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Pharmacology > Reprouctive Pharmacology > Flashcards

Reprouctive Pharmacology Flashcards

1
Q

Rhogam (Rho(D) immune globulin)

A

Rh antibodies that are injected within 72 hours after birth to prevent sensitization in the rh- mother who has had a fetal maternal transfusion of rh+ fetal blood. Prevent hemolytic disease in next newborn

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2
Q

Indications. For rhogam

A

At 28 weeks rh_ mom to prevent sensitization. Can be give phorpholactically, or after any type of exposure risk that occurs after 28 weeks of gestation (amniocentesis, second trimester, miscarriage or abortion

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3
Q

What does rhogam do

A

Suppres antibody production in mom. Following delivery, preg termination, any abdominal trauma, ectopic preg, version, or after procedures such as amniocentesis or chorionic Billy’s sampling

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4
Q

MOE rhogam

A

Causes lysis of the fetal RBS from a rh-positive infant that may have entered the rh negative mothers bloodstream. By destroying the fetal RBC the mother does not form antibodies against them. Protect from becoming sensitized in future pregnancies

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5
Q

Side effects rhogam

A

Myalgia and lethargy

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6
Q

Coombs test

A

Blood test indicates the whether the mother has already been sensitized and has the presence of antibodies

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7
Q

Positive Coombs test

A

Mom sensitized

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8
Q

Negative Coombs est

A

Mom hasn’t been sensitized so can give rhogam

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9
Q

Does of rhogam 300 mcg given to mom. Not infant.

A

Standard

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10
Q

Microdose 50 mcg coombs

A

After 1st trimester miscarriage or abortion, ectopic preg or following chorionic villus sampling

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11
Q

Why need to watch for allergic responses with rhogam

A

Considered a blood product

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12
Q

Magnesium sulfate

A

CNS depressant inhibits the release of acetylcholine at neuromuscular junctions . Preventing skeletal and uterine muscle contraction.

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13
Q

Indication for magnesium sulfate

A

Preterm labor contractions and the treatment of pressclampsia

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14
Q

Side effects magnesium sulfate

A

Warm feeling, hypotension, decreased DTR, decreased respiratoy rate, decreased urine output, paralytic ileus

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15
Q

Antidote for magnesium sulfate

A

Calcium gluconate

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16
Q

MOS magnesium sulfate

A

Muscle relaxant and depresses CNS by stopping the release of ach
Decreased neuromuscular irritability and cardiac conduction
Also decrease hyperreflexia and preven t onset of seizure from eclampsia

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17
Q

Indications for magnesium sulfate

A

Preterm labor contractions and preeclampsia

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18
Q

Side effects magnesium sulfate

A

Warn feeling, hypotension, DTrS decreased respiratory rebate, decreased urine output, paralytic ileus,

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19
Q

Why get warm feeling with magnesium sulfate

A

Vasodilator

Get flushing

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20
Q

Why get hypotension from magnesium sulfate

A

Vasodilator

Can get pulmonary edema or headache

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21
Q

Why get decreased DTR with magnesium sulfate

A

Relaxes the CNS

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22
Q

Why get decreased urine output with magnesium sulfate

A

Renal perfusion decreases as a result of lowered bp and cardiac output.

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23
Q

Antidote to magnesium sulfate

A

Calcium gluconate

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24
Q

Magnesium toxicity

A

Cardiac arrest and respiratory depression.

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25
Q

Effect of calcium glucoronate

A

Increases muscle contraction

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26
Q

Leuprolide

A

Gonadotropin releasing hormone agonist

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27
Q

MOA leuprolide when given in a pulsating manor

A

Stimulates GnRH receptors in the anterior pituitary resulting ins timulation of LH and FSh which then stimulate the ovaries and testes to produce sex steroids

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28
Q

MOA of leuprolide when given in a Continuous manor

A

Potent inhibitor of gonadotropin secretion when administered continuously resulting in suppression of ovarian and testicular production of sex steroids
Down regulation LH FSH

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29
Q

What is pulsation use of leuprolide used o treat

A

Infertility

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30
Q

What is continuous leuprolide used to treat

A

Prostate cancer, precocious puberty, uterine fibroids, and endometriosis

31
Q

Side effects of continuous leuprolide

A

*inhibit sex steroid-antiandrogenic

Decreased libido, nausea/vomiting and symptoms of menopause like amenorrhea and hot flashes

32
Q

Upregulation of FSH LH

A

Bind to receptors on the Sertoli cells (males) and the leydig cells (females) and granula cells and theca internal cells in females

33
Q

Downregulatoin FSH LH

A

Constant stimulation of GnRH receptors in anterior pituitary

34
Q

How does pulsating leuprolide help fertility

A

Increase FSH LH. Stimulates leydig cells to produce testosterone and increases sperm production

35
Q

Indications for continuous leuprolide

A

Palliative treatment of advanced prostate cancer, breast cancer

36
Q

Uterine fibroids and leuprolide

A

Continuous
Decrease e and p which temporarily puts patient in a postmenopausal state. Shrinks fibroids and the cessation of menstruation

