Card Set Information
Tocolytic drugs have what general effect?
Relax the uterus
Indomethacin (Indocin) is what type of drug?
Cyclooxygenase inhibitor that prevents uterine contraction
What is Indomethacin (Indocin) used for
Used off label to prevent premature labor/uterine contractions
What is the MOA for Indomethacin (Indocin)?
Blocks synthesis of prostaglandins (PGE1, PGE2, PGF2α)
What are the Contraindications of Indomethacin (Indocin)?
Bbleeding disorders, G.I. ulcers and renal impairment
What are the Maternal side effects of Indomethacin (Indocin)?
Nausea, heartburn, gastritis, increased postpartum bleeding
What are the Fetal side effects of Indomethacin (Indocin)?
Constriction of the ductus arteriosus causing pulmonary HTN
Deficiency of amniotic fluid
How is Indomethacin (Indocin) usually administered?
Given orally to delay labor
What type of drug is Nifedipine?
CCB that relaxes the uterus
What is Nifedipine (Procardia) used for?
Treats premature labor
What is the Mechanism of tocolytic action of Nifedipine (Procardia)?
Blocks calcium influx through L-type voltage-gated calcium channels to inhibit uterine contraction
What are the Contraindications for Nifedipine (Procardia)?
Hypotension (B/c lowers BP) and Heart failure
What are the Maternal side effects of Nifedipine (Procardia)?
Flushing, HA, dizziness, nausea, tachycardia
What are the Fetal side effects of Nifedipine (Procardia)?
Little information available in humans
How is Nifedipine (Procardia) administered?
Does Nifedipine (Procardia) cause issues with the Ductus arteriosus in the fetus/infant?
What type of drug is Terbinafine?
β2 adrenergic receptor agonist that relaxes the uterus
What is the Mechanism of uterine relaxation for Terbinafine?
Ativates protein kinase A (PKA)
Cause dephosphorylation of myosin light chains
What are the Contraindications for Terbinafine?
Tachycardia and tachycardia sensitive disease
Caution in Arrythmias
What are the Maternal side effects of Terbinafine?
Tachycardia, palpitations, hypotension, hyperglycemia, tremor
What are the Fetal side effects of Terbinafine?
Tachycardia, neonatal hypoglycemia, hypotension
What is Terbinafine used for?
Use discouraged because of adverse CV effects
What is Magnesium Sulfate approved to treat?
Seizures in preeclampsia
How is Terbinafine administered?
SQ or IV infusion for < 72 hours
What is Magnesium Sulfate used off label for?
Premature labor/ Relax the uterus
What is the Mechanism of action for Magnesium Sulfate?
Competes with calcium at voltage-gated calcium channels
Inhibits myosin light-chain kinase
Inhibits acetylcholine release
What are the Contraindications for Magnesium Sulfate?
What are the maternal side effects for Magnesium Sulfate?
Flushing, diaphoresis, palpitations, depressed reflexes, respiratory depression, impaired cardiac conduction
What are the fetal side effects for Magnesium Sulfate?
Muscle weakness and neonatal bone abnormalities ( b/c interacts with Ca)
Atosiban (Antocin) has what MOA?
Oxytocin receptor antagonist
Atosiban has what major issue for use?
Not available in the US
Commonly used outside the U.S. for premature labor
What are the Maternal side effects of Atosiban (Antocin)?
Transient headache and nausea, allergic reactions
What are the Fetal side effects of Atosiban (Antocin)?
May increase mortality when used early in pregnancy
What type of molecule is Atosiban?
How is Atosiban (Antocin) administerd?
Given by IV infusion
Hydroxyprogesterone (Makena) is approved for the treatment of what?
To prevent preterm labor
At what point, is Hydroxyprogesterone (Makena) not usedful for preterm labor?
Once labor has begun
What type of molecule is Hydroxyprogesterone (Makena) ?
What is the mechanism of tocolytic action of Hydroxyprogesterone (Makena)?
Relaxes smooth muscle
Prevents the formation of connexin-43 gap junctions
Maintains inhibitory progesterone/estrogen ratio
What are the maternal side effects of Hydroxyprogesterone (Makena)?
Contraindicated with breast, cervical, uterine, liver cancer (Causes abnormal cell growth)
Thromboembolic disease (can cause clotting)
Causes fluid retention, edema, hyperglycemia and depression
May cause itching, rash at the injection site, nausea
What are the fetal side effects of Hydroxyprogesterone (Makena)?
No major adverse effects known at this time.
How is Hydroxyprogesterone (Makena) administered?
IM x1 weekly