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Pharm II > Uterine Drugs > Flashcards

Uterine Drugs Flashcards

1
Q

What 4 things cause uterine contraction?

A

Estrogen, prostaglandins, oxytocin, stretching

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2
Q

What 4 things cause uterine relaxation?

A

beta-adrenergic drugs, progesterone, alcohol, MgSO4

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3
Q

What increases in # and sensitivity prior to labor and delivery?

A

Oxytocin receptors

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4
Q

During the 2nd trimester, the uterus is resistant to stimulation but what can cause strong labor like contractions?

A

Prostaglandins

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5
Q

What is the most common cause of postpartum hemorrhage?

A 
Uterine atony
(lack of myometrial contractions fail to squeeze and constrict the spiral arteries)
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6
Q

How much BF is getting to the placenta at term?

A

~500mL/ min

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7
Q

How much blood loss is considered to be postpartum hemorrhage for both vaginal delivery and C-section?

A

Vaginal delivery ~500mL

C-section ~1000mL

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8
Q

What is 1st line treatment for postpartum hemorrhage?

A

Massage

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9
Q

In regards to premature labor, the earlier the preterm, the greater the what?

A

Risks for the baby

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10
Q

What is the most common RF for premature labor?

A

Previous preterm labor or preterm birth

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11
Q

If preterm labor needs to happen before the 37th week, what drugs should be given and why?

A

Give corticosteroids to induce lung development

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12
Q

Pitocin drug class?

A

Oxytocin

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13
Q

Syntocin drug class?

A

Oxytocin

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14
Q

Ergonovine Maleate (Ergotreate) drug class?

A

Ergot alkaloids

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15
Q

Dinoprostone drug class?

A

Prostaglandins

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16
Q

Carboprost tromethamine drug class?

A

Prostaglandins

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17
Q

Misoprostol drug class?

A

Prostaglandins

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18
Q

Tranexamic acid drug class?

A

Non-uterotonic drugs

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19
Q

Magnesium drug class?

A

Tocolytic agents

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20
Q

Nifedipine drug class?

A

Tocolytic agents

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21
Q

Indomethacin drug class?

A

Tocolytic agents

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22
Q

Progesterone drug class?

A

Tocolytic agents

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23
Q

What is the MOA for Pitocin and Syntocin?

A

Oxytocin receptor agonists

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24
Q

What is DOC for inducing labor at term (if needed)?

A

Pitocin and Syntocin given IV

cause timed contractions = more physiological

25
Q

What is the use for Pitocin and Syntocin given IM?

A

Prevention of hemorrhage (if not already on IV, and 2nd line after massage

26
Q

What is the use for Pitocin and Syntocin given via the nasal route?

A

Milk let-down reflex

27
Q

What is the half life for Pitocin and Syntocin?

A

Short- 1-6 min

allows for on-off timed contractions

28
Q

What are the SEs of Pitocin and Syntocin? (4)

A

Water intoxication, uterine rupture, anaphylaxis, sinus bradycardia of fetus

(Water intoxication and uterine rupture only with large doses, sinus bradycardia due to forceful contractions)

29
Q

What is the contraindication to Pitocin and Syntocin?

A

Any non-vaginal delivery

30
Q

What is the MOA for Ergonovine Maleate (Ergotreate)?

A

Contraction of uterine smooth muscle through activation of serotonin and alpha-adrenergic receptors

(“always on”)

31
Q

When is Ergonovine Maleate (Ergotreate) used?

A

After completion of labor and delivery of placenta to produce firm uterine contractions and decrease uterine bleeding, 3rd line (after massage and oxytocin)

32
Q

How long after Ergonovine Maleate (Ergotreate) given IV is it active?

A

Rapid action (30-40 seconds)

33
Q

How long after Ergonovine Maleate (Ergotreate) given orally is it active?

A

10 min

34
Q

How long do the actions of Ergonovine Maleate (Ergotreate) last?

A

Several hours

35
Q

What is the SE for Ergonovine Maleate (Ergotreate)?

A

Transient HTN (contracts all smooth muscle)

36
Q

What is the contraindication for Ergonovine Maleate (Ergotreate)? (3)

A

Never used to induce labor, peripheral vascular/ CAD

37
Q

What is the DOC for inducing abortions during the 2nd trimester?

A

Prostaglandins

38
Q

What drug is used for expulsion of uterine contents (abortion) and is 4th line (after massage, oxytocin, and ergots) for postpartum atony?

A

Prostaglandins

39
Q

What is the use of Dinoprostone in the gel form?

A

Cervical ripening prior to delivery at term

40
Q

Which of the Prostaglandins is associated with the worst diarrhea as a SE?

A

Dinoprostone (black box warning)

41
Q

What are the SEs of the prostaglandins? (3)

A

GI disturbances, vomiting, diarrhea

also fever, chills, HA

42
Q

What are the contraindications for use of Prostaglandins for abortions? (7)

A 
Acute pelvic inflammation
Acute cardiac/ pulm/ renal/ hepatic disease
Asthma
HTN
Anemia
Jaundice
Epilepsy
43
Q

What is the MOA for Tranexamic acid?

A

Antifibrinolytics = inhibits plasminogen activation

44
Q

What is the use for Tranexamic acid?

A

Limits mortality from postpartum hemorrhage, given in combo with uterotonic therapy (oxytocin, ergots, PGE)

45
Q

How is Tranexamic acid given with standard uterotonic therapy?

A

IV

46
Q

What is the MOA for magnesium?

A

Relaxes uterus

47
Q

What is considered “1st line” for prevention of premature labor or to delay premature labor until the 37th week?

A

magnesium

48
Q

What drug can prevent convulsion in preeclampsia and is used to treat preeclampsia?

A

magnesium

49
Q

How is magnesium administered?

A

IV and slowly (hospital only)

50
Q

What are the SEs of magnesium?

A

Flu-like sxs

51
Q

What is the MOA of Nifedipine?

A

L-type calcium channel blocker (inhibits Ca2+ influx/ smooth muscle contractions)

52
Q

What is Nifedipine used for?

A

Prevents premature labor or delays premature labor until 37th week

53
Q

How is Nifedipine administered?

A

Orally (can be given at home)

54
Q

What is the MOA for indomethacin?

A

Inhibits COX enzyme (reduction of prostaglandin synthesis)

55
Q

When is indomethacin used?

A

Prevents premature labor or delays premature labor until 37th week

56
Q

What are the SEs of indomethacin? (2)

A

Maternal GI irritation, partial closure of fetal ductus arteriosus (usually remains open by PGE)

57
Q

What is progesterone used for with respect to labor?

A

Delays premature labor (until 37th week) when given prophylactically from 16th-37th week to women with a history of premature labor

58
Q

Why are progesterone NOT effective for acute treatment with respect to labor and delivery?

A

Work via nuclear receptors (slow reaction) and because progesterone is already naturally present (rises throughout pregnancy)

Pharm II (13 decks)

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