37
Q

Endometriosis and continuous leuprolide

A

(Cells lining the uterus appear to flourish outside the uterine cavity0in membrane lining the abdominal cavity, peritoneum)
Decrease in e
Helps control symptoms in endometriosis

38
Q

Side effects leuprolide

A

Antiandrogenic effects such as decreasing testosterone in men andesterogen in women. Manifests as decreased libido, nausea/vomiting, as well as hot flashes and amenorrhea

39
Q

Methylegonovine (methergine) and ergotamine (ergot alkaloids) examples

A

Methylergovine, ergotamine, dihydroergotamine

40
Q

What do ergot alkaloids do

A

Produce strong powerful contractions and are used to control postpartum hemorrhage and treat migraine

41
Q

Indication for ergot alkaloids

A

Migraine, postpartum hemorrhage, as second line after treatment with oxytocin

42
Q

MOA ergot alkaloids

A

Smooth muscle contraction-causes uterine contractions

Vasoconstriction-treat migraines but can cause hypertension

43
Q

Side effects ergot alkaloids

A

Nausea, vomiting, severe hypertension, tachycardia

44
Q

Why are ergot alkaloids used as second line treatment

A

Effects are often delayed

45
Q

Why are ergot alkaloids not recommended for inducing labor

A

Delayed onset of contractions and should only be used for postpartum hemorrhage after the use of oxytocin

46
Q

Why do ergot alkaloids help migrain

A

Constrict dilated blood vessels

47
Q

Oxytocin

A

Synthetic analog of the hormone produced in the hypothalamus that is stored and released int he posterior pituitary

48
Q

Function of oxytocin

A

Stimulate uterine contractions and initiate milk ejects from the nipple during breastfeeding

49
Q

Indication for oxytocin

A

Induce labor and control hemorrhage after delivery

50
Q

Why should oxytocin be give in lowest possible dose

A

Increased risk of side effects

51
Q

When cant u administer oxytocin

A

Alone or without confirming cervical ripening in a pregnant patient

52
Q

MOA oxytocin (pitocin)

A

Increased uterine contractions by stimulating receptors on the uterine muscle wall. Also stimulates milk ejection from nipple

53
Q

Indications for oxytocin

A

Labor induction

Control postpartum hemorrhage

54
Q

Side effects oxytocin

A

Uterine rupture, water intoxication

55
Q

Why risk of rupturing uterine wall with oxytocin

A

Strength of muscle contractions

*higher risk if have previous uterine scarring (multi parity) bc weakened uterine walls

56
Q

Contradictions to oxytocin

A

Fetal lung immaturity*before 20 was gestation

Cervix not ripened *may cause fetal or maternal injuries

Active genital herpes infection *TORCH need cesarean

57
Q

Why must give oxytocin in IV

A

GI system destroys it

58
Q

Carboprost (hemabate)

A

Synthetic prostaglandin used to treat postpartum hemorrhage by inducing uterine contractions.

59
Q

What is postpartum hemorrhage

A

When after birth uterus doesn’t contract and stop bleeding

60
Q

Indications for carboprost (hemabate)

A

Post partum hemorrhage

Abortion

61
Q

Side effects carboprost

A

Hypertension, fever, bronchoconstriction, nausea, vomiting, diarrhea

62
Q

MOA carboprost

A

Prostaglandin F2 alpha analog

Smooth muscle contraction-cause intense uterine contractions to stop. Postpartum bleeding

63
Q

Side effects carboprost (hemabate)

A

GI distress (SM contraction), hypertension (vasoconstrict), fever, bronchioconstriction (caution with asthma history)

64
Q

Consideration carboprost with fever

A

Fever common cause of fever must be identified (drug induced or other, such as endometriosis)

65
Q

Dinoprostone and misoprostol

A

Prostaglandin medications tat both act to ripen the cervix.

66
Q

Dinoprostone (prepidil, cervidil)

A

Only used topically as a gel or vaginal insert

Induce abortion or ripen the cervix to induce labor

67
Q

Misoprostol (cytotoxic)

A

Also used as energy contraception and to prevent GI ulcers
Also used topically as a gel or vaginal insert

Induce abortion or ripen cervix to induce labor

68
Q

MOA dinoprostone and misoprostol

A

Stimulate contraction and ripening of the cervix to stimulate induction of labor or the induction of abortion

69
Q

MOA ddinprostons is also known as a ___, while misoprostol is a _____

A 
Prostaglandin E2 (PGE2)
Prostaglandin E1 (PGE1)
70
Q

Indications for dinoprostone and misoprostol

A

Promote cervical ripening(breakdown of colalgen)
Prevent GI ulcers(stimulates secretion of mucus and bicarbonate, maintains submucosal gastric perfusion and suppresses secretion of gastric acid)
Protecting against NSAID induced ulcers (misoprostol serves as a replacement for endogenous prostagladins)medical abortion (stimulate uterine contractions to expel fetus)

71
Q

Misoprostol emergency contraception

A

Yup

72
Q

Side effects misoprostol and dinoprostone

A

Fetal distress

Hyperstimuation of uterus

73
Q

Why give prostagladins before induction of labor or initiation of oxytocin

A

Softening and ripening of cervix which should occcur before the induction of labor or use of oxytocin

Pharmacology (52 decks)

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