GI and UG spasm muscle relaxants and drugs affecting the uterus Flashcards
What are the muscarinic drugs for GI and UG spams releif?
Oxybutinin and Tolterodine
Darifenacin and Solifenacin and Tospium
Butylscopolamine, Homatropine and Methylatropine
What are the PDE inhibitors for GI spasm?
What PDE subtgype do they inhibit and what other target?
Papaverine
Drotaverine
Inhibit cPDE and L type Ca channels
What are the other -verine drugs
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.
Side effects of Papaverine and Drotaverine
Hypotension
Coronary steal syn
Sedation
Drugs that contract the uterus
Oxytocin
Ergotamine, dihydroergotamine
Misoprostol
Dinoprostone
Dinoprost tromethamine
Sulprostone
Drugs that relax the uterus
Atosiban
Terbutaline
Salbutamol
Fenoterol
Indomethacin
Nifedipine
MgSO4, Magnesium Sulfate injection.
Ethanol
Progesterone but only during 1st trim
Oxytocin
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.
What is the oxytocin antagonist
Atosiban
given i.v. to suppress preterm labor.
What is the effect of Ergotamine and when is it used in obstetrics
What are its SEs
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.
What is misoprostol
Synthetic PGE1.
Induces labor and stimulates protective gastric secretions.
Used along with Mifepristone and MTX as an abortificent.
SE:
Diarrhea
Uterine cramps.
What is Dinoprostone
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
What is Sulprostone
Synthetic PGE2.
What is Dinoprost tromethamine
PGF-2-alpha
Used as an abortificent
Side effect of bronchoconstriction.
How are the prostaglandin analogs eliminated?
Metabolized by liver and eliminated via urine.
Sulprostone is eliminated in bile.
What is Mifepristone
A steroid antagonist of progesterone and glucocorticoid receptors.
Terminates 1st trim pregnancy along with misoprostol.