drugs used in pregnancy Flashcards
what is an oxytocic
this is any agent that stimulates the uterus to contract
what are oxytocics used for
used for the induction or augmentation of labour
what can be used to control postpartum hemorrhage
oxytocics
tocolytics
this is an agent that inhibits uterine contraction
describe the role of calcium and smooth muscle contraction
the more calcium present, the more vigourous a contraction is going to be
what is oxytocin
this is a hormone produced during labour
what does oxytocin do?
increases the force and frequency of uterine contractions
what increases the force and frequency of uterine contractions
oxytocin
what are the agonist drugs for oxytocin
pitocin and syntocinon
pitocin and syntocinon are what
the proper name for oxytocin, and agonist drugs
if you administer pitocin via iv, how quickly do uterine induction and augmentation occur?
response is almost immediately and subsides in one hour
if you administer pitocin and syntocinon via IM how quickly is the response and how long does it persist for?
3-5 min and persists for 2-3 hours
what is the goal of IM injection of oxytocin
to encourage robust contractions to reduce post partum hemmorhage
what is the biological effect of oxytocin?
¡ Oxytocin from the fetus and mothers posterior pituitary stimulates the uterus to contract, stimulating the placenta to make prostaglandins which then stimulate more vigorous contractions of the uterus – positive feedback
Oxytocin from the fetus and mothers posterior pituitary stimulates the uterus to contract, stimulating the placenta to make prostaglandins which then stimulate more vigorous contractions of the uterus – positive feedback
what is this describing?
this is describing the biological effect of oxytocin
how is oxytocin administered for the induction of labour?
IV - dose is increased every 15-60 minutes
what happens when too much oxytocin is given via IV?
the body will hold onto fluids
why does the body hold onto alot of fluids when given too much oxytocin
because oxytocin binds to an ADH receptor, this will stimulate the body to conserve water, possessing an antidiuretic affect
uterine hypertonus is a result of what?
too much oxytocin administered, binding to ADH receptor gives antidiuretic affect
when should oxytocin infusion be d/c
if contractions are less than 2 min apart and last longer than 90 seconds
if contractions are less than 2 min apart and last longer than 90 seconds what should be discontinued
oxytocin adminsteration
what will happen to the uterus if there is too much over stimulation
it will begin to seize
dinoprostone
this is a oxytocic agent, works to ripen the cervix and initiate labour
what oxytocic agent causes cervical ripening and initiates labour
dinoprostone
what prostagladin agonist is used to control post partum hemorrhage in cases that are not responding to oxytocin
carborprost
what might prostagaldins cause?
nausea, vomiting, diarrhea, headache, hypertension, and bronchiospasm
ergot alkaloid
causes contractions within 1-5 minutes that persist for 3 hours, we dont use much because of increase of blood pressure
why shouldn’t ergot alkaloids be used to induce labour?
since it raises blood pressure, it can raise the chances of uterine hypertonus
why should ergot alkaloids not be used for induction or augmentation and prostagladins not be used to augmentate labour
because of the increased risk of uterine hypertonus
what drug decreases the intracellular calcium levels and reduces the strength of uterine contractions
tocolytic drugs
when are tocolytic drugs commonly administered
pre term labour, cephalic version, uterine hypertonus
what does the administration of tocolytic drugs 48 hours before preterm labour allow for
administration of gluccocorticoids, delivery at same facility, prolonged pregnancy
what does the administration of glucocorticoids in pre term pregnancy allow for
they speed up the lung maturation in the fetus, increasing outcomes
glucocorticoid therapy is recommended for who
women between 24 and 34 weeks of pregnancy that are likely to deliver a premature baby
glucocorticoid therapy reduces the risk of what complications by 50%
respiriatory distress syndrome
bleeding in the brain
necrotizing enterocolitis
spesis
when should tocolytic drugs be administered?
between 24-34 weeks of pregnancy, chance of pre term
when pt is experiencing contractions that last longer than 45 seconds occurring 2-10 min apart
what should be administered when the pt is experiencing 45 secong contractions 2-10 mins apart
tocolytic drug;
tocolytic prostaglandin inhibitors
inhibit prostaglandin synthesis via inhibiton of COX1 and COX2 enzymes
what are the side effects of giving NSAIDs after 32 weeks gestation?
premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurugitation and renal failure
Premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurgitation and renal failure are what?
side effects of adminsitering NSAIDs after 32 weeks gestation
tocolytic drugs; calcium channel blockers
what we know; calcium plays a huge role in smooth muscle contraction, so if calcium is inhibited, there will be no action on the myometrium thus causing no contraction
role of beta2 adrenergic antagonists
stimulate gs protien coupled b2-adrenergic receptors thus inducing phosphorylation and sequestration of CA
what induces phosphorylation and sequestration of Ca
beta2 adrenergic agonists
when would beta2-adrenergic agonists be used?
may be used when attempting cephaic version
oxytocin receptor antagonists are
not effective
how does atosiban (oxytocin receptor antagonist) work
it inhibits the binding of oxytocin at its receptor site
tocolytic drugs - indomethacin
first time therapy for labor inhibition in women between 24-32 weeks of labour
tocolytic drugs; nifedipine
between 32-34 week, recommended for initial treatment for preterm labour
