Uterotonics
Oxytocin is produced in the
What is the hypothalamus (stored in the posterior pituitary)
Indication for tocolytic therapy
What is delay or stop premature labor
Name 2 drug classes to treat HTN in pregnant patients
Beta blockers
Methyldopa
Calcium Channel Blockers
Hydralazine
Clonidine
Hemabate contraindicated in what patients?
Asthmatics
Mechanism of action of magnesium in pre-eclampsia
Competitive inhibition of calcium at the SR binding sites --> reduced level of intracellular Ca --> smooth muscle relaxation
Hemodynamic changes associated with Oxytocin
Hypotension: NO mediated vasodilation, negative inotropic effects
Tachycardia: compensatory and direct AV conduction effects
Decreased SVR
Increased CO
Main classes of medications used as tocolytics
What are Indomethacin, Beta Agonists and Calcium Channel Blockers
Beta: Terbutaline
CCB: Nifedipine
CHF
Severe Asthma
Route of administration for Hemabate/Carboprost
What is IM
Two indications for Mag therapy in Obstetrics
Neuro protection for preterm delivery
Eclampsia prophylaxis for severe pre-eclampsia
Eclampsia
Two primary uses for uterotonics
What are
Induce or augment labor
Control PPH bleeding due to uterine atony
Induce therapeutic abortion
Expected side effects with Terbutaline therapy
What are maternal AND fetal tachycardia, SOB, pulmonary edema, hyperglycemia, tremor
Side effects for Hydralazine
Hypotension
Tachycardia
Palpitations
Headache
Neonatal thrombocytopenia
Dose of TXA in PPH
What is 1 gram IV administered over 10 minutes
Side effects of Magnesium
Hyperreflexia, lethargy, nausea, EKG changes, pulmonary edema
Methergine is this class of medication
What is Ergot Alkaloid
Expected side effects of Nifedipine therapy
Hypotension
Uterine atony
Uterotonic medication to avoid/use with caution in HTN patients
Name 2 Risk Factors for PPH
Prior hemorrhage
Multiple Gestation
Retained POC
Bleeding disorder (vonWillebrands, thromobcytopenia)
C-section
Treatment for magnesium toxicity
Calcium Gluconate 1 gram IV over 10 minutes
Methergine is contraindicated in these patients
Severe pre-eclampsia, cardiac disease, severe HTN
Fetal side effects with Indomethacin
Possible risk of closure/constriction of ductus arteriosus
Oligohydramnios 2/2 renal dysfunction
Pulmonary HTN
Beta blockers: potential for IUGR, fetal bradycardia
Order medications are administered in PPH
Oxytocin
Methergine
Hemabate
TXA
Anesthetic Considerations with Mag therapy
Potentiation of neuromuscular blockade
Uterine atony