Reproductive Pharmacology Flashcards
What are tocolytic drugs?
Those that block contractions
Why do beta-2 receptors lead to relaxation when activated?
Because the increased cAMP leads to phosphorylation of phosphatase and the dephosphorylation of myosin light chain kinase
Misoprostol causes ___________ dilatation.
cervical (specifically, PGE2)
What kind of calcium channels are in uterine smooth muscle?
L-type
NSAIDs can ____________.
delay labor
Oxytocin binds to a ____________ receptor.
Gq (as do prostaglandins)
Topical ____________ is used to prepare the cervix for labor.
dinoprostone
Oxytocin is used to induce labor and _____________.
treat postpartum hemorrhage
What two-step approach is often used to induce labor?
Application of PGE2 gel followed by IV Pitocin when the cervix has dilated
Why is betamethasone used to stimulate lung maturation as opposed to cortisol?
Because the placenta has enzymes that inactivate cortisol but not betamethasone.
____________ is often used to delay labor, but it has to be given for less than 48 hours or postnatal pulmonary hypertension can result.
Indomethacin
The ___________ form of myosin is contractile.
phosphorylated
Calmodulin activates myosin light chain kinase which phosphorylates myosin.
What advantage do CCBs have over beta agonists?
The CCBs do not cause sympathetic activation.
______________ is most often used to prolong pregnancy from week 32 on.
Nifedipine
Although no longer used, _________ was formerly used to delay labor. Its labor-delaying properties were discovered when used to treat seizures in pre-eclampsia.
MgSO4
Weekly intramuscular injections of ___________ are often used in women at high risk of preterm delivery.
17-alpha hydroxyprogesterone
Once again, _______________ is a progesterone antagonist.
mifepristone
The prostaglandin analogs often have ________ in their names.
“-prost-“
Examples: misoPROSTol, gemePROST, sulPROSTone
Why is misoprostol used in conjunction with mifepristone to terminate pregnancies?
The uterus is sensitive to prostaglandins throughout pregnancy but is only sensitive to oxytocin toward the end.
Which type of prostaglandin receptor mediates relaxation?
The Gs (which PGE2 binds in the uterus)
Why does rupture of the amnion stimulate labor?
Prostaglandins are made by the amnion, chorion, and decidua but only degraded by the chorion and decidua. Inflammation of the amnion can release more prostaglandins.
Why doesn’t the uterus respond to oxytocin until the end of pregnancy?
The uterus doesn’t express oxytocin receptors until the end of pregnancy.
Cervical dilation is dependent upon __________.
prostaglandins
High doses of oxytocin may lead to ______________.
water intoxication (because of its similarity to ADH)
Ergot alkaloids cause ______________.
stimulation of smooth muscle contraction that can be used to stop uterine bleeding post pregnancy (never used to induce labor!); according to Dr. French’s question, though, oxytocin should be given
In a nutshell, ____________ blocks the effects of calcium.
magnesium
Fetal pulmonary hypertension is least common with which NSAID?
Acetaminophen
Which ED drug causes blue-green color vision loss?
Sildenafil (and other PDE inhibitors)
What is the only non-PDE inhibiting ED drug that is approved by the FDA?
Alprostadil
Raising cAMP in myometrial cells causes _______________.
relaxation (hence, terbutaline)
Oxytocin must be given _____________.
intravenously
________________ has a half-life of minutes.
Oxytocin
Mifepristone can be used prior to __________________.
9 weeks
Which PDE inhibitor has the longest half-life?
Tadalafil
