Labor & Delivery (KEY POINTS) Flashcards
What is the role of calcium during labor?
Controls uterine contraction
What action has an inhibitory effect on uterine contraction?
Stimulation of ATP-sensitive potassium channels
What 5 drugs promote uterine contractions?
Oxytocin PGE E2 Carboprost Mifepristone Methylergonovine
Which 3 drugs control postpartum hemorrhage?
Oxytocin
Carboprost
Methylergonovine
Which 2 drugs promote cervical ripening?
PGE E2
Oxytocin
Describe the role of mifepristone
Progesterone antagonist
Terminates pregnancy up through day 49 of gestation
Which drug induces labor?
Oxytocin DUH!
What are the 3 forms of PGE E2 available?
Gel
Vaginal insert
Vaginal suppository
What form of PGE E2 is used for termination of pregnancy?
Vaginal suppository
What are ADEs of PGE E2?
N/V, +/- fever
What is carboprost?
Methylated analogue of PGF2alpha
Which drug causes STRONG uterine contractions?
Carboprost
What is carboprost used for?
Postpartum hemorrhage (MC)
Induce uterine emptying
What is carboprost NOT used for?
Elective induction of uterine contractions w/ viable infant
What are ADEs of carboprost?
- Bronchospasm (contraindicated in asthma)
- HTN
- V/D
- “Choking”
Besides uterine contractions, which drug also causes vasoconstriction?
Methylergonovine
Which type of drugs suppress uterine contractions?
Tocolytic agents (Terbutaline, nifedipine, NSAIDs, MgSO4)
Prevents delivery of premature infant
What drug class does terbutaline belong to?
Beta2 agonist
What are the ADEs of terbutaline?
Syndrome of tachy Pulmonary edema Metabolic acidosis Hypokalemia Hypotension
Which drug should not be used > 5-7 days in women in preterm labor?
MgSO4 (Category D drug)
Can lead to hypocalcemia, osteopenia, & bone fx in newborn
What are ADEs of MgSO4?
High serum Mg levels –> weakness, paralysis, resp. failure, & hypotension
What will impair the elimination of Mg?
Renal insufficiency
What procedure is used to lower Mg levels in severe toxicity?
Hemodialysis
Which drugs cause uterine relaxation?
Terbutaline
NSAIDS (Indomethacin, ibuprofen)
What are ADEs of NSAIDs (w/ respect to the baby) ?
Decreased GFR
Narrowed/closed fetal ductus arteriosis
What is given IM weekly to women w/ hx of recurrent miscarriage @ > 20wks?
Hydroxyprogesterone caproate
