II: Parturition and Pharmacology Flashcards
_____ stimulation leads to relaxation of the myometrium around the time of delivery
Beta-adrenergic
______ stimulate uterine contractions
Prostaglandins, oxytocin
_______ induce labor
Prostaglandins
CRH ____ cortisol levels, which feeds back to ______ CRH production by the placenta
increase; increase
List 4 contraction-activated proteins.
Calcium channels, Oxytocin receptors, Prostaglandin receptors, gap junctions
List the phases of myometrial contraction (0-3).
Quiescence; Activation; Stimulation; Involution
PDE5Is should not be administered with which drugs?
Alpha blockers, nitrates
Post-partum bleeding is controlled hormonally by ______
Oxytocin
Prostglandins promote release of _______ that helps lead to facilitate membrane rupture
Metalloproteinases
Surfactant proteins increase ______ activity in the amnion
COX-2
Which clinical stage of labor? Complete dilation to delivery of fetus
2
Which clinical stage of labor? Delivery of the fetus to delivery of the placenta
3
Which clinical stage of labor? Effective contraction to complete dilatation of the cervix
1
Which clinical stage of labor? First 6 hours after delivery
4
Which drug? Administered with mifepristone
Misoprostol
Which drug? First line agent for post-partum hemorrhage
Oxytocin
Which drug? Folic acid antagonist, disrupts rapidly growing tissues
Methotrexate
Which drug? Limited use close to labor due to risk of closing ductus arteriosus
Indomethacin (NSAID)
Which drug? May inhibit pituitary oxytocin, not effective in delaying labor
Alcohol
Which drug? Oral abortifacent
Mifepristone
Which drug? Progesterone competitive receptor antagonist
Mifepristone
Which drug? Progesterone metabolite administered weekly for mothers at high risk of preterm delivery
17-alpha-hydroxyprogesterone caproate
Which drug? Prostaglandin analog as vaginal gel or oral administration
Dinoprostone; Misoprostol
Which drug? Prostaglandin analog with uterine contractility properties; may cause abdominal cramps and n/v
Misoprostol
Which drug? Relaxes uterine smooth muscle with fewer side effects than other agents
CCBs (nifedipine)
Which drug? Suppresses contraction and preterm labor, less effective if cervix is already dilated; may cause tachycardia, hypokalemia, hyperglycemia, pulmonary edema
Beta-2-agonist/Terbutaline
Which drug? Used for eclampsia; blocks calcium action; may rarely cause pulmonary edema, hypotension or muscle paralysis
Magnesium Sulfate
Which drug? Used for induction after cervical ripening
Oxytocin
Which drug? Used for post-partum hemorrhage refractory to treatment with oxytocin
Ergot alkaloids (ergonovine, methylergonovine)
Which hormone? Activate potassium channels to increase threshold required for depolarization
Beta-Sympathomimetic
Which hormone? Activates myosin light chain kinase and activates prostaglandins
Oxytocin
Which hormone? Activates Protein Kinase C pathway to increase intracellular calcium
CRH
Which hormone? Acts in a paracrine fashion increase intracellular calcium levels by activation of ligand-gated channels
Prostaglandins
Which hormone? Blocks myosin light chain kinase and inactivates prostaglandins
Progesterone
Which hormone? Facilitates weakening of chorion and amnion
Prostaglandins
Which hormone? Functions for quiescence earlier in pregnancy and contraction late in pregnancy
CRH
Which hormone? High levels are associated with preterm labor
CRH
Which hormone? Increased activation of contractility generated by change in receptor isotypes
CRH
Which hormone? Number of receptors greatly increases at time of parturition
Oxytocin
Which hormone? Stimulates contractions, greatest action at fundus
Oxytocin
Which PDE5I? Back and muscle pain
Tadalafil
Which PDE5I? Decrease blood pressure
Sildenafil, vardenafil
Which PDE5I? Longest half-life
Tadalafil
Which PDE5I? Loss of blue-green color discrimination, blurred vision
Sildenafil
