week 13

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Questions and Answers

What is the primary purpose of domperidone?

To stimulate milk production (correct)

To treat heart arrhythmias

To inhibit dopamine receptors

To improve gastric motility and decrease nausea

What is the mechanism of action of domperidone in stimulating milk production?

It blocks the effect of dopamine on prolactin-producing cells (correct)

It inhibits the release of prolactin

It stimulates the release of oxytocin

It directly activates mammary glands

What is the recommended duration for a domperidone prescription to see maximal effect on milk production?

1-2 weeks

3-5 days

6-8 weeks

2-3 weeks (correct)

What is a significant concern related to the metabolism of domperidone?

It is metabolized by CYP3A4 Signup and view all the answers

What is a significant adverse effect of domperidone?

Tremors Signup and view all the answers

What is the primary purpose of ergonovine maleate?

To treat postpartum hemorrhage Signup and view all the answers

What are the side effects of ergonovine?

Tachycardia Signup and view all the answers

What is the primary advantage of misoprostol?

Treats postpartum hemorrhage Signup and view all the answers

What are the adverse effects of misoprostol?

Shivering and fever Signup and view all the answers

What is the primary concern related to the metabolism of domperidone?

Metabolism by CYP3A4 Signup and view all the answers

What is a potential side effect of domperidone in infants?

Dystonia Signup and view all the answers

What is the effect of domperidone on lactation?

Side effect Signup and view all the answers

Which drug class is not mentioned in the agenda for the final exam?

Antibiotics Signup and view all the answers

What is the date of the final exam?

December 11th Signup and view all the answers

What is the recommended writing location for the final exam?

MDCL 2232 and 3019 Signup and view all the answers

What is the approximate point value of the final exam?

135 points Signup and view all the answers

What is the primary concern with the use of domperidone?

Potential for QT interval prolongation and ventricular tachyarrhythmia Signup and view all the answers

What is the recommended duration for a domperidone prescription to see maximal effect on milk production?

3-8 weeks Signup and view all the answers

What is a potential side effect of domperidone in infants?

Dystonia Signup and view all the answers

What is the primary purpose of ergonovine maleate?

To prevent postpartum hemorrhage Signup and view all the answers

What is a significant adverse effect of domperidone?

Tachycardia Signup and view all the answers

What is the primary advantage of misoprostol?

Low cost Signup and view all the answers

What is a significant concern related to the metabolism of domperidone?

Extensive first-pass metabolism Signup and view all the answers

What is the effect of domperidone on lactation?

It enhances prolactin secretion Signup and view all the answers

What is a significant adverse effect of misoprostol?

Shivering and fever Signup and view all the answers

What is a significant concern related to the use of ergonovine?

Contraindicated in pregnancy Signup and view all the answers

What is a potential side effect of ergonovine?

Hypertension Signup and view all the answers

What is the primary concern related to the metabolism of misoprostol?

Rapid excretion leading to subtherapeutic levels Signup and view all the answers

What is the primary focus of the final exam agenda?

Labor and delivery medications Signup and view all the answers

What is the approximate point value of the final exam?

135 points Signup and view all the answers

What is the recommended format for the final exam questions?

MCQ, T/F, Short answer Signup and view all the answers

What is the primary purpose of the drug Tranexamic Acid mentioned in the agenda?

To manage postpartum hemorrhage Signup and view all the answers

What is a potential side effect of ergonovine?

Headache Signup and view all the answers

What is the primary advantage of misoprostol?

Low cost Signup and view all the answers

What is a significant adverse effect of domperidone?

Ventricular tachyarrhythmia Signup and view all the answers

What is the primary concern related to the metabolism of domperidone?

Extensive first-pass metabolism Signup and view all the answers

What is the primary purpose of domperidone?

To improve gastric motility and decrease nausea Signup and view all the answers

What is a significant concern related to the use of ergonovine?

Hypertension Signup and view all the answers

What is the recommended duration for a domperidone prescription to see maximal effect on milk production?

2-3 weeks Signup and view all the answers

What is the effect of domperidone on lactation?

