaglandin, an analogue of prostaglandin E1

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9
Q

Why is ergometrine regulated?

A

Chemically similar to LSD and can be used to manufacture LSD

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10
Q

What kind of drugs are carbegoline and bromocriptine?

A

D2 dopamine receptor agonists - they suppress prolactin and therefore can be used in treatment of prolactinomas and suppression of lactation

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11
Q

What kind of drug is prochlorperazine?

A

dopamine D2 receptor antagonist

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12
Q

What kind of drug is ondansetron?

A

serotonin 5HT3 antagonist

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13
Q

What kind of drug is cyclizine?

A

Histamine H1 receptor antagonist

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14
Q

What kind of drug is promethazine?

A

Histamine H1 receptor antagonist

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15
Q

What is carbergoline?

A

A D2 agonist used to suppress lactation (inhibits prolactin)

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16
Q

What is bromicriptine?

A

A D2 agonist used to suppress lactation (inhibits prolactin)

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17
Q

What is domperidone?

A

A dopamine antagonist - stimulates lactation

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18
Q

Morphine vs. diamorphine

A

diamorphine prodrug of morphine, more lipophilic, can cross blood brain barrier

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19
Q

Where is methadone stored in the fetus?

A

liver, lung, spleen

20
Q

When are the symptoms of neonatal narcotic abstinence syndrome seen?

A

may occur in first 48 hours or can occur within 4 weeks (methadone is stored by fetal tissues - lung/liver/spleen)

21
Q

Features of neonatal narcotic abstinence syndrome

A

iritability, poor feeding, hyperreflexia/hypertonic, high pitched cry, respiratory distress, seizures

22
Q

What are the features of lidocaine anaesthesia toxicity?

A 
perioral/tongue numbness
metallic taste
tinnitus
blurred vision
seizures or LOC
widening PR/QRS
Cardiovascular compromise
cardiac toxicity
23
Q

In which conditions would you avoid lidocaine?

A

patients with heart conditions particularly wPw syndrome

24
Q

What are the features of wolf-Parkinson-white syndrome?

A

cardiac pre-excitation syndrome due to an accessory pathway (bundle of kent) - delta waves on ECG - predispose to risk of supraventricular tachycardias

25
Q

Max dose of lidocaine with adrenaline?

A

7mg/kg

26
Q

max dose of lidocaine without adrenaline?

A

3-5mg/kg

27
Q

Which receptors does lidocaine act?

A

Fast-voltage gated sodium channels

28
Q

How does clomifene affect fertility?

A

selective oestrogen receptor modulator
Blocks oestrogen receptors of the hypothalamus
Leads to reflex increase in Gnrh and therefore FSH/LH

29
Q

What receptor type does oxytocin bind to?

A

G-couple protein receptors

30
Q

Preferred first line treatment of hyperthyroidism in pregnancy

A

propylthiouracil
Carbimazole crosses the placenta too easily and is associated with congenital abnormalities (choanal atresia, aplasia cutis)

31
Q

Which drug is an oxytocin receptor antagonis?

A

atosiban

32
Q

What molecules are required for oxytocin receptor functioning?

A

cholesterol and magnesium

33
Q

Hypothesised action of oxytocin on fetal brain

A

reduces effect of hypoxic insult by inducing a switch of GABA signalling from excitatory to inhibitory

34
Q

Side effects of oxytocin

A

hypertension, tachycardia, increased cardiac output
Can cause arrythmia
can cause uterine rupture
can have same effect as ADH and cause oliguria, water intoxication
risk of seizure and subarachnoid haemorrhage

35
Q

What are prostaglandins derived from?

A

fatty acids

36
Q

What is prostaglandin E1 used for?

A

misoprostol (synthetic prostaglandin E1) is used for PPH and termination of pregnancy

37
Q

What is prostaglandin E2 used for?

A

Dinoprostone is used for induction of labour (cervical ripening)

38
Q

What is prostaglandin F2alpha used for?

A

Dinoprost or carboprost is used for termination of pregnancy, induction of labour and PPH

39
Q

What is dinoprost?

A

a naturally occurring prostaglandin (F alpha)

40
Q

What is carboprost?

A

synthetic prostaglandin F alpha

used for termination/PPH/induction of labour

41
Q

What is dinoprostone?

A

naturally occurring prostaglandin E2 used in labour induction

42
Q

Non-uterine use of misoprostol

A

synthetic prostaglandin E1 is also used in gastric acid prevention by inhibition of adenylate cyclase in parietal cells

43
Q

Which prostaglandin is associated with transient hyperthermia?

A

dinoprostone (E2) analogue

44
Q

What are the different tocolytic mechanisms?

A

oxytocin receptor antagonist
calcium channel blocker
NSAIDs
Beta 2 agonists

45
Q

How is atosiban administered?

A

IV

Pharmacology (14 decks)

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