Uterine drugs

Question 0

Ergonovine Maleate (Ergotrate)
Methylergonovine Maleate (Methergine)

Answer 0

Uterine specific ergots, 5HT & a agonist.
Lasts hours- 2nd line tx for PPH
Adv: ergot hypersensitivity, angina, MI
CI: NOT FOR INDUCING LABOR, hepatic/renal dz, vascular dz

Question 1

Oxytocin (Pitocin, Syntocinon)

Answer 1

DOC to induce labor at term (IV), for PPH (IM), milk let down (nasal)
Adv: water intox, uterine rupture, anaphylaxis, fetal sinus brady
CI: indications for C-section.

Question 2

Dinoprostone (Prostin E2)

Answer 2

Synthetic PGE2, suppository/gel
Induces abortion, cervical ripening
Adv: GI, DIARRHEA, fever
CI: any pbs in mom/baby for ripening

Question 3

Caboprost Tromethamine

Answer 3

(Prostin/M15, Hemabate)
Derivative PGF2a (IM)- For: 2nd trim abortion, 3rd line tx for PPH.
Adv: V/D, fever, rash
CI: PID, cardiac, pulm, renal, hepatiz dz, asthma, HTN, anemia, jaundice

Question 4

MgSO4

Answer 4

For uterine relaxation (not approved) in pre-eclampsia
IV- inpt use only
Adv: flush/sweat, hypotension, dec DTR, paralysis, weakness, cardiac CNS and resp depression
DO NOT combine w/ Nifedipine

Question 5

Nifedipine

Answer 5

(Procardia)- L-type Ca2+ ch blocker
Use: delay premature labor (not approved)
Adv: flus/sweat, hypotension, dizzy
DO NOT combine w/ MgSO4

Question 6

Indomethacin

Answer 6

(Indocin)
Dec PG synth -Tocolytic/Uterine relaxation
Adv: GI, partial closure of ductus arteriosus

Question 7

Progesterone

Answer 7

Prophylactic tx for preterm labor in high risk women, not for acute.

Question 8

Nitroglycerin

Answer 8

Emergency use for uterine rupture - Tocolytic

CI: hypovolemia, anemia, inc ICP, pericarditis, tamponade.

Question 9

Ethanol

Answer 9

Tocolytic- Direct uterine relaxant effect

Inhibits premature labor