Term
| oxytocin [Pitocin, Syntocin] |
|
Definition
stimulates uterine activity;
9 AA peptide hormone;
short half-life, metabolized in liver & kidney, Administerd IV;
Uses:
Induction of labor contractions;
Stimulates contraction of myoepithelial cells in breast --> milk letdown/ejection;
in high risk pregnancies, tests for fetal respiratory capabilities;
Reduces postpartum hemorrhage;
Used with hypertonic urea or dinoprostone for inducing abortions; |
|
|
Term
| PGE2 - dinoprostone [Prepidil, Cervidil, Prostin E2] |
|
Definition
stimulates uterine activity/contractions; causes softening & dilation of cervix (CERVICAL RIPENING); also stimulates uterine contractions;
intrvaginal suppositories uesd to induce 2nd trimester abortion & to expel uterine products; |
|
|
Term
| 15-methyl PGF-2alpha - carboprost tromethamine [Hemabate] |
|
Definition
stimulates uterine activity;
IM administered to control postpartum bleeding;
also used to induce 2nd trimester abortion |
|
|
Term
| PGE-1 analog - misoprostol [Cytotec] |
|
Definition
stimulates uterine activity;
used with antiprogestin mifepristone-RU486 (Mifeprex) for early termination of pregnancy (up to 49 days from last menstrual period) |
|
|
Term
| ergot alkaloids - ergonovine maleate [Ergotrate], methlyergonovine maleate [Methergine] |
|
Definition
stimulates uterine activity;
use INCREASED # of STILLBORN children - DO NOT use to induct or augment labor;
used to treat postpartu or postabortion hemorrhage;
ADRs:
HTN due to severe vasoconstriction --> gangrene of fingers & toes;
nausea, vomiting, diarrhea;
seizures;
C/Is: HTN, CVD, hepatic dx, renal dx |
|
|
Term
| mifepristone-RU486 [Mifeprex] |
|
Definition
stimulates uterine activity;
antiprogestin/progesterone receptor antagonist --> causes detachment of products of conception;
Uses:
termination of pregnancy (up to 49 days from last mestrual period), administerd with misoprostol [Cytotec];
Side Effects:
bleeding, cramping |
|
|
Term
| terbutaline sulfate [Brethine], ritodrine HCl [Yutopar] |
|
Definition
beta-2 agonist that inhibits uterine activity;
beta-adrenergic receptor agonism in uterine smooth muscle --> increase in cAMP --> decreases contractions of smooth muscle;
failure to inhibit uterine contractions may be due to rapid receptor desensitization;
use IV first, then give oral if still needed;
Toxicities, ADRs, & C/Is:
fetal & maternal tachycardia; maternal pulmonary edema; maternal hyperglycemia (use w/ caution in pts with DM); nausea/vomiting, transient hypokalemia, nervousness, dizziness, tremor, weakness |
|
|
Term
|
Definition
inhibits uterine activity;
relaxes uterine smooth muscle, also *used to prevent seizures during preclampsia*;
MoA: unknown;
DRUG OF CHOICE for pts with C/Is for ritodrine or terbutaline;
DRUG OF CHOICE for pts w/ DIABETES;
Give IV
C/I: renal failure;
ADRs (Intoxication):
flushing, sweating, hypotension, depressed reflexes, hypothermia, cardiac & CNS depression, respiratory paralysis;
*CHECK PATELLAR (KNEE-JERK) REFLEX to DETERMINE TOXICITY* |
|
|
Term
|
Definition
prostaglandin-synthetase inhibitor used to inhibit uterine activity;
MoA: inhibits production of prostaglandins --> important for cervical ripening & myometrial contraction;
May cause premature closure of ductus arteriosus & pulmonary HTN;
Uses:
tx painful menstrual cramps associated with primary dysmenorrhea |
|
|
Term
| Clinical Uses for Drugs that Stimulate Uterine Motility |
|
Definition
induce or augment labor;
control postpartum uterine hemorrhage;
cause uterine contraction after C-section;
induce abortion |
|
|
Term
| Clinical Uses of Drugs which Decrease Uterine motility |
|
Definition
1) delay or prevent premature parturition/preterm labor;
to slow or arrest delivery so other therapeutic measures can be performed |
|
|
Term
| ADRs, Toxicities, & C/Is for use of Oxytocin |
|
Definition
decreased BP, increased HR, arrhythmias;
antidiuretic effect --> hyponatremia secondary to water retention;
sustained uterine contractions --> interferes with fetal circulation;
C/I: abnormal fetal position, fetal distress/placental abnormalities, previous uterine surgery |
|
|
Term
| Indications for use of Oxytocin for Labor Induction |
|
Definition
1) if continuation of pregnancy presents risk to mother, fetus, or both;
2) premature rupture of membranes;
3) erythroblastis fetalis;
4) antepartum bleeding
5) placental insufficiency
6) PROLONGED PREGNANCY (>42 wks)
7) selective induction |
|
|
Term
| Toxicities, Adverse Effects, & C/Is of PGE2 - dinoprostone (Prepidil, Cervidil, Prostin E2) |
|
Definition
GI disturbances - nausea/vomiting;
uterine hyperstimulation;
Others: HA, chills, hotflashes, transient increase in BP, cardiac arrhythmias, wheezing, coughing, chest pain;
C/Is: abnormal fetal position, fetal distress/placental abnormalities, previous uterine surgery |
|
|
Term
| CCBs - nifedipine [Procardia, Adalat] |
|
Definition
inhibits uterine contractions by decreasing Ca influx into myocardial smooth muscle cells;
Adv: causes decreased cardiovascular SEs compared to terbutaline |
|
|
Term
|
Definition
drug used to enhance fetal lung formation by stimulating surfactant inside fetal lungs;
Give drug during 48 hours of prevention of preterm labor via tocolytic drugs --> increases fetal survival rates |
|
|
