GI and UG spasm muscle relaxants and drugs affecting the uterus Flashcards

1
Q

What are the muscarinic drugs for GI and UG spams releif?

A

Oxybutinin and Tolterodine

Darifenacin and Solifenacin and Tospium

Butylscopolamine, Homatropine and Methylatropine

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2
Q

What are the PDE inhibitors for GI spasm?

What PDE subtgype do they inhibit and what other target?

A

Papaverine
Drotaverine

Inhibit cPDE and L type Ca channels

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3
Q

What are the other -verine drugs

A

Pinaverin - inhibits Ca channels only. Used in IBS and biliary disorders

Mebeverine - Unclear mechanism, direct SM relaxation effects possibly through Ca. Also used for IBS.

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4
Q

Side effects of Papaverine and Drotaverine

A

Hypotension

Coronary steal syn

Sedation

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5
Q

Drugs that contract the uterus

A

Oxytocin

Ergotamine, dihydroergotamine

Misoprostol

Dinoprostone

Dinoprost tromethamine

Sulprostone

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6
Q

Drugs that relax the uterus

A

Atosiban

Terbutaline
Salbutamol
Fenoterol

Indomethacin

Nifedipine

MgSO4, Magnesium Sulfate injection.

Ethanol

Progesterone but only during 1st trim

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7
Q

Oxytocin

A

Given i.v. for labor or postpartum bleeding.
Stimulates rhythmic contractions of the uterus and can induce or reinforce labor.

Reduces postpartum bleeding

Can also stimulate lactation, given as intranasal spray.

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8
Q

What is the oxytocin antagonist

A

Atosiban

given i.v. to suppress preterm labor.

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9
Q

What is the effect of Ergotamine and when is it used in obstetrics

What are its SEs

A

Used ONLY after delivery to reduce post partum bleeding.

Causes a powerful tonic contraction of the uterus

SEs
Hypertension, potential intestinal ischemia.
neurologic SEs, seizures.

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10
Q

What is misoprostol

A

Synthetic PGE1.

Induces labor and stimulates protective gastric secretions.

Used along with Mifepristone and MTX as an abortificent.

SE:
Diarrhea
Uterine cramps.

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11
Q

What is Dinoprostone

A

another name for PGE2.

Also can induce labor or abortion.
Reduce post partum bleeding

Maintains patent ducuts arteriousus in newborns with cardiac or vessel malformations, until surgery

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12
Q

What is Sulprostone

A

Synthetic PGE2.

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13
Q

What is Dinoprost tromethamine

A

PGF-2-alpha

Used as an abortificent

Side effect of bronchoconstriction.

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14
Q

How are the prostaglandin analogs eliminated?

A

Metabolized by liver and eliminated via urine.

Sulprostone is eliminated in bile.

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15
Q

What is Mifepristone

A

A steroid antagonist of progesterone and glucocorticoid receptors.

Terminates 1st trim pregnancy along with misoprostol.

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16
Q

What is the term for a drug that delays labor

A

Tocolytic

17
Q

What are the tocolytics

A

Atosiban
Terbutaline
Salbutamol, Fenoterol

Nifedipine
MG sulfate injection
Ethanol
Progesteron

(NOT indomethacin, its just used as a uterine relaxer to reduce menstrual cramps)

18
Q

How long can Terbutaline be used to delay pregnancy?

When is it used?

A

After week 16, can be used for up to 48 hours while a C section is prepared for.

Also to delay contractions when the baby is in a position that may cause uterine rupture.

19
Q

How long can nifedipine be used to delay?

A

Ideally, no tocolytic should be used more than 48 hours, but Nifedipine has been used off label for up to a week.

20
Q

MoA of terbutaline and side effects

A

Terbutaline is a Beta-2 AGONIST.
Stimulating uterine relaxation.

systemic side effects,
Tachycardia, hypotension, hyperglycemia