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HRM > TRH's uterine drugs; 4.8 > Flashcards

TRH's uterine drugs; 4.8 Flashcards

1
Q

What category of drugs is used to either promote labor or to limit bleeding post-labor?

A

Oxytocics

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2
Q

What are three types of oxytocics?

A

Oxytocin analogs
Prostaglandins
Ergots

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3
Q

Oxytocin analogs obviously work on oxytocin receptors (OTRs). What kind of receptor is this? Where are they in the body?

A

OTRs are Gq receptors

OTRs are present in myoepithelial cells of mammary gland, pregnant myometrium, and CNS

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4
Q

What is required for OTRs to function?

A

Well, clearly oxytocin, but also Mg++ and cholesterol

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5
Q

What is the pharmacology utility of oxytocin analogs?

A

Uterine contractions
Milk let-down
Antidiuretic and vasoactive at high concentrations (ADH-like)

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6
Q

What kind of hormone is oxytocin (and its analogs)? What does this mean about administration?

A

Oxytocin is peptide hormone…so it canNOT be given orally

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7
Q

What enzyme of uterine/placental origin degrades oxytocin?

A

Oxytocinase…causes oxytocin (and analogs?) to be broken faster at pregnancy term

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8
Q

What is the name of the synthetic oxytocin?

A

Pitocin

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9
Q

When is pitocin used?

A

Drug of choice for labor induction
Milk let-down postpartum
Stimulation of uterine motility postpartum to reduce bleeding

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10
Q

When shouldn’t pitocin be used?

A

As an abortifacient
When there is cephalo-pelvic disproportion
Hypertonic uterine contractions
Use in women w/ previous C-sections (increased risk of uterine rupture)

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11
Q

What is the role of prostaglandins during labor?

A

Uterine contractions and hyperalgesia

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12
Q

What is the hormonal control of prostaglandins (PGs)?

A

Progesterone → decreased PGs

Estrogen → increased PGs

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13
Q

What are three examples of PROSTaglandin drugs?

A

DinoPROSTone
CarboPROST
MisoPROSTol

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14
Q

Which PG drugs mimic PGE2?

A

Dinoprostone

Misoprostol

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15
Q

What PG does carboprost mimic?

A

PGF2α

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16
Q

How are PGs used?

A

Basically, they cause the cervix to ripen/dilate and for delivery of whatever is in the uterus (fetus/baby/mole)

17
Q

How is carboprost given?

A

Carboprost is given IM

18
Q

How is misoprostol given? What is typically given with it?

A

Misoprostol is given vaginally or orally with mifepristone (a progesterone receptor antagonist)

19
Q

How do ergots work?

A

Ergots are potent smooth muscle stimulators

20
Q

How are ergots obtained?

A

From a fungus that grows on rye

21
Q

What are examples of ergots?

A

Ergonovine
Ergotamine
LSD

22
Q

Which ergot is used to control postpartum bleeding by causing uterine contraction?

A

Ergonovine

23
Q

What is ergotamine used for?

A

Ergotamine is used for migraine headaches…it causes blood vessels to contract

24
Q

What is LSD used for?

A

To smell colors and taste music

25
Q

What are tocolytics used for?

A

Tocolytics reduce uterine contractions

26
Q

What are examples of tocolytics?

A

β2 agonist
MgSO4
OTR antagonist
NSAID

27
Q

What do β2 agonist do?

A

Activates adenylyl cyclase → increased cAMP → activated PKA → Inhibited MLCK → NO phosphorylated myosin → NO contraction

28
Q

What are the potential side effects of β2 agonist?

A

Elevate maternal BP and cause pulmonary edema
Cause hyperglycemia
Increase oxygen demand → can precipitate an MI

29
Q

Which β2 agonists are used to reduce uterine contractility?

A

Terbutaline

Ritodrine

30
Q

How does magnesium sulfate cause smooth muscle relaxation?

A

Mg++ competes with Ca++

31
Q

How is MgSO4 administered? What is it used to prevent?

A

MgSO4 is given IV to prevent seizures associated with eclampsia

32
Q

What is an example of an OTR antagonist?

A

AtOsiBAN

O for oxytocin…Oxytocin is BANned

33
Q

When is atosiban used?

A

Atosiban delays labor

34
Q

What is a key side effect of atosiban?

A

Increased fetal mortality

35
Q

Which NSAID is used to reduce uterine contractility?

A

Indomethacin

HRM (40 decks)

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