It increases milk production Signup and view all the answers

What is the mechanism of action of domperidone in stimulating milk production?

Blocks the effect of dopamine on prolactin-producing cells Signup and view all the answers

What is a significant concern related to the metabolism of misoprostol?

Low bioavailability Signup and view all the answers

What is the primary purpose of ergonovine maleate?

To stimulate uterine contractions Signup and view all the answers

What is a potential side effect of domperidone in infants?

Vomiting Signup and view all the answers

What is the approximate point value of the final exam?

135 points Signup and view all the answers

When is the final exam scheduled to take place?

December 11th Signup and view all the answers

What will be the primary exam format for the final?

Multiple Choice Questions Signup and view all the answers

What percentage of the final exam content will come from material covered since Test #2?

50% Signup and view all the answers

What is the primary concern with the use of domperidone?

Potential risk of heart arrhythmias Signup and view all the answers

What is a significant adverse effect of misoprostol?

Hypertension Signup and view all the answers

What is the primary advantage of ergonovine maleate?

Low cost Signup and view all the answers

What is the recommended duration for a domperidone prescription to see maximal effect on milk production?

3-8 weeks Signup and view all the answers

What is a potential side effect of ergonovine?

Nausea and vomiting Signup and view all the answers

What is the primary purpose of misoprostol?

To prevent postpartum hemorrhage Signup and view all the answers

What is the effect of domperidone on lactation?

It enhances milk production Signup and view all the answers

What is the primary concern related to the metabolism of misoprostol?

Extensive first-pass metabolism Signup and view all the answers

What is a potential side effect of domperidone in infants?

Dystonia Signup and view all the answers

What is the approximate point value of the final exam?

Not mentioned in the provided text Signup and view all the answers

What is the recommended writing location for the final exam?

Not mentioned in the provided text Signup and view all the answers

What is the primary purpose of ergonovine maleate?

To prevent postpartum hemorrhage Signup and view all the answers

What is the approximate point value of the final exam?

135 points Signup and view all the answers

What is the primary focus of the final exam agenda?

Oxytocics for PPH Signup and view all the answers

When is the final exam scheduled to take place?

December 11th from 0900-1200 Signup and view all the answers

What is the recommended writing location for the final exam?

MDCL 2232 and 3019 Signup and view all the answers

What is the primary mechanism of action of domperidone in stimulating milk production?

Blocking the effect of dopamine on prolactin-producing cells Signup and view all the answers

What is a significant concern about the use of domperidone?

Potential adverse effects on heart arrhythmias Signup and view all the answers

What is a significant adverse effect of misoprostol?

Shivering and fever Signup and view all the answers

What is a potential side effect of ergonovine?

Nausea and vomiting Signup and view all the answers

What is the recommended duration for a domperidone prescription to see maximal effect on milk production?

At least 3 weeks Signup and view all the answers

What is the primary advantage of misoprostol?

Low cost and long shelf life Signup and view all the answers

What is a potential side effect of domperidone in infants?

Dystonia Signup and view all the answers

What is a significant concern related to the metabolism of misoprostol?

Rapid first-pass metabolism Signup and view all the answers

What is the primary purpose of ergonovine maleate?

Preventing postpartum hemorrhage Signup and view all the answers

What is the approximate bioavailability of domperidone when taken orally?

13% to 17% Signup and view all the answers

What is a significant concern related to the use of ergonovine?

Contraindicated in pregnancy Signup and view all the answers

What is a significant adverse effect of domperidone?

Ventricular tachyarrhythmia Signup and view all the answers

What is the primary mechanism of action of domperidone in increasing milk production?

Increasing the secretion of prolactin in the pituitary gland Signup and view all the answers

What is the primary reason for not giving domperidone to patients with hepatic impairment?

Potential overdose due to extensive liver metabolism Signup and view all the answers

Which hormone is responsible for causing lactotrophic cells to produce and release prolactin?

Prolactin-releasing hormone (PRH) Signup and view all the answers

What is the approximate oral bioavailability of domperidone?

13% to 17% Signup and view all the answers

What is a known adverse effect of domperidone?

