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LC 02 > Repro pharm > Flashcards

Repro pharm Flashcards

1
Q

After delivery of a healthy infant, a young woman begins to bleed extensively because her uterus has failed to contract. What can you give her?

A

Oxytocin
contracts uterine smooth muscle
- also used to control post partum hemorrhage

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2
Q

Gq

A

Increased by oxytocin

-increase PLC

Myometrial contraction

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3
Q

Gs

A

increased by beta 2 - relaxes

B2 agonist –> increases Gs –> increases cAMP –> decreases MLCK

*myosin light chain kinase

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4
Q

PGE2, PGF2a, and oxytocin all activate Gq, which increase Ca2+ and causes myometrial contraction, What is their receptors?

A

PGE2: EP1

PGF2a: FP

Oxytocin: OXT

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5
Q

PGE2: EP1

PGF2a: FP

Oxytocin: OXT

these receptors do what?

A

activate Gq and cause increase in Ca2+ (thru L type Ca2+ channels) and cause myometrial contraction

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6
Q

PGE and EPI increase Gs and have what effects?

A

PGE –> Ep2-4 –> Gs –> increase cAMP –> cervic ripening-dilation

EPI –> B2 –> Gs –> increase cAMP –> myometrial relaxation

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7
Q

Cervical dilatation is dependent upon ______

A

prostaglandins

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8
Q

Oxytocic –>

Tocolytic –>

A

Oxytocic –> contract

Tocolytic –> relax

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9
Q

Uterin sm also expresses B2-adrenergic receptors that mediate _____

A

relaxation

Epi –> B2 –> Gs –> Increase cAMP –> myometrial relaxation

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10
Q

HELLP

A

Hemolysis
Elevated Liver enzymes
Low Platelet count

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11
Q

Leading cause of infant mortality

A

Preventing preterm labor

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12
Q

Adverse drug rxns of oxytocin

A

Higher doses –> water intoxication –> coma, convulsions, death

Uterine rupture

Impaired fetal oxygenation

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13
Q

Misoprostol

A

PGE1 analog

- given orally to induce uterine contractions

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14
Q

CCB

  • Nifedipine
  • DIltiazem
  • Verapamil
A

all vasodilators

Nifedipine increases HR

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15
Q

Ergot alkaloids

A

act via a1 and 5HT2 receptors –> direct contraction of vascular and uterine sm

  • ONLY used for control of LATE uterine bleeding (if oxytocin doesnt work)
  • reduce bleeding by causing sustained contraction of the uterus
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16
Q

A pregnant women presents at term for induction of labor, what to give her?

A

Admin of PGE2 vaginal gel until cervix has ripened followed in 6 hrs by admin of IC oxytocin thru an infusion pump if active labor has not occured

17
Q

Wen are tocolytic agents indicated?

A

when delay in delivery for 48 hours will provide benefit to newborn
- reduce prematurity problems

ie: indomethacin

18
Q

Indomethacin

A

tocolytic agent
Prostaglandin synthesis inhibitors (NSAIDS)

Most potent and widely used in suppressing labor in first 24-32 weeks gestation

19
Q

Choice of inhibition of labor (tocolytic agent) if NSAIDS are contraindicated
(platelet disorders, renal dysfxn, GI ulcer disease, asthma)

A

Nifedipine CCB

  • a vascular sm dilation
  • potential concern is that fall in maternal BP may have negative fx on blood flow betwen uterus and placenta
20
Q

Terbutaline

A

b2 adrenergic agonist

  • tocolytic agent
  • inhibition of labor
  • less effective if cervix has dilated and membranes have ruptured
  • higher relative incidence of maternal side effects
    (risk of maternal hyperglycemia, and fetal hypoglycemia)
21
Q

MgSO4

A

decreases Ca2+ –> decreases MLCK

  • indicated for pre-eclampsia and eclampsia

(tocolytic agent)

22
Q

drug class that will cause uterine contractions and deliver the products of conception following interruption of an established pregnancy with mifepristone is:

A

prostaglandin analogs (misoprostol)

*note: prostaglandin analogs have Prost in the name

23
Q

What drug interacts with nitroglycerin by inhibiting metabolism of cGMP?

A

sildenafil

24
Q

Phosphodiesterase inhibitors

A

-afils

Sildenafil (viagra)

1st line for ED

  • blocks cGMP breakdown –> increases cGMP –> enhance vasodilation –> increase blood flow
  • enhance fx of nitric oxide
25
Q

Adverse rxns of sildenafil

A

H’s

  1. “hot and sweaty”
  2. H/A
  3. Heartburn
  4. HYPOtension
  5. Cyanopsia (blue-tinted vision)
26
Q

PDE-5 inhibitors

A

“fils” that fill the penis

  1. Sildenafil
  2. Vardenafil
  3. Tadalafill

Inhibit PDE-5 –> increase cGMP –>
sm relaxation in corpus cavernosum –> increase BF –> erection
*enhance NO effect

27
Q

Risk of taking PDE-5 inhibitors with:

  • Nitrates:
  • alpha-blockers:
A
  • Nitrates: hypotension

- alpha-blockers: hypotension

LC 02 (15 decks)

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