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Reproductive > Uterine Stimulahts And Relaxants > Flashcards

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
Q

What is dinoprostome

A

Naturally occurring prostaglandin E2 found in mammals tissues

26
Q

What is carbosprost tromethanien

A

Naturally occurring prostaglandin F2 found in mammals tissues

27
Q

Can prostaglandin analogues cause abortion between weeks 12 to 20 weeks

A

Yes

28
Q

Dinorprostone action

A

Cervical dilation
stimulation of the uterus
alternative to oxytocin labor induction

29
Q

Where do you place dinoprostone

A

Cervix, posterior formix

30
Q

Dinoprostone action

A

Cervical dilation

Stimulation of uterus

31
Q

This prostaglandin analog given intramuscular cause immediate and sustained uterine contraction Which has saved a life of number of women

A

Carboprost

32
Q

Misoprostol uss

A

Cervical dilation
Uterine stimulant activity
Peptic ulcer disease

33
Q

Adverse effects of prostaglandin Analogues

A 
Nausea vomiting diarrhea
Transient fever 
retain placental fragments 
excessive bleeding
 decreased diastolic blood pressure 
headache
34
Q

Why cannot use oxytocin with prostaglandin analogue

A

Because possibility of uterine rupture

35
Q

Drugs used to inhibits early labor

A

uterine relaxants

36
Q

Second name of uterine relaxants

A

Tocolytics

37
Q

Example of tocolytics

A 
ethanol 
magnesium sulfate 
prostaglandin inhibitors 
calcium channel blockers
 hydroxy progesterone
 beta2 adrenergic agonist
38
Q

Adverse events of tocolytics

A 
Pulmonary edema 
myocardial infarction 
respiratory arrest 
cardiac arrest
 death
39
Q

Do we still use intravenous ethanol to inhibits premature labor

A

No

40
Q

Action of ethanol

A

Inhibits oxytocin released from PT cherry which decreases myometrial contractility

41
Q

MOA magnesium sulfate

A

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
Q

At which plasma level should you maintain magnesium for tocolysis to to maybe occur

A

5.5meq/l

43
Q

Side effects of magnesium sulfate

A 
Cardiac arrest
 sweating 
warmth
Flushing
 dry mouth 
nausea 
vomiting
 dizziness 
nystagmus
 headache
 palpitations
44
Q

B2 adrenergic agonists are they effective in premature labor

A

Not completely

45
Q

How long can beta2 adrenergic agonist arrest preterm labor

A

48 to 72

46
Q

Percentage of increase in probability of survival for the new born with a 2 day delay in delivery due to beta2 adrenergic

A

10 to 15%

47
Q

Mode of action of beta2 adrenergic agonist

A

Binds to the reçeptors in the Myometrium and activates cyclic AMP dependent protein kinase and decreases intracellular calcium leading to myometrial muscle relaxation

48
Q

Side effects of beta-2 adrenergic agonist

A 
Palpitations 
Tremor
 nausea 
vomiting 
nervousness
 hyperglycemia 
hypokalemia
49
Q

Classical example of beta-2 adrenergic agonist

A

Terbutaline

Ritodrine

50
Q

Can the combination of terbutaline in magnesium sulfate cause cardiac disturbances

A

Yes

51
Q

Side effects of Terbutaline

A

Tachycardia
hyperglycemia
hypokalemia

52
Q

What does administration of terbutaline

A

Subcutaneous intravenous oral

53
Q

Example of prostaglandin inhibitors

A

Indomethacin - NSAIDS

54
Q

What does administration of indomethacin

A

Rectal

oral

55
Q

Side effects of indomethacin

A

Decrees amniotic fluid volume
oligohydramnios
Intraventricular hemorrhage in the newborn

56
Q

Which calcium channel blocking is used as uterine relaxants

A

Nifedipine

57
Q

Action of nifedipine

A

Impair entry of calcium into my metro cells and inhibits contractility

58
Q

When do you use hydroxy progesterone as a uterine relaxants

A

As a prophylaxis in women who are a high-risk category for premature delivery

59
Q

Why is the use of hydroxy progesterone limited

A

Teratogenic but I

Reproductive (14 decks)

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