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Pharmacology 3 > Module 1: Chapter 53 Drugs Affecting Uterine Motility > Flashcards

Module 1: Chapter 53 Drugs Affecting Uterine Motility Flashcards

1
Q

what homrone is responsible for uterine contractions

A

oxytocin

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2
Q

The induction of labor is related to what hormone

A

oxytocin

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3
Q

the oxytocin receptors that are located in the _______ increase during ______ and reach peak levels at _____

A

endometerium
labor
birth

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4
Q

what also has a role in preparing the uterus for labor and delivery

A

prostaglandins

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5
Q

what prostaglandin leads to sensitization of the myometrium to oxytocin

A

prostaglandin E2

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6
Q

what does prostaglandin E2 do

A

leads to sensitization of the myometrium to oxytocin

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7
Q

what are the three phases of uterine contractions

A

incremental phase
stable phase
third phase

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8
Q

what occurs in the incremental phase of uterine contractions

A

oxytocin receptors endometrium wait for oxytocin

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9
Q

what happens in teh stable phase of uterine contractions

A

oxytocin receptors are fully occupied

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10
Q

what occurs in the third phase of uterine contractions

A

uterine tetany (prolonged contractions)

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11
Q

what are the two categories of obstetric situations that require drug administration to intitate the onset of contractions

A

1) labor that does not begin at term

2) pregnancy that is determental to the patient or her fetus

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12
Q

what is the name for synthetic forms of the endogenous hormone oxytocin

A

oxytocic drugs

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13
Q

where is the hormone oxytocin produced

A

posterior pituitary

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14
Q

what do oxytocic drugs produce

A

uterine contractions and milk ejection for breast-feeding

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15
Q

what is the prototype drug for oxytocics

A

pitocin

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16
Q

what are the pharacotherapeutics for oxytocin

A

given by IV drip infusion to initate or augment (improve) labor contractions

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17
Q

how is oxytocin administered

A

via IV

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18
Q

what is the onset for oxytocin

A

immediate

19
Q

how is oxytocin eliminated

A

through the liver, kidney and mammary glands

20
Q

does synthetic exogenous oxytocin have the same effects on the body as natural endogenous oxytocin

A

yes

21
Q

what are some contraindications and precautions for oxytocin

A

cephalopelvic disproportion and unfavorable fetal positions

22
Q

what are some adverse effects for oxytocin

A

nausea, vomiting, uterine hypteronicity and cardiac arrhythmias

23
Q

what drugs have interactions with oxytocin

A

sympathomimetic drugs

24
Q

what should we assess for before giving oxytocin

A

assess pelvic adequacy
assess druation of pregnancy
consider the patient risk of water intoxication
assess environment where drug will be given

25
Q

what are two ways to maximize thereapeautic effects of oxytocin

A

assess cervical ripening using the bishop scoring system

use an infusion pump for precise administration of oxytocin

26
Q

what are two ways to minimize adverse effects of oxytocin

A

piggyback the diluted oxytocin solution into a primary IV line
The FHR monitor continuously records the patients uterine contraction pattern

27
Q

what are the most severe adverse effect of oxytocin

A

water intoxication
uterine rupture
permanent CNS damage to the fetus

28
Q

what are 5 other adverse effects of oxytocin to the fetus

A 
preamture ventricular contractions
arrhythmias
impaired fetal oxygenation
premanet brain or CNS damage
death
29
Q

what is the class of drugs called that inhibit uterine activity

A

tocolytics

30
Q

what is the medical complication that requires the use of tocolytics

A

preterm labor

31
Q

what gestational time frame are tocolytics used

A

when true labor begins after 20 weeks and usually before completion of the 34th gestational week

32
Q

what is the prototype drug for tocolytics

A

terbutaline (Bretheine)

33
Q

what is the off-label therapeutic use of terbutaline

A

control preterm labor in pregnancies of 20-34 weeks

34
Q

how is terbutaline administered

A

SC or orally

35
Q

how does terbutaline work

A

beta-receptor agonist (stimulant) that selectively prefers the beta-2 receptors over beta-1 receptors

36
Q

when is terbutaline contraindicated

A

before the 20th week of pregnancy

37
Q

what are the adverse effects of terbutaline

A 
tachycardia
hypotension
dyspnea
nervousness
transient hyperglycemia 
pulmonary edema
cerebral and myocardial ischemia
N/V
38
Q

what other class of drugs has interactions with terbutaline

A

beta stimulants

39
Q

what pregnancy category is terbutaline

A

category B

40
Q

to maximize terbutaline effects when should you begin drug therapy

A

as soon as possible after preterm labor is diagnosed

41
Q

what should be done to minimize adverese effects

A

closely monitor the patients fluid status to avoid fluid overload

42
Q

what should be done if a patient demonstrates signs of adverse effects when being treated with terbutaline

A

dosage should be decreased

43
Q

why side should a patient lie on when being administered terbutaline

A

left

decrease chance of hypotension and promote fetal circulation

44
Q

T or F: terbutaline inhibits contractility of uterine smooth muscle by inhibition of the alpha receptors in the uterine smooth muscle

A

True: terbutaline is a beta-receptor agonist (stimulant) that selectively prefers the beta-2 over beta-1 receptors
simulation of these receptors inhibits contractility of uterine smooth muscle

Pharmacology 3 (6 decks)

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