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S4M3 > Pharmacotherapy of Parturition and Lactation > Flashcards

Pharmacotherapy of Parturition and Lactation Flashcards

1
Q

What is the therapy for Medical termination of pregnancy?

A

It is achieved by administering Mifepristone or methotrexate followed by misoprostol to expel uterine contents. Approved for gestational ages up to 49 days

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2
Q

What is the MOA of Mifepristone?

A

Progesterone receptor antagonist -> induces detachment of blastocyst

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3
Q

What is the MOA of Methotrexate?

A

Anti-folate-> feticidal action on blastocyst

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4
Q

What is the MOA of Misoprostol?

A

PGE1 - contract uterus and expels uterine contents

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5
Q

What are the AE of Mifepristone, methotrexate and misoprostol?

A

Nausea, diarrhea, fever, excessive uterine bleeding, uterine rupture, and incomplete abortion

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6
Q

What are the Tocolytic drugs?

A

Used to decrease uterine contractility and delay labor- pts diagnozed with preterm labor prior to 34 weeks and they also receive glucocorticoids for mature lung.

1) Terbutaline
2) Nifedipine
3) Indomethacin

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7
Q

What is the MOA of terbutaline?

A

Beta 2 agonist-> relaxation of myometrium

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8
Q

What is the use of terbutaline?

A

Preterm labor

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9
Q

What is the AE of terbutaline?

A

tachycardia, tremors, hypotension, hyperglycemia

C/I in women with cardiac disease, hypothyroidism, or diabetes mellitus

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10
Q

What is the MOA of Nifedipine?

A

Inhibits activity of myosin light chain kinase by decreasing intracellular Ca -> relaxation of myometrium

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11
Q

What is the use of nifedipine?

A

preterm labor

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12
Q

What are the AE of nifedipine?

A

nausea, flushing, headache, dizziness and palpitations

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13
Q

What is the MOA indomethacin?

A

inhibits cyclooxygenaase activity to decrease PG synthesis (PGs normally stimulate sensitize the myometrium to contractile stimuli)

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14
Q

What is the use of indomethacin?

A

preterm labor

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15
Q

What is the AE of indomethasone?

A

nausea, vomitting, gastritis in mothers

*** premature closure of ductus arteriosus in fetus

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16
Q

What are the drugs used for induction and maintenance of labor?

A

involves stimulation of uterine contractions to accomplish delivery prior to onset of spontaneous labor - intravaginal PGs are used to dilate the cervix followed by oxytocin to augment labor

1) Misoprostol
2) Dinoprostone
3) Oxytocin

17
Q

What is the MOA for misoprostol?

A

Prostaglandin analog help ripen cervix and initiate labor (PGE1)

18
Q

What is the use for misoprostol?

A

labor

19
Q

What is the MOA of Dinoprostone?

A

Prostaglandin analogs help ripen cervix and initiate labor (PGE2)

20
Q

What is the use of Dinoprosterone?

A

Labor

21
Q

What is the MOA of oxytocin?

A

Augments force and frequency of uterine contractions; iv admin, short half life so easy to control

22
Q

What is the use of oxytocin?

A

labor

23
Q

What is the AE of oxytocin?

A

Water intoxication, excessive uterine contractions and uterine rupture

24
Q

What are the drugs used for postpartum hemorrhage?

A

can be treated with oxytocin, ergonovine or misoprostol (rectal admin)

25
Q

What is the MOA of ergonovine?

A

partial agonist at 5-HT2 and alpha receptors -> sustained contraction of uterine muscles stops bleeding

26
Q

What is the use of ergonovine?

A

post partum hemorrhage

27
Q

What is the AE of ergonovine?

A

CI in HTN, liver/ kidney disease, sepsis

28
Q

What are the drugs used for lactation?

A

Metoclopramide, Domperidone, Bromocriptine, Cabergoline, oral contraceptives

29
Q

What is the MOA of Metoclopramide and Domperidone?

A

dopamine antagonist - increase milk production by increasing prolactin secretion

30
Q

What is the MOA of Bromocriptine and Cabergoline?

A

Suppress milk production by decreasing prolactin secretion

31
Q

What is the MOA of oral contraceptives

A

Estogens may suppress lactation, but combined OCs not recommended immediately post partum (progestin - only preps preferred)

32
Q

What is FDA pregnancy category A?

A

Studies show no risk to human fetus

33
Q

What is FDA pregnancy category B?

A

Animals studies show no risk

34
Q

What is FDA pregnancy category C?

A

Animals studies show risk

35
Q

What is FDA pregnancy category D?

A

Positive evidence of human fetal risk

36
Q

What is FDA pregnancy category X?

A

Contraindicated in pregnancy

S4M3 (5 decks)

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