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Pharm Midterm 1 > Uterine > Flashcards

Uterine Flashcards

1
Q

What are the Oxytocics

A 
Stimulants
Oxytocin
Ergonovine
Methylergonovine
Carboprost tromethamine
Dinoprostone
Misoprostol
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2
Q

What are the Tocolytics

A 
Relaxants
Mg sulfate
Indomethacin
Nifedipine
Atosiban
Terbutaline (beta 2 agonists)
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3
Q

How does Oxytocin work

A

Activate Gq - SM contraction

Increase PG synthesis

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4
Q

When is the uterus more sensitive to Oxytocin

A

2nd half of pregnancy

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5
Q

DOC for induction of labor

A

Oxytocin

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6
Q

When do you give oxytocin

A

Augment dysfunctional labor
Limit post-partum hemorrhage (1st line)
Induce abortion

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7
Q

What is the Oxytocin challenge test

A

Measure HR to check for fetal hypoxia

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8
Q

What are the AE for Oxytocin

A

Fetal distress
Placental abruption
Uterine rupture
Activate vasopressin receptors

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9
Q

What are partial alpha agonists and have some 5HT activity

A

Ergonovine

Methylergonovine

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10
Q

Sensitivity to what increases in pregnancy

A

Ergot alkaloids

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11
Q

2nd line for post-partum hemorrhage

A

Ergonovine

Methylergonovine

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12
Q

What is found in breast milk

A

Ergonovine

Methylergonovine

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13
Q

What can cause gangrene in nursing infant

A

Ergonovine

Methylergonovine

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14
Q

Contraindication for Ergot Alkaloids

A 
Angina
MI
Pregnancy
CVA
HTN
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15
Q

Which is a PGF2 alpha analog

A

Carboprost tromethamine

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16
Q

Give if pt has benign hydatiform mole

A

Dinoprostone

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17
Q

Used to induce abortion in 2nd trimester

A

Carboprost tromethamine

Dinoprostone

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18
Q

3rd line for post-partum hemorrhage

A

Carboprost tromethamine

19
Q

Used to evacuate uterus after missed abortion

A

Dinoprostone

20
Q

Used to ripen the cervix

A

Dinoprostone

Misoprostone

21
Q

Which is a PGE1 analog

A

Misoprostol

22
Q

What is the only FDA approved use of Misoprostol

A

NSAID induced gastric ulcers

23
Q

What else can Misoprostol be used for

A

Induce labor

Post-partum hemorrhage

24
Q

What is the leading cause of neonatal mortality

A

Preterm birth (< 37wks)

25
Q

What is the most popular tocolytic

A

Mg sulfate

26
Q

Which tocolytic has similar efficacy to terbutaline but with better tolerance

A

Mg sulfate

27
Q

Which tocolytics cross the placenta

A

Mg sulfate

Indomethacin

28
Q

How does Mg sulfate work

A

Uncouples excitation-contraction in myometrium

29
Q

Mg sulfate AE

A

Resp depression

Cardiac arrest

30
Q

How does Indomethacin act

A

Inhibit PG synthesis (NSAID)

31
Q

When do you give Indomethacin

A

To delay preterm labor

32
Q

Indomethacin AE

A

Oligohydramnios (decreased fetal RBF)

Premature closure of ductus arteriosus

33
Q

Contraindications for Indomethacin

A

> 32 weeks

34
Q

What is the Ca channel blocking tocolytic

A

Nifedipine

35
Q

How does Nifedipine work

A

Inhibit contractility

Decreased Ca = Decreased MLCK

36
Q

What is more successful than Indomethacin at prolonging preterm labor

A

Nifedipine

37
Q

Nifedipine AE

A

Maternal tachycardia
Palpitations
Flushing, nausea
HA, dizziness

38
Q

Which tocolytic is a competitive oxytocin receptor antagonist

A

Atosiban (NOT USA)

39
Q

How does Terbutaline act

A

Activate Gs = Increase cAMP, PKA
Decreased SM-MLCK affinity for Ca-calmodulin
SM relax

40
Q

What should not be used to treat preterm labor

A

Oral Terbutaline

41
Q

When should injectable Terbutaline be given

A

72hrs or less

42
Q

Which tocolytic has a black box warning

A

Terbutaline

43
Q

Terbutaline AE

A 
Palpitation, tremor 	
N/V
Anxiety 
Chest pain	 &dyspnea 	
Hyperglycemia	
Hypokalemia	
Hypotension	
Pulmonaryedema	
CardiacInsufficiency 	
Arrhythmia, MI 	
Maternaldeath

Pharm Midterm 1 (36 decks)

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