Pharm

Question 1

what medication is used to induce ovulation?

Answer 1

clomiphene citrate

Question 2

what is the MOA of clomiphene?

Answer 2

induces ovulation as its a selective estrogen receptor modulator
it blocks estrogen’s negative effects on the hypothalamus leading to inc. GnRH

Question 3

what pharmicokinetic changes of drugs cause higher fetal concentrations?

Answer 3

lipophilic, low molecular wt, high Pka, not affected by protein binding

Question 4

what drug can cause significant renal failure in infants?

Answer 4

ACEIs

Question 5

what drugs can cause neonatal abstinence syndrome

Answer 5

opiods

Question 6

what can cause spina bifida?

Answer 6

dec. folic acid in diet

Question 7

what does thalidomide do to a fetus? when are they most at risk?

Answer 7

causes limb malformations (phocomelia)

4-7 weeks gestation

Question 8

what shows the following symptoms: low nasal bridge, small head and jaw, thin upper lip, epicanthal folds, poor growth, heart defects, delayed development?

Answer 8

fetal alcohol syndrome

Question 9

what causes intrauterine growth retardation, stillbirth, risk for SIDs, neurobehavioral def?

Answer 9

tobacco use/nicotine`

Question 10

what is the first line treatment for GBS?

Answer 10

penicillin

Question 11

what is the second line treatment for GBS if there is no significant reaction to penicilin?

Answer 11

cefazolin

Question 12

what do you treat GBS with if a patient is highly allergic to penicillin?

Answer 12

clindamycin and vacnomycin

Question 13

what is used for a 1st trimester abortion?

Answer 13

misoprostol + mifepristone

Question 14

what is the moa of mifepristone?

Answer 14

progesterone receptor antagonist

leads to endometrial decay

Question 15

what is the MOA of misoprostol?

Answer 15

PGE1 analogue that causes uterine contractions

Question 16

what do you use for a missed abortion/intrauterine fetal death?

Answer 16

dinoprostone (PGE2 analogue)

Question 17

what is used for PPH due to uterine antony?

Answer 17

carboprost (hemabate)

PGF2 alpha analogue

Question 18

what are the various obstetrical uses for misoprostol?

Answer 18

abortificant, ripen cervix, induce labor, treat PPH

Question 19

what HTN drugs do you avoid in pregnancy?

Answer 19

prils and sartans

Question 20

what drugs do you use for acute and chronic control of HTN in pregnancy?

Answer 20

methyldopa, hydralazine, labetalol, nifedipine

Question 21

MOA of methyldopa

Answer 21

stimulates the central inhibitory alpha-2-adrenergic receptors, leading to a reduction in sympathetic tone, total peripheral resistance, and blood pressure

Question 22

moa of hydralazine

Answer 22

Direct acting arterial vasodilator

Question 23

moa of labetalol

Answer 23

Selective Alpha-1- blocker = vasodilate

Non selective Beta-1 block = decreased CO

Question 24

moa of nifedipine

Answer 24

Calcium Channel Blocker = arterial vasodilator

Fast release gel caps for acute, slow release tabs for chronic

Question 25

Explain the rationale for using magnesium sulfate in treating preeclampsia and eclampsia

Answer 25

prevents seizures with eclampsia

Question 26

Describe how magnesium sulfate is administered

Answer 26

Given as an IV loading dose followed by a constant IV infusion

Question 27

Explain the mechanisms of action of magnesium sulfate’s anticonvulsant effects

Answer 27

Unique calcium antagonist, an anticonvulsant: It inhibits calcium movement through its channels in a variety of tissues Relaxes smooth muscle, also has the ability to decrease platelet aggregation and increase release of NO. Increase the seizure threshold by inhibiting NMDA receptors, thereby limiting the effect of glutamate

Question 28

Recognize the signs of magnesium toxicity

Answer 28

N, warmth, flushing, somnolence, double vision, slurred speech, weakness, loss of patellar reflexes muscular paralysis, respiratory arrest, cardiac arrest

Question 29

identify a magnesium antidote

Answer 29

calcium gluconate

Question 30

Therapeutic use of misoprostol

Answer 30

cervical ripening induction of labor abortificient PPH (prevent/treat)

Question 31

ADRs of misprostol

Answer 31

Diarrhea | shivering

Question 32

MOA of methylergonovine

Answer 32

ergot alkaloid | alpha 1 adrenergic, dopaminergic, agonist at serotonin receptors. induces uteronic effect and dec. blood loss

Question 33

MOA of oxytocin

Answer 33

stimulates uterine contractions | stimulates PG release

Question 34

therapeutic use of methylergonovine

Answer 34

prevent and treat PPH, not inducement of labor

Question 35

ADRs of methylergonovine

Answer 35

diarrhea N/V *hallucinations, abortifacient vasospasm for toxicity

Question 36

Treatments for PPH

Answer 36

Oxytocin methylergonovine carboprost dinoprostone

Question 37

therapeutic use of oxytocin

Answer 37

Dilute: IOL after ripening via PGs | PPH

Question 38

ADRs of oxytocin

Answer 38

hyperstimulation of uterine contractions | activation of vasopressin receptors -> excessive fluid retention (hyponatremia, HF, seizures, or death)

Question 39

MOA of dinoprostone, misoprostol, and carboprost

Answer 39

bind PG receptors and inc. intracellular Ca leading to inc. adenylyl cyclase

Question 40

ADRs of carboprost

Answer 40

N/V | diarrhea

Question 41

therapeutic use of carboprost

Answer 41

PPH due to uterine atony

Question 42

therapeutic use of dinoprostone

Answer 42

cervical ripening (most common) IOL cervidil is sustained release

Question 43

contraindication to misoprostol use

Answer 43

women attempting vaginal birth w/ prior C/S

Question 44

what PG analogue is misoprostol

Answer 44

PG E1

Question 45

what PG analogue is dinoprost

Answer 45

PGE2

Question 46

what PG analogue is carboprost

Answer 46

PGF2alpha

Question 47

contraindications for dinoprostone

Answer 47

HTN, hepatic and renal dysfunction, glaucoma

Question 48

ADRs for dinoprostone

Answer 48

uterine hyperstimulation | uterine rupture w/wo fetal heart rate changes

Question 49

contraindications to carboprost

Answer 49

hypersensitivity | active renal, hepatic, or cardiac dz

Question 50

contraindications to methylergonovine

Answer 50

obstructive vascular dz | collagen dz

Question 51

contraindications for oxytocin

Answer 51

fetal distress premi abnormal fetal presentation