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ENRP Exam 1 > Wolff Ante- and Perinatal Pharm > Flashcards

Wolff Ante- and Perinatal Pharm Flashcards

(54 cards)

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1
Q

What drugs are used for the induction of labor and control of post partum bleeding?

A
  • Misoprostol
  • Dinoprostone
  • Carboprost
  • Oxytocin
  • Ergot alkaloids
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2
Q

What drugs are used to maintain and close a patent ductus arteriosus?

A
  • Maintain: Alprostadil
  • Close:
    • indomethacin
    • ibuprofen
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3
Q

What are the Tocolytics used to delay labor?

A
  • terbutaline
  • Indomethacin
  • Nifedipine
  • MgSO4
  • Atosiban
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4
Q

What are the anti hypertensives used in pregnancy?

A
  • a-methyldopa
  • labetalol
  • hydralazine
  • sodium nitroprusside
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5
Q

Misoprostol MOA?

A
  • synthetic prostaglandin E1 analog
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6
Q

Misoprostol indications

A
  • Termination of uterine pregnancy if <77 days in combo with mifepristone
  • off label for cervical ripening to induce labor and help control post partum bleeding
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7
Q

Contraindications to misoprostol?

A
  • Pregnancy unless being used for abortion
  • Previous C-section
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8
Q

Pharmacokinetics of Misoprostol?

A
  • Stable at room temperature
  • oral
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9
Q

AE’s of Misoprostol?

A
  • n/v diarrhea
  • chills shivering
  • abd. pain
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10
Q

Dinoprostone MOA?

A
  • Prostaglandin E2 analog
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11
Q

Dinoprostone Indications?

A
  • Induces uterine contractions and cervical ripening
  • off label for abortions at later stages
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12
Q

Dinoprostone pharmacokinetics?

A
  • Comes in a gel and an insert or suppository
    • needs refridgeration
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13
Q

AE’s of dinoprostone?

A
  • Back pain
  • n/v diarrhea
  • fever chills
  • warm feeling in vagina
  • during an abortion can have fever unresponsive to NSAIDs
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14
Q

Carboprost MOA?

A

Synthetic prostaglandin F2alpha analog

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15
Q

Indications for Carboprost?

A
  • used to induce abortion btw 13 and 20 weeks
  • post partum hemostasis for refractory bleeding
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16
Q

Contraindications for Carboprost?

A
  • acute PID
  • active cardiac pulmonary renal or hepatic dysfunction
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17
Q

Carboprost AE’s?

A
  • Htn and pulonary edema
  • chills/shivering (reduces body temp)
  • dizzy
  • heartburn, gagging, diarrhea
  • choking sensation
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18
Q

Carboprost pharmacokinetics?

A

Deep IM injection

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19
Q

Oxytocin MOA?

A

Posterior pituitary hm

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20
Q

Oxytocin indications?

A
  • Induce labor
  • post partum hemostasis for refractory bleeding
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21
Q

Oxytocin pharmacokinetics

A

IV

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22
Q

Oxytocin AEs?

Study These Flashcards
A
  • water intoxication-hyponatremia
    • rare
23
Q

Oxytocin contraindications?

Study These Flashcards
A
  • DON’T induce labor if:
    • lungs are not mature
    • cervix is not ripe, it could lead to rupture
24
Q

Ergot Alkaloids MOA?

