Tocolytic drugs

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Author:
kyleannkelsey
ID:
266746
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Tocolytic drugs
Updated:
2014-03-17 10:29:21
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Tocolytic drugs
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Tocolytic drugs
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Tocolytic drugs
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  1. Tocolytic drugs have what general effect? 
    Relax the uterus
  2. Indomethacin (Indocin) is what type of drug?
    Cyclooxygenase inhibitor that prevents uterine contraction
  3. What is Indomethacin (Indocin) used for
    Used off label to prevent premature labor/uterine contractions
  4. What is the MOA for Indomethacin (Indocin)?
    • Inhibits cyclooxygenase:
    • Blocks synthesis of prostaglandins (PGE1, PGE2, PGF2α) 
  5. What are the Contraindications of Indomethacin (Indocin)?
    Bbleeding disorders, G.I. ulcers and renal impairment
  6. What are the Maternal side effects of Indomethacin (Indocin)?
    Nausea, heartburn, gastritis, increased postpartum bleeding
  7. What are the Fetal side effects of Indomethacin (Indocin)?
    • Constriction of the ductus arteriosus causing pulmonary HTN
    • Renal insufficiency
    • Deficiency of amniotic fluid
  8. How is Indomethacin (Indocin) usually administered?
    Given orally to delay labor
  9. What type of drug is Nifedipine?
    CCB  that relaxes the uterus
  10. What is Nifedipine (Procardia) used for?
    Treats premature labor
  11. What is the Mechanism of tocolytic action of Nifedipine (Procardia)?
    Blocks calcium influx through L-type voltage-gated calcium channels to inhibit uterine contraction
  12. What are the Contraindications for Nifedipine (Procardia)?
    Hypotension (B/c lowers BP) and Heart failure
  13. What are the Maternal side effects of Nifedipine (Procardia)?
    Flushing, HA, dizziness, nausea, tachycardia
  14. What are the Fetal side effects of Nifedipine (Procardia)? 
    Little information available in humans 
  15. How is Nifedipine (Procardia) administered?
    Given orally 
  16. Does Nifedipine (Procardia) cause issues with the Ductus arteriosus in the fetus/infant?
    No
  17. What type of drug is Terbinafine?
     β2 adrenergic receptor agonist that relaxes the uterus
  18. What is the Mechanism of uterine relaxation for Terbinafine?
    • Increases cAMP
    • Ativates protein kinase A (PKA) 
    • Cause dephosphorylation of myosin light chains
  19. What are the Contraindications for Terbinafine?
    • Tachycardia and tachycardia sensitive disease
    • Caution in Arrythmias
  20. What are the Maternal side effects of Terbinafine?
    • Tachycardia, palpitations, hypotension, hyperglycemia, tremor
    • Tachyphylaxis. 
  21. What are the Fetal side effects of Terbinafine?
    Tachycardia, neonatal hypoglycemia, hypotension
  22. What is Terbinafine used for?
    Use discouraged because of adverse CV effects
  23. What is Magnesium Sulfate approved to treat?
    Seizures in preeclampsia
  24. How is Terbinafine administered?
    SQ or IV infusion for < 72 hours
  25. What is Magnesium Sulfate used off label for?
    Premature labor/ Relax the uterus
  26. What is the Mechanism of action for Magnesium Sulfate?
    • Competes with calcium at voltage-gated calcium channels
    • Causes hyperpolarization
    • Inhibits myosin light-chain kinase
    • Inhibits acetylcholine release
  27. What are the Contraindications for Magnesium Sulfate?
    • Cardiac dysfunction
    • Renal dysfunction
  28. What are the maternal side effects for Magnesium Sulfate? 
    Flushing, diaphoresis, palpitations, depressed reflexes, respiratory depression, impaired cardiac conduction
  29. What are the fetal side effects for Magnesium Sulfate? 
    Muscle weakness and neonatal bone abnormalities ( b/c interacts with Ca)
  30. 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
  31. What are the Maternal side effects of Atosiban (Antocin)?
    Transient headache and nausea, allergic reactions
  32. What are the Fetal side effects of Atosiban (Antocin)?
    • Few reported
    • May increase mortality when used early in pregnancy 
  33. What type of molecule is Atosiban?
    Peptide
  34. How is Atosiban (Antocin) administerd?
    Given by IV infusion 
  35. Hydroxyprogesterone (Makena) is approved for the treatment of what?
    To prevent preterm labor
  36. At what point, is Hydroxyprogesterone (Makena) not usedful for preterm labor?
    Once labor has begun
  37. What type of molecule is Hydroxyprogesterone (Makena) ?
    A progestin
  38. 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
  39. 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
  40. What are the fetal side effects of Hydroxyprogesterone (Makena)?
    No major adverse effects known at this time.
  41. How is Hydroxyprogesterone (Makena) administered?
    IM x1 weekly

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