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  • Sec Drugs Acting On The Uterus 1

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    This document discusses uterine stimulants (oxytocics) and relaxants (tocolytics). It outlines several classes of oxytocics including oxytocin, ergot alkaloids, and prostaglandins. These drugs are used to induce or augment labor as well as treat postpartum hemorrhage. Potential adverse effects include fetal asphyxia, water intoxication, hypotension, and arrhythmias. Tocolytics are used to prevent preterm labor by decreasing uterine contractions. Examples mentioned include beta agonists, COX inhibitors, atosiban, calcium channel blockers, and magnesium sulfate. However, their use is contraindicated if membranes have ruptured or there are signs of infection, fetal death

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    This document discusses uterine stimulants (oxytocics) and relaxants (tocolytics). It outlines several classes of oxytocics including oxytocin, ergot alkaloids, and prostaglandins. These drugs are used to induce or augment labor as well as treat postpartum hemorrhage. Potential adverse effects include fetal asphyxia, water intoxication, hypotension, and arrhythmias. Tocolytics are used to prevent preterm labor by decreasing uterine contractions. Examples mentioned include beta agonists, COX inhibitors, atosiban, calcium channel blockers, and magnesium sulfate. However, their use is contraindicated if membranes have ruptured or there are signs of infection, fetal death

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    20 views13 pages

    Sec Drugs Acting On The Uterus 1

    Uploaded by

    Lo Ds
    This document discusses uterine stimulants (oxytocics) and relaxants (tocolytics). It outlines several classes of oxytocics including oxytocin, ergot alkaloids, and prostaglandins. These drugs are used to induce or augment labor as well as treat postpartum hemorrhage. Potential adverse effects include fetal asphyxia, water intoxication, hypotension, and arrhythmias. Tocolytics are used to prevent preterm labor by decreasing uterine contractions. Examples mentioned include beta agonists, COX inhibitors, atosiban, calcium channel blockers, and magnesium sulfate. However, their use is contraindicated if membranes have ruptured or there are signs of infection, fetal death

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    of 13

    Prepared by:

    Dr/Aya Gaber keshk


    Uterine stimulants
    (Oxytocics,Abortifacients)
    These drugs increase uterine motility including:
    1-Posterior pituitary hormone: oxytocin
    2-Ergot alkaloids:
    Ergometrine,Methylergometrine
    3-Prostaglandins:PGE2,PGF2α,misoprostol
    Oxytocin:
    -Actions:
    1-Milk ejection from the breast.
    2-stimulates contraction of uterine smooth muscle.
    -Mechanism of action:
    Activates G protein-coupled receptors,increasing
    intracellular calcium levels in uterine myofibrils.It also
    increases local PG production,stimulating uterine
    contraction.
    Clinical uses:
    1-To induce or augment labor.
    2-Treatment of postpartum hemorrhage.
    3-stimulate milk secretion in nursing mothers.
    Adverse effects:
    1-may produce vigorous contractions causing fetal asphyxia
    and uterine rupture.
    2-water intoxication due to its ADH-like action when given in
    large doses so this may be a problem in case of cardiac ,renal
    disease or preeclampsia.
    3- Bolus injection of oxytocin cause hypotension due to
    vasodilatation.
    4-cardiac arrhythmia.
    Contraindications:
    1-cardiac disease
    2-fetal distress
    3-cephalopelvic disproportion.
    Prostaglandins
    PGE2&PGF2α cause uterine contraction in pregnant
    women but nonpregnant uterus has variable response to
    prostaglandins
    (PGF2α causes contraction and PGE2 causes relaxation).
    -Drugs used are:
    1-PGE2
    2- PGF2α
    3-Misoprostol(PGE1 analogues)
    -Clinical uses:
    1-Therapeutic abortion
    2-Induction of labor
    3-cervical ripening.:PGE2 reduces the collagen network
    within the cervix.It softens the cervix,
    Relaxes the smooth muscle,allowing dilatation and
    passage of the fetus through the birth canal.
    -Adverse effects:
    1-bronchospasm
    2-nausea,vomiting and diarrhea.
    Ergometrine:
    Powerful oxytocic.
    -Clinical uses:
    Postpartum hemorrhage: used to reduce postpartum
    bleeding as it produces a powerful and long lasting
    contraction that reduces bleeding.
    N.B:
    Ergometrine is unsuitable for labor induction as it
    produces fast contractions superimposed on a tonic
    persistent contraction causing fetal distress but
    oxytocin produces slow contractions with full relaxations
    between so fetal oxygenation doesn’t suffer.
    -Adverse effects:
    1-vasoconstriction associated with hypertension,blurred
    vision,headache and may lead to angina.
    2-Nausea,vomiting.
    - Contraindications:
    Hypertension
    Uterine relaxants
    (Tocolytics)
    These are drugs which decrease uterine contractions to
    prevent preterm labor and immature birth.
    Indications: DAD
    1-Delaying labor.
    2-Arrest threatened abortion
    3-Dysmenorrhea.
    Measures to delay labor should not be undertaken if 
    (MI FAT):
    1- Membranes ruptured.
    2- Intrauterine infection
    3- Intrauterine fetal death.
    4- Antepartum hemorrhage.
    5- Toxemia of pregnancy.
    DRUG CLASS EXAMPLES ADVERSES EFFECTS

    Beta agonists Ritodrine,terbutaline and Hypotension, tachycardia,


    salbutamol hyperglycemia

    CoX inhibitors indomethacin Oligohydraminos, premature


    ,GIT upset, closure of ductus
    arteriosus
    Oxytocin antagonist Atosiban GIT upset

    Calcium channel blockers Nifedipine Hypotension,headache

    Mgnesium sulphate Magnesium sulphate Respiratory depression,cardiac


    arrest.

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