Repro 1

Question 1

Name the drugs for induction of labor/control of post pardum bleeding

Answer 1

1. Misoprostol
2. Dinoprostone
3. Carboprost
4. Oxytocin
5. Ergot alkaloids

Question 2

Name the drugs for patent ductus arteriosos

Answer 2

Maintain - alprostadil
Close - indomethacin, Ibuprofen

Question 3

Name corticosteroids used

Answer 3

1. Cortisol
2. Betamethasone
3. Dexamethasone

Question 4

Drugs for newborns (given right after birth)

Answer 4

1. Erythromycin ointment
2. Vitamin K
3. Hepatitis B vaccine

Question 5

Delaying labor drugs

Answer 5

1. Indomethacin
2. Nifedipine
3. Terbutaline
4. MgSO4
5. Atosiban

Question 6

Antihypertensives for pregnancy

Answer 6

1. A-methyldopa (a2 agonist)
2. Labetalol (a/b blocker)
3. Nifedipine (CCB)
4. Hydralazine (for severe, given IV)

Question 7

What are the teratogen risk categories

Answer 7

A- low chance of fetal harm
D- evidence of fetal harm but benifits may outweigh negatives in some instances
X- contraindicated in pregnancy or in women who may become pregnant

Question 8

What stops prostaglandins from acting on maternal tissue during pregnancy?

Answer 8

Enzyme PGDH inactivated amnion prositiglandins but it decreases during labor

Question 9

What feedforward cascade is created in late gestation

Answer 9

Placental CRH stimulates fetal adrenal production of DHEA and cortisol

Question 10

What is the role of connections and gap junctions in pregnancy

Answer 10

The allow for interconnectivity and extensive waves of depolarization over the large uterus

Question 11

What changes do the cervix undergo doing ripening?

Answer 11

Collagen fibrils become disorganized and loosely packed

Question 12

What drug is used for termination of pregnancy if less than 77 days and off label cervical ripening

Answer 12

Misoprostol. A prostaglandin E1 analog. This will also maintain the ductus arteriosus

Question 13

What drug comes in a gel, vaginal insert, and suppository but it’s very expensive and needs refrigeration. What is an adverse effect

Answer 13

Dinoprostone. Mostly used for cervical ripening. Suppository will terminate pregnancy if before 20 weeks. Can cause fever unresponsive to NSAIDs

Question 14

What drug can induced abortion but is mostly used for refractory bleeding after delivery

Answer 14

Carboprost. Prostaglandin F2a analog. Given by deep intramuscular injection

Question 15

What drug causes prolonged tonic uterine contractions and constricts arterials and veins. What is its adverse effect

Answer 15

Ergot Alkaloids. Causes Saint Anthony’s fire, mania psychosis vomiting and gangrene of digits

Question 16

What management for preterm premature rupture of membranes happens at 34 weeks

Answer 16

Group B strep prophylaxis’ and single corticosteroids. If less than 34 weeks ad antimicrobials to prolong latency

Question 17

What management of pre-term rupture of membranes happens before 32 weeks

Answer 17

Magnesium sulfate for Nuro protection, antimicrobials, corticosteroid course, Group B strep prophylaxis and possibly tocolytics

Question 18

What do corticosteroids do in order to increase surfactant production

Answer 18

Induces transcription of proteins in alveolar type two pneumocytes

Question 19

Why is cortisol not administered to pregnant women

Answer 19

The placenta will metabolize Cortizone. Adding an OH at carbon 11 will allow the corticosteroid to pass

Question 20

What drug blocks synthesis of PGF2a in order to prevent contractions

Answer 20

Indomethacin. Agent of choice from 24 to 32 weeks. After 32 weeks can close ductus arteriosus

Question 21

What drug delays contractions by blocking calcium influx

Answer 21

Nifedipine. First choice from 32 to 34 weeks when NSAIDs are contraindicated

Question 22

What drug delays contractions by increasing CAMP and potassium channel mediated hyper polarization, dephosphorylation of myosin light chains

Answer 22

Terbutaline. Should not be used for more than 2 to 3 days in injectable form, should not be used orally to prevent labor

Question 23

What drug is used to prevent eclamptic seizures and has Neuro protection

Answer 23

Magnesium sulfate. Competes with calcium at channels

Question 24

What drug blocks oxytocin

Answer 24

Atosaban 

Question 25

What can cause tocolytic unresponsiveness

Answer 25

Sub clinical infection. Perform amniocentesis to measure glucose and look for subclinical infections prior to administering tocolytics

Question 26

What drug is given to babies to prevent bleeding

Answer 26

Vitamin K

Question 27

What parentally administer drug maintains a patent ductus arteriosus

Answer 27

Alprostadil. Can cause pyrexia

Question 28

What is a risk factor for using ibuprofen to close a patent ductus arteriosus

Answer 28

Decreases kidney function

Question 29

What should be avoided in hypertension during pregnancy

Answer 29

Thiazides because the impact volume contraction and ace inhibitors/Arbes/spironolactone (androgen)