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GOSH > GOSH drugs > Flashcards

GOSH drugs Flashcards

1
Q

What is the other name given to Syntocinon?

A

Synthetic Oxytocin

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2
Q

What are the indications for Oxytocin?

A
  • 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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3
Q

What are the contraindications to using Syntocinon?

A
  • Spontaneous labour inadvisable
  • Vaginal delivery inadvisable
  • Fetal distress
  • Hypertonic uterine contractions
  • Severe CVD
  • Severe pre-eclampsia
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4
Q

What are the side effects of Oxytocin?

A

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

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5
Q

What are the indications for tranexamic acid?

A
  • Local/general fibrinolysis
  • Menorrhagia
  • Epistaxis
  • Prevent/treat significant haemorrhage following trauma
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6
Q

What are the contraindications for tranexamic acid?

A
  • Fibrinolytic conditions following DIC
  • Thromboembolic disease
  • Hx of convulsions
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7
Q

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

A
  • Oral contraceptives (inc risk of VTE)
  • Irregular menstrual bleeding
  • Massive haematuria (risk ureteric obstruction)
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8
Q

What are the side effects caused by tranexamic acid?

A
  • Diarrhoea
  • N&V
  • Uncommon: Dermatitis
  • RARE: Impaired colour vision, VTE, visual disturbance
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9
Q

What are the drug interactions with tranexamic acid?

A

-Methotrexate
-Tamoxifen
-Thalidomide
All inc risk of VTE

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10
Q

What are the indications for Mefenamic acid?

A
  • Acute pain inc dysmenorrhoea, menorrhagia

- Pain & inflammation in RA/OA

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11
Q

What are the contraindications of Mefenamic acid?

A
  • Active GI bleeds
  • Active GI ulcer
  • Hx of GI bleed related to NSAIDs
  • IBD
  • Severe HF
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12
Q

What are the side effects of Mefenamic acid?

A
  • Diarrhoea
  • Rashes
  • Stomatitis
  • Uncommon: Paresthesia, fatigue
  • RARE: Alveoli’s, aplastic anaemia, bronchospasm, colitis, photosensitivity
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13
Q

What are the drug interactions of Mefenamic acid?

A
  • Alteplase
  • Apixaban
  • Beclometasone
  • Bendroflumethiazide
  • Betamethasone
  • Budesonide
  • Ciprofloxacin
  • Dabigatran
  • Dexamethasone
  • Enoxaparin
  • Fludrocortisone
  • Fondaparniux
  • Glucose
  • Heparin
  • Hydrocortisone
  • Lithium
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14
Q

What are the allergy contraindications for Mefenamic acid?

A

Hx of hypersensitivity to aspirin/NSAID

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

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15
Q

What are the drug interactions of Ergometrine?

A
  • Atenolol/Bisoprolol/Labetalol
  • Clarithromycin
  • Diltiazem
  • Dopamine
  • Erythromycin
  • Fluconazole
  • Itra/ketoconazole
  • NorA
  • Verapamil
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16
Q

What are the indications of ergometrine?

A

Postpartum haemorrhage caused by uterine atony

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17
Q

What are the contraindications of Ergometrine?

A
  • Eclampsia
  • 1st & 2nd stage of labour
  • Induction of labour
  • Sepsis
  • Severe cardiac disease
  • Severe hypertension
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18
Q

What are the side effects of ergometrine?

A
  • Abdo & chest pain
  • Arrhythmia/bradycardia/ palpitations
  • Headache
  • Hypertension
  • Pulmonary oedema
  • VasoC
  • Tinnitus
  • RARE: MI
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19
Q

What are the indications of Misoprostol?

A

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

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20
Q

How long after Mifepristone is Misoprostol given?

A

24-48hours

21
Q

What type of drug is Misoprostol?

A

Prostaglandin E1

22
Q

What are the side effects of Misoprostol?

A
  • Diarrhoea
  • IMB/menorrhagia
  • Postmenopausal bleeding
  • Abdo pain
23
Q

In what state is Misoprostol contraindicated?

A

1st trimester of pregnancy (teratogenic risk)

Avoid-potent uterine stimulant

24
Q

Name the main GnRH analogues

A

Goserelin

Leuprorelin

25
Q

What are the indications of Goserelin?

A
  • Endometriosis
  • Endometrial thinning before intra-uterine surgery
  • Before surgery in women who have anaemia due to uterine fibroids
  • IVF related
26
Q

What are the contraindications for Goserelin/Leuprorelin?

A

Undiagnosed vaginal bleeding

Use >6months in endometriosis (do not repeat)

27
Q

What are the side effects of Goserelin?

A
  • RARE: HyperCa

- Tumour flare in use as cancer treatment

28
Q

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

A

NO

29
Q

What are the directions for use of Goserelin?

A

Rotate injection site to prevent atrophy and nodule formation

30
Q

What are the indications for Leuprorelin?

A
  • Same as Goserelin

- Reduction of size of uterine fibroids & associated bleeding before surgery

31
Q

What VTE medication can be used in pregnancy?

A

LMWH (Tinzaparin)

Unfractionated Heparin

32
Q

What VTE should not be used in pregnancy? Why?

A

Warfarin

Inc risk of stillbirth & prematurity

33
Q

What is Syntometrine made up of?

A

Oxytocin & Ergometrine

34
Q

What is the brand name of Leuprorelin?

A

Prostap

35
Q

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

A

CAN: Labetalol, Nifedipine

CAN’T: ACE/ARB

36
Q

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

A

CAN: Magnesium Sulphate

CAN’T: Valproate (risk of neural tube defects)

37
Q

What are tocolytics used for? Name the main ones used

A

Aim to holt/slow down premature labour

  • Beta mimetic: Terbutaline (22-37weeks)
  • CCB: Nifedipine
38
Q

What are contraindications of tocolytics?

A

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

39
Q

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

A
  • Placenta praaevia
  • Placental abruption
  • Antepartum haemorrhage
  • Eclampsia
  • Hx of intra-uterine fetal death/infection
40
Q

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

A

Cephalosporins

Penicillins

41
Q

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

A

Increased risk of necrotising enterocolitis

42
Q

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

A

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

43
Q

Which antibiotic should be prescribed in PPROM and why?

A

Erythromycin

Prophylaxis for chorioamnionitis

44
Q

What is used to treat chorioamnionitis?

A

Cefotaxime & Metronidazole

45
Q

What are the indications for Mifepristone?

A
  • 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
46
Q

What are the contraindications of Mifepristone?

A

Acute porphyria
Ectopic
Uncontrolled severe asthma

47
Q

What are the side effects of Mifepristone?

A
  • GI cramps, uterine contractions, vaginal bleeding

- RARE: TSS, chills, fever, hypoT, headache, hot flushes

48
Q

What are the indications of maternal corticosteroids?

A

Accelerate fatal lung maturation

49
Q

When should maternal corticosteroids be considered?

A

-24-35

weeks preterm labour

GOSH (17 decks)

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