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pharmacology > drugs used in pregnancy > Flashcards

drugs used in pregnancy Flashcards

1
Q

what is an oxytocic

A

this is any agent that stimulates the uterus to contract

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2
Q

what are oxytocics used for

A

used for the induction or augmentation of labour

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3
Q

what can be used to control postpartum hemorrhage

A

oxytocics

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4
Q

tocolytics

A

this is an agent that inhibits uterine contraction

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5
Q

describe the role of calcium and smooth muscle contraction

A

the more calcium present, the more vigourous a contraction is going to be

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6
Q

what is oxytocin

A

this is a hormone produced during labour

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7
Q

what does oxytocin do?

A

increases the force and frequency of uterine contractions

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8
Q

what increases the force and frequency of uterine contractions

A

oxytocin

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9
Q

what are the agonist drugs for oxytocin

A

pitocin and syntocinon

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10
Q

pitocin and syntocinon are what

A

the proper name for oxytocin, and agonist drugs

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11
Q

if you administer pitocin via iv, how quickly do uterine induction and augmentation occur?

A

response is almost immediately and subsides in one hour

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12
Q

if you administer pitocin and syntocinon via IM how quickly is the response and how long does it persist for?

A

3-5 min and persists for 2-3 hours

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13
Q

what is the goal of IM injection of oxytocin

A

to encourage robust contractions to reduce post partum hemmorhage

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14
Q

what is the biological effect of oxytocin?

A

¡ 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

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15
Q

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?

A

this is describing the biological effect of oxytocin

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16
Q

how is oxytocin administered for the induction of labour?

A

IV - dose is increased every 15-60 minutes

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17
Q

what happens when too much oxytocin is given via IV?

A

the body will hold onto fluids

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18
Q

why does the body hold onto alot of fluids when given too much oxytocin

A

because oxytocin binds to an ADH receptor, this will stimulate the body to conserve water, possessing an antidiuretic affect

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19
Q

uterine hypertonus is a result of what?

A

too much oxytocin administered, binding to ADH receptor gives antidiuretic affect

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20
Q

when should oxytocin infusion be d/c

A

if contractions are less than 2 min apart and last longer than 90 seconds

21
Q

if contractions are less than 2 min apart and last longer than 90 seconds what should be discontinued

A

oxytocin adminsteration

22
Q

what will happen to the uterus if there is too much over stimulation

A

it will begin to seize

23
Q

dinoprostone

A

this is a oxytocic agent, works to ripen the cervix and initiate labour

24
Q

what oxytocic agent causes cervical ripening and initiates labour

A

dinoprostone

25
Q

what prostagladin agonist is used to control post partum hemorrhage in cases that are not responding to oxytocin

A

carborprost

26
Q

what might prostagaldins cause?

A

nausea, vomiting, diarrhea, headache, hypertension, and bronchiospasm

27
Q

ergot alkaloid

A

causes contractions within 1-5 minutes that persist for 3 hours, we dont use much because of increase of blood pressure

28
Q

why shouldn’t ergot alkaloids be used to induce labour?

A

since it raises blood pressure, it can raise the chances of uterine hypertonus

29
Q

why should ergot alkaloids not be used for induction or augmentation and prostagladins not be used to augmentate labour

A

because of the increased risk of uterine hypertonus

30
Q

what drug decreases the intracellular calcium levels and reduces the strength of uterine contractions

A

tocolytic drugs

31
Q

when are tocolytic drugs commonly administered

A

pre term labour, cephalic version, uterine hypertonus

32
Q

what does the administration of tocolytic drugs 48 hours before preterm labour allow for

A

administration of gluccocorticoids, delivery at same facility, prolonged pregnancy

33
Q

what does the administration of glucocorticoids in pre term pregnancy allow for

A

they speed up the lung maturation in the fetus, increasing outcomes

34
Q

glucocorticoid therapy is recommended for who

A

women between 24 and 34 weeks of pregnancy that are likely to deliver a premature baby

35
Q

glucocorticoid therapy reduces the risk of what complications by 50%

A

respiriatory distress syndrome
bleeding in the brain
necrotizing enterocolitis
spesis

36
Q

when should tocolytic drugs be administered?

A

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

37
Q

what should be administered when the pt is experiencing 45 secong contractions 2-10 mins apart

A

tocolytic drug;

38
Q

tocolytic prostaglandin inhibitors

A

inhibit prostaglandin synthesis via inhibiton of COX1 and COX2 enzymes

39
Q

what are the side effects of giving NSAIDs after 32 weeks gestation?

A

premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurugitation and renal failure

40
Q

Premature closure of the ductus arteriosus, causing pulmonary hypertension, tricuspid regurgitation and renal failure are what?

A

side effects of adminsitering NSAIDs after 32 weeks gestation

41
Q

tocolytic drugs; calcium channel blockers

A

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

42
Q

role of beta2 adrenergic antagonists

A

stimulate gs protien coupled b2-adrenergic receptors thus inducing phosphorylation and sequestration of CA

43
Q

what induces phosphorylation and sequestration of Ca

A

beta2 adrenergic agonists

44
Q

when would beta2-adrenergic agonists be used?

A

may be used when attempting cephaic version

45
Q

oxytocin receptor antagonists are

A

not effective

46
Q

how does atosiban (oxytocin receptor antagonist) work

A

it inhibits the binding of oxytocin at its receptor site

47
Q

tocolytic drugs - indomethacin

A

first time therapy for labor inhibition in women between 24-32 weeks of labour

48
Q

tocolytic drugs; nifedipine

A

between 32-34 week, recommended for initial treatment for preterm labour

pharmacology (26 decks)

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