Drugs Y4 Flashcards
What’s Ritodrine?
MoA, class, side effects
Ritodrine
MoA: A tocolytic → inhibits smooth muscle contraction in the uterus (delays labour)
Class: beta-agonist
SE: tachycardia, headache, palpitations and impaired glucose tolerance
To avoid in cardiac disease and diabetes!
Atosiban
MoA, class
MoA: oxytocin antagonist/inhibitor →tocolytic
(reduces labour within 48-hour period)
*it is preferable to use rather than ritodrine
Examples of tocolytics (5)
Tocolytics → to reduce onset of labour
- Ritodrine → beta-agonist
- Atosiban → oxytocin inhibitor (preferable to Ritodrine in view of better SEs)
- Nifedipine → CCB, often used as tocolytic (not yet licensed for use in the UK)
- magnesium sulphate
- indometacin → NSAID (to close a hemodynamically significant patent ductus arteriosus, as indicated by clinical evidence, in premature infants)
Relative contraindications to tocolysis (3)
- rupture of membranes
- fetal distress
- intrauterine infection
When and why are corticosteroids indicated in preterm gestation?
What corticosteroids?
Betamethasone and dexamethasone (corticosteroids)
- between 24 - 34 weeks of gestation (in preterm labour and absence of infection)
- Use: to promote pulmonary maturity and to stimulate surfactant production
- Proven to reduce risk of: respiratory distress, intraventricular haemorrhage and necrotizing enterocolitis (in premature babies)
Antibiotic used for infection prophylaxis in premature rupture of membranes
Erythromycin
*Penicillin is given in addition if group B strep has been isolated)
Use of what drug in a pre-mature labour is associated with necrotising enterocolitis?
Co-amoxiclav
Can Gentamicin be given in pregnancy?
Not, it has been associated with auditory and vestibular damage (2nd and 3rd trimester)
Mnemonic to remember DMARDs
‘CALM GASP’
- Cyclophosphamide
- Azathioprine
- Leflunomide
- Methotrexate
- Gold
- Anti-malarias
- Sulfasalazine
- Penicillamine
SEs of Cyclophosphamide (2)
Cyclophosphamide = DMARD
SEs:
- risk of malignancy
- bone marrow supression
Side effects (2) of Azathioprine
Azathioprine = DMARD
- GI upset
- bone marrow suppression
Side effects (2) of Leflunomide
Leflunomide = DMARD
- hepatitis
- hypertension
Side effects (2) of Methotrexate
Methotrexate = DMARD
- worsening of rheumatoid nodules
- liver/lung fibrosis
Side effects of Gold (3)
Gold = DMARD
- rash
- proteinuria
- bone marrow supression
Side effect of anti-malaria (1)
retinal damage
