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What effects do prostaglandins have on the uterus?
- Cervical ripening
- Onset of labor
- Uterine contractility
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What is the point of using prostaglandin to ripen the cervix?
increase the success of vaginal delivery
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T/F: cervix is made up of smooth muscle, just like the uterus
False; it is composed of collagen
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Prostaglandin binds prostaglandin receptor, which is a _______ (type) receptor, and leads to uterine _____
- G-protein coupled
- Contractions
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Agents of prostaglandin:
- Misoprostol (PGE1)
- Dinoprostone (PGE 2)
- Carboprost (PGF2alpha)
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Which prostaglandin does not cause cervical ripening?
Carboprost (PGF 2 alpha)
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Cervical ripening can be achieved with ______ and ______ use?
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Which prostaglandin can be inserted or be in a gel form?
Dinoprostone
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Which dinoprostone has a longer duration: gel vs insert?
Vaginal insert has a longer duration than vaginal gel
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What is ADR of dinoprostone?
Uterine tachysystole
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What is a contraindication for dinoprostone?
- Vaginal birth after c-section, this can lead to ruptured uterus
- (same c/I as misoprostol)
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What is a contraindication for misorprostol?
Vaginal birth after C section (same as dinoprostone)
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ADR of misoprostol?
- Diarrhea and shivering
- Uterine tachysystole
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Which prostaglandin has side effect of diarrhea and shivering?
- Misoprostol
- (carboprost is n/v/d)
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T/F: misorprostol can be a vaginal insert or in gel form
False; that is dinoprostone. Misoprostol is either ORAL or VAGINAL
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Therapeutic indications for misoprostol?
- Cervical ripening and induction of labor
- Abortifacient
- Postpartum hemorrhage
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T/F: drug of choice of treatment/prevention of postpartum hemorrhage is oxytocin
Si. Misoprostol is also used for post partum hemorrhage, but I guess oxytocin is the drug of choice
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Therapeutic indication for oxytocin:
- Preferred for induction or augmentation (After cervical ripening_
- Postpartum hemorrhage
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What is ADR of oxytocin?
- Excessive fluid retention (hyponatremia)
- Fetal distress
- Uterine rupture
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Contraindications for oxytocin:
- Fetal distress
- Fetal malpresentation
- Predisposition uterine rupture
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T/F: increase oxytocin can lead to increased ADH which leads to hyponatremia
True
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Therapeutic indications for carboprost?
- Abortifacient
- Postpartum hemorrhage
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Contraindications for carboprost?
- Hypersensitivity to drug
- Active renal, hepatic or cardiac disease
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Which drug is derived from ergot alkaloid, which is from fungus?
Methylergonovine
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What is the MOA of methylergonovine?
Alpha-1 adrenergic, dopaminergic agonist at serotonin receptors
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Therapeutic indication for methylergonovine?
Postpartum hemorrhage
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Contraindication of methylergonovine
- Obstructive vascular disease
- Collagen disease
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