Term
WHich part of the uterus undergoes hypertropy during pregnancy? |
|
Definition
|
|
Term
Myometrial cells express which excitatory receptors? |
|
Definition
Alpha-1, Oxytocin receptors, Prostaglandin receptors |
|
|
Term
Myometrial cells express which inhibitory receptors? |
|
Definition
|
|
Term
what things inititate labor in humans? |
|
Definition
elevated cortisol, depressed progesterone, increased oxytocin and PG receptors.... all to increase the frequency and organization of contractions. |
|
|
Term
What drug is used for induction of labor? |
|
Definition
|
|
Term
What drugs are used for control of postpartum atony and hemorrhage? |
|
Definition
oxytocin, ergonovine, and misoprostol |
|
|
Term
What drug is used for induction of uterine contractions after c-secton or uterine surgery? |
|
Definition
|
|
Term
what drugs are used for therapeutic abortion? |
|
Definition
prostaglandin and Mifepristone |
|
|
Term
Where are Vasopressin and Oxytocin made? Secreted from? |
|
Definition
They are very similar and are made in the Magnocellular neurons of the Hypothalamus and are secretedf rom the Posterior Pituitary |
|
|
Term
|
Definition
Iv infusion; it is a peptide, so it is not orally active |
|
|
Term
What 3 things does Oxytocin increase? |
|
Definition
electrical activity, strength of contractions, increases organization of contractions |
|
|
Term
When is the uterus most sensitive/responsive to Oxytocin? |
|
Definition
late gestation because there is upregulation of oxytocin receptors. |
|
|
Term
When is Oxytocin contraindicated? |
|
Definition
previous uterine surgery, abnormal fetal position, evidence of fetal distres |
|
|
Term
How is Oxytocin administration started? |
|
Definition
Very slowly because response is very variable among individuals. |
|
|
Term
|
Definition
It is very safe because of a very short half life |
|
|
Term
What are side effects of oxytocin and are they common? |
|
Definition
they are very rare: include nausea, fetal trauma, uterine rupture and water intoxication |
|
|
Term
What is the Water intoxication side effect of Oxytocin due to? |
|
Definition
ADH-like activity of Oxytocin |
|
|
Term
What are the uses of Ergonovine? |
|
Definition
prevention of postpartum uterine atony and hemorrhage |
|
|
Term
What is the onset of Ergonovine and how long does it act? |
|
Definition
rapid onset with prolonged actin |
|
|
Term
what is a PGF2alpha analog? |
|
Definition
|
|
Term
|
Definition
|
|
Term
How are Prostaglandin analogs given? |
|
Definition
itraamniotic injection or vaginal supposiotry |
|
|
Term
What 2 drugs are Prostaglandins often used in combo with? |
|
Definition
Mifepristone or Methotrexate |
|
|
Term
What is the direct action of Prostaglandins? |
|
Definition
induce contractions, soften the cervix |
|
|
Term
What are side effects of Prostaglandins? |
|
Definition
uterine rupture, transient pyrexia, nausea, diarrhea |
|
|
Term
what hormone is bifunctional |
|
Definition
with efects on the kidney and the vasculature?,ADH/Vasopressin |
|
|
Term
What is the effect of Vasopressin mediated by V1 receptors? |
|
Definition
Vasculature: causes vasoconstriction |
|
|
Term
What is the effect of Vasopressin mediated by V2 receptors? |
|
Definition
Kidney: water reabsorption |
|
|
Term
What is the MOA of Vasopressin binding to V1 receptor in the vasculature? |
|
Definition
PLC- IP3- Ca2+ ionophore---->vasoconstriction |
|
|
Term
What ist he MOA of Vasopressin binding to V2 receptors in the kidney? |
|
Definition
|
|
Term
What is a Vasopressin V1 recetpor-selective agonist? |
|
Definition
|
|
Term
What is Terlipressin used for? |
|
Definition
Treatment of bleeding, esophageal varices, and hemorrhagic shock |
|
|
Term
What is a Vasopressin V2 receptor-selective agonist? |
|
Definition
|
|
Term
WHat is Desmopressin used for? |
|
Definition
Treatment of Diabetes Insipidus, also increases vWF and used for bleeding disorders |
|
|
Term
How is Desmopressin administered? |
|
Definition
|
|
Term
For treatment of esophageal varices |
|
Definition
how is Terlipressin administered?,topically to the vessels |
|
|
Term
Which tocolytic class hasnt been used because of its side effects |
|
Definition
but if preparations were made that lacked the side effects, they would theoretically be great tocolytic agents?,Oxytocin antagonists |
|
|
Term
Many women respond to ____ and do not need tocolytic agents |
|
Definition
|
|
Term
When are tocolytics contraindicated? |
|
Definition
fetal distress or ruptured membranes |
|
|
Term
Which tocolytic agent is administered IV |
|
Definition
is excreted by the kidneys, and reduces excitability of the uterus?,Magnesium Sulfate |
|
|
Term
Which Ca2+ blockers are used as tocolytics? |
|
Definition
Verapamil, Nifedipine, and Nicardipine |
|
|
Term
What are side effects of Magnesium sulfate? |
|
Definition
respiratory depression, Hypotension, cardiac arrest |
|
|
Term
What are side effects of Calcium channel blockers? |
|
Definition
Headaches, Hypotension, Tachycardia |
|
|
Term
What are 2 beta-2 agonists that are used as tocolytics? |
|
Definition
|
|
Term
What are maternal side effects of b-2 agonists used as tocolytic agents? |
|
Definition
tachycardia, Hyperglycemia, Pulmonary edema |
|
|
Term
What are fetal side effects of beta-2 agonists used as tocolytics? |
|
Definition
|
|
Term
What is the MOA of B-2 agonists used as tocolytics? |
|
Definition
Gs, AC, cAMP, PKA, phosphorylation of MLCK, decreased sensitivity of Myosin to Ca2+, decreased uterine contraction |
|
|
Term
What 2 drugs used as tocolytics inhibit synthesis of Prostaglandins and are short term? |
|
Definition
Indomethacin or COX-2 inhibitors |
|
|
Term
How ins Indomethacin administered? |
|
Definition
|
|
Term
what are side effects of Indomethacin/COX2 inhibitors? |
|
Definition
nausea, diarrhea, allergic rash, oligohydramnios, prematrue closure of ductus arteriosus |
|
|
Term
what is important to give with Indomethacin? |
|
Definition
use of synthetic corticosteroid to mature surfactant in lungs |
|
|
Term
What is not a tocolytic drug |
|
Definition
but is given to women at high risk of premature delivery (previous miscarriage)?,Progesterone or 17 Hydroxyprogesterone |
|
|
Term
What is the efficacy of Progesterone/17-Hydroxyprogesterone at preventing premature delivery? |
|
Definition
reduces incidence by 30% when administered starting at 14-16 weeks gestation |
|
|
Term
What defines Oligohydramnios? |
|
Definition
less than 300mL of Amniotic fluid at term |
|
|
Term
|
Definition
on average, delay labor by?,48 hrs |
|
|