uterine drugs

Question 1

During pregnancy what hormone is of more abundance?

Answer 1

Progesterone> estridiol

Question 2

What is the hormone of greater abundance during labor?

Answer 2

Estradiol> progesterone

Question 3

What are the affects of high progesterone and low estridiol?

Answer 3

1. progesterone causes hyperplasia of the myometrium 
Decrease andenergic receptors
Inhibits oxytocin receptor synthesis
Inhibits estrogen receptor synthesis
Promotes storage of prostaglandins

Question 4

What are the physiological affects of estridiol>progesterone?

Answer 4

• Increases oxytocin receptors
• promotes cervical ripening
• Increase local prostaglandin release from the placenta cause myometrial contractions

Question 5

what causes the stimulation release of oxytocin? What are the effects during labor?

Answer 5

Prostaglandins

- causes stronger myometrial contractions

Question 6

What else induces the release of oxytocin?

Answer 6

Uterine contractions

- thus positive feedback

Question 7

What tissues does oxytocin affect?

Answer 7

Breast and uterus

- causes smooth muscle contractions

Question 8

What 2ndary pathway does oxytocin act through?

Answer 8

Binds to G-protein coupled receptor (OTR)

• causes increase in Phospholipase C
• leads to influx of Ca2+
• Release of Calcium from SR

Question 9

Where are OTR’s found?

Answer 9

Myoepithelial cells of mammillary glands
Preggers myometrium
CNS

Question 10

What affect does oxytocin have in relationships?

Answer 10

Release during orgasm

- needed for bonding with mates

Question 11

what is the drug of choice for labor induction?

Answer 11

Pitocin

Question 12

what and when is pitocin used?

Answer 12

Speed up labor for HTN and pre-eclampsia

• post due date
• augment labor

Question 13

what can one give to reduce uterine contractions and how?

Answer 13

Indomethacin

- reduced Prostaglandins

Question 14

What affect does Prostaglandins have on the cervix?

Answer 14

Ripens it

- cervix thins, softens and relaxes and dilates in response to uterine contractions

Question 15

Thus ahat drugs can be used to ripen cervix as well as abortifacients?

Answer 15

Dinoprostone

Misoprostol

Question 16

What are dinoprostone and minoprostol commonly used for?

Answer 16

Hydrataform mole

Question 17

What are the PGF2a and what are they used for?

Answer 17

Dinoprost
Carboprost
- induce labor and abortifacient

Question 18

What are ergots and where do they come from?

Answer 18

Alkaloids of fungus from rye, wheat and other cereal grasses

Question 19

What is the MOA of ergots?

Answer 19

potent smooth muscle stimulator

Question 20

what type of ergot mediates uterius contraction?

Answer 20

erognovine

Ergometrine

Question 21

How does ergots and oxytocin and prostaglandins lead to reduction of uterine bleeding?

Answer 21

Contraction of the uterus leads to constriction of the blood vessels

Question 22

What ergot leads to contraction of blood vessels?

Answer 22

Ergotmine

Question 23

What are tocolytics?

Answer 23

any drug used to suppress uterine smooth muscle contraction and there by suppress premature labor

Question 24

What is the MOA of tocolytics?

Answer 24

selective B2 agonists

• activate adenylyl cyclase and raise cAMP levels which interfere with myosin light chain kinase
• Gs pathway

Question 25

How is Magnesium used on the labor ward/

Answer 25

competes with CA and relaxes Smooth muscle

Question 26

What is Atosiban?

Answer 26

Tractocile | - oxytocin receptor antagonist

Question 27

Why is atosiban used and not used?

Answer 27

Less maternal AE's than B2 agonists | - but increase fetal mortality