Repro pharm Flashcards
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?
Oxytocin
contracts uterine smooth muscle
- also used to control post partum hemorrhage
Gq
Increased by oxytocin
-increase PLC
Myometrial contraction
Gs
increased by beta 2 - relaxes
B2 agonist –> increases Gs –> increases cAMP –> decreases MLCK
*myosin light chain kinase
PGE2, PGF2a, and oxytocin all activate Gq, which increase Ca2+ and causes myometrial contraction, What is their receptors?
PGE2: EP1
PGF2a: FP
Oxytocin: OXT
PGE2: EP1
PGF2a: FP
Oxytocin: OXT
these receptors do what?
activate Gq and cause increase in Ca2+ (thru L type Ca2+ channels) and cause myometrial contraction
PGE and EPI increase Gs and have what effects?
PGE –> Ep2-4 –> Gs –> increase cAMP –> cervic ripening-dilation
EPI –> B2 –> Gs –> increase cAMP –> myometrial relaxation
Cervical dilatation is dependent upon ______
prostaglandins
Oxytocic –>
Tocolytic –>
Oxytocic –> contract
Tocolytic –> relax
Uterin sm also expresses B2-adrenergic receptors that mediate _____
relaxation
Epi –> B2 –> Gs –> Increase cAMP –> myometrial relaxation
HELLP
Hemolysis
Elevated Liver enzymes
Low Platelet count
Leading cause of infant mortality
Preventing preterm labor
Adverse drug rxns of oxytocin
Higher doses –> water intoxication –> coma, convulsions, death
Uterine rupture
Impaired fetal oxygenation
Misoprostol
PGE1 analog
- given orally to induce uterine contractions
CCB
- Nifedipine
- DIltiazem
- Verapamil
all vasodilators
Nifedipine increases HR
Ergot alkaloids
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