Female Repro: Prenatal Vitamins

Question 1

MOA of misoprostol

Answer 1

synthetic prostaglandin E1 analog

Question 2

Clinical indications for misoprostol (2)

Answer 2

Termination of preg if within 77 days

Cervical ripening to help with labor (off label)
-promotes cervical contraction

Question 3

Misoprostol is stable at what temp?

Answer 3

Room temp

Question 4

MOA of dinoprostone

Answer 4

synthetic prostaglandin E2 analog

Question 5

Clinical indications for dinoprostone

Answer 5

Cervical ripening

-promotes cervical contractions

Question 6

Adverse effects of dinoprostone if used for abortion

Answer 6

Fever that is unresponsive to NSAIDs

Question 7

MOA of carboprost

Answer 7

prostaglandin F2α analog

Question 8

Clinical indications for carboprost (2)

Answer 8

Induce abortion

Control post partum hemorrhage that is refractory

Question 9

Adverse effects of carboprost

Answer 9

HTN and pulmonary edema

Chills/shivering

Question 10

MOA of oxytocin

Answer 10

Post pit hormone used to increase frequency, force, and duration of contractions during preg

Question 11

Clinical indications for oxytocin

Answer 11

Inducing labor

Question 12

What G protein does oxytocin bind to?

Answer 12

Gq
-IP3-DAG pathway, increase Ca++

Sorry, no idea what Wolff will ask

Question 13

When would you not give oxytocin?

Answer 13

If:

• fetal lungs not mature
• Cervix is not ripe

Question 14

What drugs are the ergot alkaloids?

Answer 14

Ergonovine

Ethyl-ergonovine

Question 15

MOA of the ergot alkaloids (-novines)

Answer 15

Stimualtes adrenergic, dopamanergic, and serotonergic receptors

Question 16

Effects of the ergot alkaloids? (2)

Answer 16

Dose dependent prolonged/tonic uterine contractions

Constricts arterioles and venules

Question 17

What are the names for the drugs that induce contractions vs the ones that stop contractions?

Answer 17

Start: oxytocics

Stop: tocolytics

Question 18

What drugs should you give if infant is delivered 24 weeks+?

Answer 18

GBS prophylaxis (intrapartum penicillin)
Single corticosteroid

Question 19

What drug is given if infant is less than 34 weeks to prolong latency?

Answer 19

Other antimicrobials

Question 20

Do you give GBS prophylaxis if infant is less than 24 weeks?

Answer 20

Not recommended

Question 21

Preterm birth increases the risk of what in infants? Why does this happen?

Answer 21

Respiratory distress syndrome (RDS)

-not enough surfactant production!

Question 22

Which two drugs can you give for to drive fetal lung maturation and surfactant production?

Answer 22

Corticosteroids

Betamethasone
Dexamethasone

Question 23

MOA and clinical use of ritodrine?

Answer 23

β2-agonist, used to stop contractions (not FDA approved)

Question 24

Adverese effects of ritodrine

Answer 24

Hallucinations

Question 25

Clinical use of magnesium sulfate in pregnancy

Answer 25

Eclampsia

Question 26

MOA of terbutaline

Answer 26

β2-agonist

Question 27

Which drugs can be used for tocolysis but are not FDA approved?

Answer 27

Terbutaline
Ritodrine
MgSulfate
Nifedipine
Indomethacine
Nitroglycerine
Atosiban

Question 28

MOA of atosiban

Answer 28

oxytocin inhibitor

Not available in US.. why are we learning it?

Question 29

What are the two BEST choices for tocolysis, even though there are none currently FDA approved?

Answer 29

Nifedipine (CCB) or indomethacin (NSAID)

Question 30

What drugs/vaccines are given to every infant after delivery? (3)

Answer 30

Erythromycin eye oinment
-reduce gonococcal conjunctivitis

Vitamin K
-prevent neonatal hemorrhage

Hep B vaccine

Question 31

How do you maintain a patent Patent Ductus Arteriosus?

Answer 31

Alprostadil

Question 32

MOA of alprostadil

Answer 32

PGE1 analog

Question 33

How do you close a Patent Ductus Arteriosus??

Answer 33

NSAIDs

-indomethacin or ibuprofen

Question 34

What are the first line treatments for HTN in preg?

Answer 34

α-methyldopa (α2-agonist)

Oral labetalol (α/β blocker)