II: Parturition and Pharmacology

Question 1

_____ stimulation leads to relaxation of the myometrium around the time of delivery

Answer 1

Beta-adrenergic

Question 2

______ stimulate uterine contractions

Answer 2

Prostaglandins, oxytocin

Question 3

_______ induce labor

Answer 3

Prostaglandins

Question 4

CRH ____ cortisol levels, which feeds back to ______ CRH production by the placenta

Answer 4

increase; increase

Question 5

List 4 contraction-activated proteins.

Answer 5

Calcium channels, Oxytocin receptors, Prostaglandin receptors, gap junctions

Question 6

List the phases of myometrial contraction (0-3).

Answer 6

Quiescence; Activation; Stimulation; Involution

Question 7

PDE5Is should not be administered with which drugs?

Answer 7

Alpha blockers, nitrates

Question 8

Post-partum bleeding is controlled hormonally by ______

Answer 8

Oxytocin

Question 9

Prostglandins promote release of _______ that helps lead to facilitate membrane rupture

Answer 9

Metalloproteinases

Question 10

Surfactant proteins increase ______ activity in the amnion

Answer 10

COX-2

Question 11

Which clinical stage of labor? Complete dilation to delivery of fetus

Answer 11

2

Question 12

Which clinical stage of labor? Delivery of the fetus to delivery of the placenta

Answer 12

3

Question 13

Which clinical stage of labor? Effective contraction to complete dilatation of the cervix

Answer 13

1

Question 14

Which clinical stage of labor? First 6 hours after delivery

Answer 14

4

Question 15

Which drug? Administered with mifepristone

Answer 15

Misoprostol

Question 16

Which drug? First line agent for post-partum hemorrhage

Answer 16

Oxytocin

Question 17

Which drug? Folic acid antagonist, disrupts rapidly growing tissues

Answer 17

Methotrexate

Question 18

Which drug? Limited use close to labor due to risk of closing ductus arteriosus

Answer 18

Indomethacin (NSAID)

Question 19

Which drug? May inhibit pituitary oxytocin, not effective in delaying labor

Answer 19

Alcohol

Question 20

Which drug? Oral abortifacent

Answer 20

Mifepristone

Question 21

Which drug? Progesterone competitive receptor antagonist

Answer 21

Mifepristone

Question 22

Which drug? Progesterone metabolite administered weekly for mothers at high risk of preterm delivery

Answer 22

17-alpha-hydroxyprogesterone caproate

Question 23

Which drug? Prostaglandin analog as vaginal gel or oral administration

Answer 23

Dinoprostone; Misoprostol

Question 24

Which drug? Prostaglandin analog with uterine contractility properties; may cause abdominal cramps and n/v

Answer 24

Misoprostol

Question 25

Which drug? Relaxes uterine smooth muscle with fewer side effects than other agents

Answer 25

CCBs (nifedipine)

Question 26

Which drug? Suppresses contraction and preterm labor, less effective if cervix is already dilated; may cause tachycardia, hypokalemia, hyperglycemia, pulmonary edema

Answer 26

Beta-2-agonist/Terbutaline

Question 27

Which drug? Used for eclampsia; blocks calcium action; may rarely cause pulmonary edema, hypotension or muscle paralysis

Answer 27

Magnesium Sulfate

Question 28

Which drug? Used for induction after cervical ripening

Answer 28

Oxytocin

Question 29

Which drug? Used for post-partum hemorrhage refractory to treatment with oxytocin

Answer 29

Ergot alkaloids (ergonovine, methylergonovine)

Question 30

Which hormone? Activate potassium channels to increase threshold required for depolarization

Answer 30

Beta-Sympathomimetic

Question 31

Which hormone? Activates myosin light chain kinase and activates prostaglandins

Answer 31

Oxytocin

Question 32

Which hormone? Activates Protein Kinase C pathway to increase intracellular calcium

Answer 32

CRH

Question 33

Which hormone? Acts in a paracrine fashion increase intracellular calcium levels by activation of ligand-gated channels

Answer 33

Prostaglandins

Question 34

Which hormone? Blocks myosin light chain kinase and inactivates prostaglandins

Answer 34

Progesterone

Question 35

Which hormone? Facilitates weakening of chorion and amnion

Answer 35

Prostaglandins

Question 36

Which hormone? Functions for quiescence earlier in pregnancy and contraction late in pregnancy

Answer 36

CRH

Question 37

Which hormone? High levels are associated with preterm labor

Answer 37

CRH

Question 38

Which hormone? Increased activation of contractility generated by change in receptor isotypes

Answer 38

CRH

Question 39

Which hormone? Number of receptors greatly increases at time of parturition

Answer 39

Oxytocin

Question 40

Which hormone? Stimulates contractions, greatest action at fundus

Answer 40

Oxytocin

Question 41

Which PDE5I? Back and muscle pain

Answer 41

Tadalafil

Question 42

Which PDE5I? Decrease blood pressure

Answer 42

Sildenafil, vardenafil

Question 43

Which PDE5I? Longest half-life

Answer 43

Tadalafil

Question 44

Which PDE5I? Loss of blue-green color discrimination, blurred vision

Answer 44

Sildenafil