Study These Flashcards
A
  • Ergonovine or ethyl ergonovine
  • stimulates adreneerrgic, dopaminergic, and serotonergic receptors
25
Ergot Alkaloid effects?
* on the uterus it can cause prolonged tonic uterine contractions * Vascular effects are that it constricts arterioles and veins
26
Ergot Alkaloids indications?
* Increase uterine tone and decrease bleeding * given after delivery
27
Pharmacokinetics of ergot alkaloids?
Oral, IV, IM
28
Ergot alkaloids AE's?
* rare significant AE's * historically **St. Anthony's Fire** * mania psychosis vomiting * dry gangrene affecting poorly vascularized areas
29
Ergot Alkaloids contraindication?
Hypertension and hypersensitivity
30
How do we attempt to reduce RDS risk in a premie?
* corticosteroids are used in pre term delivery to promote lung maturation and increase surfactant production
31
Indications for Antenatal Corticosteroids?
* Between 24 weeks and 36 weeks with: * threatened pre term labor * antepartum hemorrhage * preterm rupture of membranes * conditions that require C-sections * pre-eclampsia and HELLP
32
How are betamethasone and dexamethasone given and what for?
* Betamethasone: two **IM injections** over 24 hr intervals * Dexamethasone: four **IM injections** over 12 hr intervals * used to induce transcription of surfactant proteins in alveolar type 2 pneumocytes
33
How do you treat RDS in premature infants?
CPAP, IPPV or intubation
34
Ritodrine MOA and AE's and historical use?
* beta 2 agonist * severe hallucinations * previously FDA approved as a tocolytic, but no longer approved or on market
35
MgSO4 uses?
* used and works to prevent eclamptic seizures * long term drug of choice for tocolysis in the US
36
Magnesium Sulfate unique protection?
Evidence for neuroprotection, decreases risk for cereberal palsy
37
AE's of Magnium Sulfate?
* maternal: * flushing, palpitations, HA, depressed reflexes and respiration, * Fetal: muscle relaxation and rarely CNS depression
38
Terbutaline tocolytic MOA?
* increases cAMP leading to K channel mediated hyperpolarization and dephosphorylation of myosin light chains
39
Terbutaline contraindications?
* tachycacrdia sensitive cardiac disease * poor controlled thyroid disease or DM
40
Maternal AE of Terbutaline?
* cardiac arrrhythmia * pulm edema * myocardial ischemia * hypotension, tachycardia, SOB * Hyperglycemia
41
Are there FDA approved Tocolytics?
No
42
Terbutaline use according to up to date?
Second choice to Nefidipine btw 32 and 34 weeks when NSAIDs are contraindicated
43
How is Terbutaline given?
* Off label as a subcutaneous injection * **should not be given for prevention or prolonged treatment longer than 48-72 hrs** * NO oral use
44
Contraindications to Nifedipine use as a tocolytic?
* cardiac disease and renal and hypotension * avoid using magnesium sulfate as same time as it can cause cardiovascular collapse
45
What choice agent is nifedipine?
2nd choice for 24-32 weeks and first choice for 32-34 weeks
46
When is Indomethacin chosen as a tocolytic?
1st choice for 24-32 weeks Nifedipine is second choice contraindicated after 32 wks due to potential ductus arterosus closure
47
What is erythomycin eye ointment used for?
Prophylaxis against gonococcal conjunctivitis, it is not effective against C. trachomatis
48
What is Vitamin K given to a neonate for and how is it administered?
IM dose given to prevent vitamin K deficient bleeding
49
When is hepatitis B vaccine given to neonates?
Within 24 hours of delivery and more rapidly if mother has Hep B
50
What is Alprostadil and its AE's ?
* Synthetic PGE1 simiilar to misoprostol given parenterally to **maintain patent ductus arteriosus** * **Pyrexia**, hypotension, tachycardia, apnea
51
How do we close a patent ducturs arteriosus?
Indomethacin classically, but now ibuprofen
52
What are the two first line antihypertensive drugss used in pregnancy and do they cross the placenta?
* Oral alpha-methyldopa (alpha 2 agonist) * Oral labetalol (alpha/beta blocker) * ALL anti hypertensives cross the placenta
53
Second line anti-hypertensives ued for severe hypertension?
* Parenteral labetalol * hydralazine * sodium nitroprusside
54
ACE/ARBS in pregnancy?
Absolute contraindication, can lead to death of baby

ENRP Exam 1 (7 decks)

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