Labor and Delivery Flashcards
What electrolyte helps control uterine contractions?
Calcium
What channel has an inhibitory effect in controlling uterine contractions
KATP - ATP sensitive potassium channel
What affect does Oxytocin produce?
Uterine contraction and Cervical ripening
Controls post partum depression
Whats an example of a oxytocin drug?
Pitocin
What is the MOA of Prostaglandin E2 (PGE2)
Promotes contractions and cervical ripening
What drug is Prostglandin E2?
Dinoprostone
What are the 2 forms of Dinoprostone (PGE2)
Gel and vaginal insert
What analogue does Carbapost promote?
Prostaglandin F2-alpha (F2a)
What is the MOA of Carbapost?
Causes strong uterine contractions
What situation is Carbapost most commonly used during
Postpartum hemorrhage
What stage in pregnancy is Carbapost used in and why?
13-20 weeks
Used by some to induce uterine emptying
Side effects of Carbapost?
Bronchospasma - contrainidicates in asthma
Hypertension
Choking
What is the use of Mifeprestone
Prostaglandin antagonist used to terminate pregnancy up to 49 days
MOA of Mifeprestone
Uterine contractions up to day 49
What 3 drugs can be given to control postpartum hemorrhage?
Oxytocin
Carbopost
Methylergonovine
What is the MOA of Methlergonovine?
Uterine contraction and vasoconstriction
Name of an agent that ceases uterine contractions?
Tocolytic agents
When is a Tocolytic agent most commonly used for?
To suppress labor that would result in delivery of a premature infant
Tocolytic agents allow the maturity of what system in an fetus?
Lung maturity - with the use or corticosteroids
What are 4 drugs that suppress uterine contractions?
Terbutaline
Nifedipine
NSAIDs (indomethacin, ibuprofen)
Magnesium
What drug class does Terbutaline fall under?
B2 agonist
MOA of Terbutaline?
B2 agonist that causes uterine smooth muscle relaxation
Side effects when using Terbutaline as a B2 agonist?
Tachycardia pulmonary edema hypokalemia metabolic acidosis Hypotension
What Black box warning is including when taking Terbutaline?
Avoid taking for a prolonged period of time, can cause maternal cardiotoxicity and death
How many days can Magnesium be used for without experiencing ADE?
5-7 days
What FDA warning is associated with prolonged use of Mg for uterine contraction suppression?
Can cause hypocalcemia –> osteopenia or bone fractures
What category drugs is Mg?
category D
What are side effects of taking Mg?
Weakness
paralysis
Respiratory failure
Hypotension
What type of drug is Nifedipine? MOA
Calcium channel blocker
Relaxes uterus smooth muscle
What two NSAIDs are used to prevent uterine contractions?
Indomethacin
Ibuprofen
What is the MOA of NSAIDs for uterus contraction suppression?
Prevent the formation of prostaglandins
What side effects do NSAIDS cause?
Decrease GFR
Narrow closure of fetal ductus arteriosis
What drug is given to pregnant women with a history of miscarriages?
Hydroxyprogesterone caproate?
