Reproductive Pharmacology

Question 1

What are tocolytic drugs?

Answer 1

Those that block contractions

Question 2

Why do beta-2 receptors lead to relaxation when activated?

Answer 2

Because the increased cAMP leads to phosphorylation of phosphatase and the dephosphorylation of myosin light chain kinase

Question 3

Misoprostol causes ___________ dilatation.

Answer 3

cervical (specifically, PGE2)

Question 4

What kind of calcium channels are in uterine smooth muscle?

Answer 4

L-type

Question 5

NSAIDs can ____________.

Answer 5

delay labor

Question 6

Oxytocin binds to a ____________ receptor.

Answer 6

Gq (as do prostaglandins)

Question 7

Topical ____________ is used to prepare the cervix for labor.

Answer 7

dinoprostone

Question 8

Oxytocin is used to induce labor and _____________.

Answer 8

treat postpartum hemorrhage

Question 9

What two-step approach is often used to induce labor?

Answer 9

Application of PGE2 gel followed by IV Pitocin when the cervix has dilated

Question 10

Why is betamethasone used to stimulate lung maturation as opposed to cortisol?

Answer 10

Because the placenta has enzymes that inactivate cortisol but not betamethasone.

Question 11

____________ is often used to delay labor, but it has to be given for less than 48 hours or postnatal pulmonary hypertension can result.

Answer 11

Indomethacin

Question 12

The ___________ form of myosin is contractile.

Answer 12

phosphorylated

Calmodulin activates myosin light chain kinase which phosphorylates myosin.

Question 13

What advantage do CCBs have over beta agonists?

Answer 13

The CCBs do not cause sympathetic activation.

Question 14

______________ is most often used to prolong pregnancy from week 32 on.

Answer 14

Nifedipine

Question 15

Although no longer used, _________ was formerly used to delay labor. Its labor-delaying properties were discovered when used to treat seizures in pre-eclampsia.

Answer 15

MgSO4

Question 16

Weekly intramuscular injections of ___________ are often used in women at high risk of preterm delivery.

Answer 16

17-alpha hydroxyprogesterone

Question 17

Once again, _______________ is a progesterone antagonist.

Answer 17

mifepristone

Question 18

The prostaglandin analogs often have ________ in their names.

Answer 18

“-prost-“

Examples: misoPROSTol, gemePROST, sulPROSTone

Question 19

Why is misoprostol used in conjunction with mifepristone to terminate pregnancies?

Answer 19

The uterus is sensitive to prostaglandins throughout pregnancy but is only sensitive to oxytocin toward the end.

Question 20

Which type of prostaglandin receptor mediates relaxation?

Answer 20

The Gs (which PGE2 binds in the uterus)

Question 21

Why does rupture of the amnion stimulate labor?

Answer 21

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.

Question 22

Why doesn’t the uterus respond to oxytocin until the end of pregnancy?

Answer 22

The uterus doesn’t express oxytocin receptors until the end of pregnancy.

Question 23

Cervical dilation is dependent upon __________.

Answer 23

prostaglandins

Question 24

High doses of oxytocin may lead to ______________.

Answer 24

water intoxication (because of its similarity to ADH)

Question 25

Ergot alkaloids cause ______________.

Answer 25

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

Question 26

In a nutshell, ____________ blocks the effects of calcium.

Answer 26

magnesium

Question 27

Fetal pulmonary hypertension is least common with which NSAID?

Answer 27

Acetaminophen

Question 28

Which ED drug causes blue-green color vision loss?

Answer 28

Sildenafil (and other PDE inhibitors)

Question 29

What is the only non-PDE inhibiting ED drug that is approved by the FDA?

Answer 29

Alprostadil

Question 30

Raising cAMP in myometrial cells causes _______________.

Answer 30

relaxation (hence, terbutaline)

Question 31

Oxytocin must be given _____________.

Answer 31

intravenously

Question 32

________________ has a half-life of minutes.

Answer 32

Oxytocin

Question 33

Mifepristone can be used prior to __________________.

Answer 33

9 weeks

Question 34

Which PDE inhibitor has the longest half-life?

Answer 34

Tadalafil