Obstetrics and Gyn Drugs

Question 1

Which drug is used prophylactically in C -selections to prevent PPH?

Answer 1

Syntometrine

• ergometrine
  +
• Oxytocin

Question 2

What are some side effects of Syntometrine:

Answer 2

Increased BP
Headache
Arrhythmias

Question 3

Which drugs can be used as tocolytics?

Answer 3

Nifedipine

Salbutamol

Terbutaline

Question 4

Which drug is used for medical treatment of ectopic pregnancy and what are its indications?

Answer 4

IM Methotrexate

Indications:

• stable patient
• No fetal heartbeat
• Unruptured
• hCG <1500iU

Question 5

What is the vaccine against HPV?

Answer 5

Gardasil

• offered to females >12 years old.
• needs to be repeated 6-12months

Question 6

What drug class is Norethisterone?

Answer 6

Progesterone

Question 7

What factors regarding contraception need to be taking into account when a woman is epileptic?

Answer 7

The effect of contraception on the Anti-epileptic medication

The effect of the anti epileptic medication (inducers) on the contraception

tetragenic effects of anti-epileptic medication

Question 8

What is the glucocorticoid and dose given for preterm delivery, and when should it be given?

Answer 8

Betamethasone or dexamethasone 12mg IM

2nd dose is 12-24 hours later

it is given to any:

• mother at 24-34 weeks
• if growth restriction to 35 weeks
• electives up to 38 weeks

Question 9

What medication is used for prophylaxis of DVT in pregnancy and who is it offered to?

Answer 9

Sub cut LMWH. Offered antenatally and 6 weeks postnatal.

Offered to:
Previous unprovoked DVT 
>35 years old 
BMI >30 
Gross varicose veins 
Immobility >4 days 
Smokers

Question 10

Which type of oral contraception can’t be used during breast feeding?

Answer 10

COCP

all other types are safe

Question 11

What are some of the advantages of COCP?

Answer 11

Ease of use

Reduces menstruation pain and blood loss

Good for premenstrual symptoms

Reduces risk of ovarian cancer and endometrial cancer

Question 12

How can Combined oestrogen and progesterone contraception be supplied?

Answer 12

Pill

Transdermal Patch
- not affected by vomiting or diarrhoea

Ring pessary

Question 13

What are some side effects of progesterone only pill?

Answer 13

Headaches

Weight gain

Acne

Changes in cycle

Worsening of pre-menstrual syndrome symptoms
(progesterone is thought to the cause)

Question 14

How does the progesterone only injection work? what are some notable side effects with it?

Answer 14

Inhibits ovulation

Weight gain
Long time to restart menstruation cycle
Associated with Osteoporosis *as such should be avoided in adolescents

Question 15

What is the first line of contraception recommended for dysmenorrhoea and menorrhagia?

Answer 15

Mirena IUS

• decreases endometrial thickening.
• can also be useful for endometrioses

Question 16

What advice do you want to give a woman starting the COCP?

Answer 16

If started on first 5 days of cycle they are protected.
If after 5 days, 7 days of condoms is needed

If they get migraines with aura they should report it

Look out for signs of DVT/ P.E

Use of medication and what happens if missed pill

Vomiting and diarrhoea effects on pill

Question 17

Which cancers does COCP protect against?

Answer 17

Colorectal

Endometrial

Ovarian

Question 18

Which type of contraception is associated with a long time before periods go back to normal?

Answer 18

Injection

Question 19

What is an absolute contraindication to the IUD?

Answer 19

PID