Fitz - Antenatal & Perinatal Pharm

Question 1

Used to promote lung maturation in pre-term delivery

Answer 1

Corticosteroids

Question 2

Surfactant deficiency in pre-term infants (before 32 wks) leads to

Answer 2

RDS

Question 3

Women btwn 24-34 wks gestation with threatened preterm labor, antepartum hemorrhage, preterm rupture of membranes, and conditions needing c-section( pre-eclampsia, HELLP) require

Answer 3

Antenatl corticosteroid

Question 4

Antenatal corticosteroids used in pre-term delivery

Answer 4

Betamethasone, dexamethasone

Question 5

Want to use corticosteroids that have higher activity at

Answer 5

Glucocorticoid receptors, not mineralicorticoid

Question 6

Betamethasone and dexamethasone downstream effects in pre-term infants

Answer 6

Transcription of surfactant proteins by type 2 pneumocytes

Question 7

CI’s antenatal corticosteroid tx

Answer 7

Mom with systemic infection, TB

Question 8

Enzyme present in placenta that decreases efficacy of cortisol

Answer 8

11beta-HSD-2, cortisol > cortisone = not as active at GCRs!

Question 9

Stimulus for oxytocin release from maternal post pit

Answer 9

Uterine stretch nerve impuse

Question 10

Released from placenta to drive uterine contractions

Answer 10

PGF-2alpha

Question 11

PG analogues that facilitate cervical ripening and uterine contrations

Answer 11

Dinoprostone, misoprostol

Question 12

PG analogue that is more utero-selective

Answer 12

Dinoprostone

Question 13

PG analogue that is a vaginal or cervical gel

Answer 13

Dinoprostone

Question 14

Favored pharm agent for inducing labor

Answer 14

Oxytocin

Question 15

Other use for oxytocin (not to induce labor)

Answer 15

Fetal stress tests

Question 16

Drugs used to stop uterine contraction and prevent neonatal risk ass’d with prematurity

Answer 16

Tocolytic agents

Question 17

MCly use tocolytic agent

Answer 17

MgSO4

Question 18

MgSO4 helps protect mom against

Answer 18

Seizures ass’d with pre-eclampsia and HELLP synd

Question 19

Drugs that relax uterine smooth m (5)

Answer 19

• beta 2 RAs
• Ca2+ ch antagonists
• MgSO4
• COX inhibitors
• oxytocin receptor antagonists

Question 20

MCly used NSAIDs used

Answer 20

Infomethacin, ibuprofen

Question 21

Oxytocin receptor antagonists

Answer 21

Atosiban

Question 22

Ca cannel blocker used to dec uterine contractions

Answer 22

Nifedipine

Question 23

Beta2 receptor agonists to induce uterine relaxation

Answer 23

Ritodrine, salbutamol, terbutaline

Question 24

Competeive antagonist at Ca2+ channels

Answer 24

MgSO4

Question 25

AE: beta androgneric agonsts

Answer 25

Tachy, hypotension, hypoK, hyperglycemia

Question 26

AE: indomethicin

Answer 26

1st trimester - facial anomly (hairlip),

At term - early closure of PDA; mom - bleeding risk, ulcer

Question 27

AE: nifedipine

Answer 27

Mom - hypotension, dizziness

Question 28

CI: MgSO4

Answer 28

Mayasthenia gravis

Question 29

Keeps ductus ateriosus patent in utero

Answer 29

PGE2

Question 30

Used to maintain ductus and pulmonary blood flow in per-term infacts

Answer 30

Alprostadil (PGE1)

Question 31

AEs: alprostadil

Answer 31

Hypotension, tachy, apnea, PYREXIA!

Question 32

AE: NSAIDs

Answer 32

Renal vasculature constrction

Question 33

Causes kernicterus

Answer 33

Sulfonamides

Question 34

Causes gray baby syndrome

Answer 34

Chloamphenicol

Question 35

Pregnancy grade B antibiotics

Answer 35

Cephalosporins, penicillins

Question 36

Pregnancy category C antibiotics

Answer 36

Floroquinolones, TMP-SMX

Question 37

Pregnancy category D antibiotics

Answer 37

Tetracyclines

Question 38

Cause cartilage erosion in baby

Answer 38

Fluroquinolones

Question 39

Deposition into bone or teeth of baby

Answer 39

Tetracyclins

Question 40

Can cause folate inhibition and cause birth defects in baby

Answer 40

TMP-SMX

Question 41

FDA risk categories don’t take int account

Answer 41

Agents or metabolites in breast milk