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Uterine Stimulahts And Relaxants Flashcards

1
Q

Are there contractions in the first to trimesters of pregnancy , why

A

No

Inhibitor reaction of progesterone in the uterine musculature

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2
Q

What is false labor

A

When contraction goes to the extent of feeling like onset of labor

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3
Q

What doesparturition requires

A

Cervical canal dilation

uterine smooth muscle contraction

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4
Q

Hormone responsible for cervical canal dilation

A

Relaxin

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5
Q

Where is relaxin produced

A

In the corpus luteum and the placenta

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6
Q

Hormone responsible for the association of connective tissue between the pelvic bones

A

Relaxin

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7
Q

Hormones responsible for contractions during labor

A

Oxytocin and prostagland

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8
Q

What causes contraction : oxytocin increasing levels or oxytocin receptors increasing level

A

Oxytocin receptors increasing level

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9
Q

The release of this hormone promotes prostaglandin production

A

Oxytocin

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10
Q

This compound is a powerful myometrial stimulants

A

Prostaglandins

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11
Q

Type of uterine Stimulants

A

Oxytocin
Ergonovine, methylergonovine maleate
prostaglandin analogues

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12
Q

Where is oxytocin produced

A

Hypothalamus and released by the posterior pituitary

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13
Q

Mechanism of action of Oxytocin

A

Direct stimulation of oxytocin receptors on the myometrial cell

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14
Q

Half life of oxytocin

A

15 minutes

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15
Q

Drug of choice to induce labor

A

Ox

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16
Q

Percentage of patients that progressed into labor after administration of oxytocin

A

80

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17
Q

Inappropriate use of oxytocin lead to

A

Uterine rupture
Anaphylactoid rxns
Maternal death

Fetal adverse rxns

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18
Q

Source of ergonovine

A

Ergot

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19
Q

Action of Ergonovine

A

Stimulate smooth muscle directly which
induces sustained tetanic contraction

Inhibit endothelial derived relaxation factor
Induce arterial vasoconstriction
Minor action on CNS
I

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20
Q

Ergonovine act on which receptors

A

Partial agonists at alpha adrenergic , dopamine and serotonin receptors

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21
Q

Mode of administration of Ergonovine and methylergonovine

A

IM

IV

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22
Q

Unwanted effect of IV administration of Ergonovine

A

Severe hypertension

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23
Q

Contra indications of Ergonovine

A

Angina pectoris
myocardial infarction
transient ischemic attack
hypertension

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24
Q

Examples of prostaglandin analogues

A

Dinoprostone
Carboprost tromethamine
Misoprostol

25
What is dinoprostome
Naturally occurring prostaglandin E2 found in mammals tissues
26
What is carbosprost tromethanien
Naturally occurring prostaglandin F2 found in mammals tissues
27
Can prostaglandin analogues cause abortion between weeks 12 to 20 weeks
Yes
28
Dinorprostone action
Cervical dilation stimulation of the uterus alternative to oxytocin labor induction
29
Where do you place dinoprostone
Cervix, posterior formix
30
Dinoprostone action
Cervical dilation | Stimulation of uterus
31
This prostaglandin analog given intramuscular cause immediate and sustained uterine contraction Which has saved a life of number of women
Carboprost
32
Misoprostol uss
Cervical dilation Uterine stimulant activity Peptic ulcer disease
33
Adverse effects of prostaglandin Analogues
``` Nausea vomiting diarrhea Transient fever retain placental fragments excessive bleeding decreased diastolic blood pressure headache ```
34
Why cannot use oxytocin with prostaglandin analogue
Because possibility of uterine rupture
35
Drugs used to inhibits early labor
uterine relaxants
36
Second name of uterine relaxants
Tocolytics
37
Example of tocolytics
``` ethanol magnesium sulfate prostaglandin inhibitors calcium channel blockers hydroxy progesterone beta2 adrenergic agonist ```
38
Adverse events of tocolytics
``` Pulmonary edema myocardial infarction respiratory arrest cardiac arrest death ```
39
Do we still use intravenous ethanol to inhibits premature labor
No
40
Action of ethanol
Inhibits oxytocin released from PT cherry which decreases myometrial contractility
41
MOA magnesium sulfate
Uncouples excitation contraction in myometrial cells through the inhibition of cellular action potentials decreases calcium uptake by competing for binding sites which reduces intracellular calcium
42
At which plasma level should you maintain magnesium for tocolysis to to maybe occur
5.5meq/l
43
Side effects of magnesium sulfate
``` Cardiac arrest sweating warmth Flushing dry mouth nausea vomiting dizziness nystagmus headache palpitations ```
44
B2 adrenergic agonists are they effective in premature labor
Not completely
45
How long can beta2 adrenergic agonist arrest preterm labor
48 to 72
46
Percentage of increase in probability of survival for the new born with a 2 day delay in delivery due to beta2 adrenergic
10 to 15%
47
Mode of action of beta2 adrenergic agonist
Binds to the reçeptors in the Myometrium and activates cyclic AMP dependent protein kinase and decreases intracellular calcium leading to myometrial muscle relaxation
48
Side effects of beta-2 adrenergic agonist
``` Palpitations Tremor nausea vomiting nervousness hyperglycemia hypokalemia ```
49
Classical example of beta-2 adrenergic agonist
Terbutaline | Ritodrine
50
Can the combination of terbutaline in magnesium sulfate cause cardiac disturbances
Yes
51
Side effects of Terbutaline
Tachycardia hyperglycemia hypokalemia
52
What does administration of terbutaline
Subcutaneous intravenous oral
53
Example of prostaglandin inhibitors
Indomethacin - NSAIDS
54
What does administration of indomethacin
Rectal | oral
55
Side effects of indomethacin
Decrees amniotic fluid volume oligohydramnios Intraventricular hemorrhage in the newborn
56
Which calcium channel blocking is used as uterine relaxants
Nifedipine
57
Action of nifedipine
Impair entry of calcium into my metro cells and inhibits contractility
58
When do you use hydroxy progesterone as a uterine relaxants
As a prophylaxis in women who are a high-risk category for premature delivery
59
Why is the use of hydroxy progesterone limited
Teratogenic but I

Reproductive (14 decks)

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