GOSH drugs Flashcards by Amy Spicer

What is the other name given to Syntocinon?

Synthetic Oxytocin

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What are the indications for Oxytocin?

Induction of labour for medical reasons
Stimulation of labour in hypnotic uterine inertia
C-Section
Prevention & treatment of (severe) postpartum haemorrhage after delivery of the placenta
Induction of labour in incomplete/inevitable/missed miscarriage/abortion
Augmentation of labour

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What are the contraindications to using Syntocinon?

Spontaneous labour inadvisable
Vaginal delivery inadvisable
Fetal distress
Hypertonic uterine contractions
Severe CVD
Severe pre-eclampsia

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What are the side effects of Oxytocin?

Arrhythmia
Headache
N&V
RARE: Anaphylaxis, DIC, hypoN, uterine hyperstimulation/spasm

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What are the indications for tranexamic acid?

Local/general fibrinolysis
Menorrhagia
Epistaxis
Prevent/treat significant haemorrhage following trauma

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What are the contraindications for tranexamic acid?

Fibrinolytic conditions following DIC
Thromboembolic disease
Hx of convulsions

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What are the cautions needed to be taken into account when prescribing tranexamic acid?

Oral contraceptives (inc risk of VTE)
Irregular menstrual bleeding
Massive haematuria (risk ureteric obstruction)

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What are the side effects caused by tranexamic acid?

Diarrhoea
N&V
Uncommon: Dermatitis
RARE: Impaired colour vision, VTE, visual disturbance

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What are the drug interactions with tranexamic acid?

-Methotrexate
-Tamoxifen
-Thalidomide
All inc risk of VTE

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What are the indications for Mefenamic acid?

Acute pain inc dysmenorrhoea, menorrhagia

- Pain & inflammation in RA/OA

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What are the contraindications of Mefenamic acid?

Active GI bleeds
Active GI ulcer
Hx of GI bleed related to NSAIDs
IBD
Severe HF

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What are the side effects of Mefenamic acid?

Diarrhoea
Rashes
Stomatitis
Uncommon: Paresthesia, fatigue
RARE: Alveoli’s, aplastic anaemia, bronchospasm, colitis, photosensitivity

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What are the drug interactions of Mefenamic acid?

Alteplase
Apixaban
Beclometasone
Bendroflumethiazide
Betamethasone
Budesonide
Ciprofloxacin
Dabigatran
Dexamethasone
Enoxaparin
Fludrocortisone
Fondaparniux
Glucose
Heparin
Hydrocortisone
Lithium

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What are the allergy contraindications for Mefenamic acid?

Hx of hypersensitivity to aspirin/NSAID

Those in whom asthma attacks, angioedema, urticaria, rhinitis precipitated by aspirin/NSAIDs

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What are the drug interactions of Ergometrine?

Atenolol/Bisoprolol/Labetalol
Clarithromycin
Diltiazem
Dopamine
Erythromycin
Fluconazole
Itra/ketoconazole
NorA
Verapamil

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What are the indications of ergometrine?

Postpartum haemorrhage caused by uterine atony

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What are the contraindications of Ergometrine?

Eclampsia
1st & 2nd stage of labour
Induction of labour
Sepsis
Severe cardiac disease
Severe hypertension

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What are the side effects of ergometrine?

Abdo & chest pain
Arrhythmia/bradycardia/ palpitations
Headache
Hypertension
Pulmonary oedema
VasoC
Tinnitus
RARE: MI

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What are the indications of Misoprostol?

-Termination of pregnancy following Mifepristone (gestation up to 49days, 50-63days, 9-13weeks, 13-24weeks)

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How long after Mifepristone is Misoprostol given?

24-48hours

What type of drug is Misoprostol?

Prostaglandin E1

What are the side effects of Misoprostol?

Diarrhoea
IMB/menorrhagia
Postmenopausal bleeding
Abdo pain

In what state is Misoprostol contraindicated?

1st trimester of pregnancy (teratogenic risk)

Avoid-potent uterine stimulant

Name the main GnRH analogues

Goserelin

Leuprorelin

What are the indications of Goserelin?

- Endometriosis - Endometrial thinning before intra-uterine surgery - Before surgery in women who have anaemia due to uterine fibroids - IVF related

What are the contraindications for Goserelin/Leuprorelin?

Undiagnosed vaginal bleeding | Use >6months in endometriosis (do not repeat)

What are the side effects of Goserelin?

- RARE: HyperCa | - Tumour flare in use as cancer treatment

Can Goserelin/Leuprorelin be used in pregnancy or breast-feeding?

What are the directions for use of Goserelin?

Rotate injection site to prevent atrophy and nodule formation

What are the indications for Leuprorelin?

- Same as Goserelin | - Reduction of size of uterine fibroids & associated bleeding before surgery

What VTE medication can be used in pregnancy?

LMWH (Tinzaparin) | Unfractionated Heparin

What VTE should not be used in pregnancy? Why?

Warfarin | Inc risk of stillbirth & prematurity

What is Syntometrine made up of?

Oxytocin & Ergometrine

What is the brand name of Leuprorelin?

Prostap

In pregnancy, which medications can & can't be used to control blood pressure?

CAN: Labetalol, Nifedipine | CAN'T: ACE/ARB

In pregnancy, which medications can & can't be used to control seizures?

CAN: Magnesium Sulphate | CAN'T: Valproate (risk of neural tube defects)

What are tocolytics used for? Name the main ones used

Aim to holt/slow down premature labour - Beta mimetic: Terbutaline (22-37weeks) - CCB: Nifedipine

What are contraindications of tocolytics?

T: Pre-eclampsia N: Acute angina, CardioShock, aortic stenosis, 1month post-MI

What are the contraindications specific to premature labour use of Terbutaline?

- Placenta praaevia - Placental abruption - Antepartum haemorrhage - Eclampsia - Hx of intra-uterine fetal death/infection

What antibiotics can be given to a pregnant woman with a UTI?

Cephalosporins | Penicillins

Why can Co-Amoxiclav not be given to pregnant women?

Increased risk of necrotising enterocolitis

Why can Trimethoprim, Tetracyclines & Nitrofurantoin not be given to pregnant women?

N: 3rd trimester increases risk of neonatal haemolysis T: 1st trimester= anti-folate inc risk of neural tube defects Tetra: Neonatal tooth discolouration

Which antibiotic should be prescribed in PPROM and why?

Erythromycin | Prophylaxis for chorioamnionitis

What is used to treat chorioamnionitis?

Cefotaxime & Metronidazole

What are the indications for Mifepristone?

- Cervical ripening before mechanical cervical dilatation for TOP <84days - Labour induction in fatal death in utero - mTOP <49days/50-63days - mTOP 13-24weeks w/prostaglandin

What are the contraindications of Mifepristone?

Acute porphyria Ectopic Uncontrolled severe asthma

What are the side effects of Mifepristone?

- GI cramps, uterine contractions, vaginal bleeding | - RARE: TSS, chills, fever, hypoT, headache, hot flushes

What are the indications of maternal corticosteroids?

Accelerate fatal lung maturation

When should maternal corticosteroids be considered?

-24-35 | weeks preterm labour