Prolongation of the corrected QT (QTc) interval Signup and view all the answers

Which drug interaction is likely to increase circulating levels of domperidone?

Erythromycin Signup and view all the answers

How does topically applied ketoconazole affect the likelihood of adverse effects or drug interactions with other drugs?

Unlikely to cause side effects or have interactions with other drugs Signup and view all the answers

What is a known adverse effect of domperidone related to heart rhythm?

Prolongation of the corrected QT (QTc) interval Signup and view all the answers

Which drug is mentioned as a strong inhibitor of CYP3A4, potentially increasing circulating levels of domperidone?

Erythromycin Signup and view all the answers

What is the reported absorption of topically applied ketoconazole into the bloodstream?

Not appearing in measurable quantities Signup and view all the answers

What is the primary mechanism of action of domperidone in stimulating milk production?

It inhibits the lactotrophic cells by binding to their D2 receptors Signup and view all the answers

What is a significant concern related to the use of domperidone?

It may cause direct stimulation of mammary glands leading to overproduction of milk Signup and view all the answers

What is the approximate oral bioavailability of domperidone?

10% to 15% Signup and view all the answers

What is the primary reason for not giving domperidone to patients with hepatic impairment?

It may lead to overdose due to extensive liver metabolism Signup and view all the answers

What is the primary mechanism of action of domperidone in increasing milk production?

Blocking dopamine receptors to increase prolactin production Signup and view all the answers

What is the primary reason why patients with hepatic impairment should not be given domperidone?

Extensive liver metabolism leading to overdose risk Signup and view all the answers

What is the primary function of prolactin-inhibiting hormone (PIH, dopamine) in the lactotrophic cells?

Inhibiting the lactotrophic cells by binding to their D2 receptors Signup and view all the answers

What is the primary function of prolactin-releasing hormone (PRH) in the lactotrophic cells?

Causing the lactotrophic cells to produce and release prolactin Signup and view all the answers

What is a significant concern related to the use of domperidone?

Effect on heart rhythm Signup and view all the answers

Which drug is mentioned as a strong inhibitor of CYP3A4, potentially increasing circulating levels of domperidone?

Erythromycin Signup and view all the answers

How does topically applied ketoconazole affect the likelihood of adverse effects or drug interactions with other drugs?

It has no impact on adverse effects or drug interactions Signup and view all the answers

What is the effect of domperidone on heart rhythm?

It causes prolongation of the corrected QT (QTc) interval Signup and view all the answers

Which drug interaction is likely to increase circulating levels of domperidone?

Erythromycin Signup and view all the answers

What is the reported absorption of topically applied ketoconazole into the bloodstream?

Not appearing in the blood in measurable quantities Signup and view all the answers

What is the primary mechanism of action of domperidone in increasing milk production?

Blocking dopamine receptors to increase prolactin production Signup and view all the answers

What is the approximate oral bioavailability of domperidone?

13% to 17% Signup and view all the answers

What is the primary concern with the use of domperidone in patients with hepatic impairment?

Extensive liver metabolism leading to overdose Signup and view all the answers

What is the primary function of prolactin-inhibiting hormone (PIH, dopamine) in lactotrophic cells?

Inhibits lactotrophic cells by binding to their D2 receptors Signup and view all the answers

What is a potential adverse effect of domperidone?

Prolongation of the QT interval Signup and view all the answers

Which drug is likely to increase circulating levels of domperidone?

Erythromycin Signup and view all the answers

What is the reported absorption of topically applied ketoconazole into the bloodstream?

Less than 3% Signup and view all the answers

What is the primary mechanism of action of domperidone in increasing milk production?

Blocking the action of dopamine Signup and view all the answers

What is the primary concern related to the metabolism of domperidone?

Potential overdose in patients with hepatic impairment Signup and view all the answers

What is the primary function of prolactin-releasing hormone (PRH) in the lactotrophic cells?

Causing the lactotrophic cells to produce and release prolactin Signup and view all the answers

What is a potential side effect of domperidone in infants?

Cardiac arrhythmias Signup and view all the answers

What is the primary cause of normal contractions of the uterus?

Activation of myosin light-chain kinase by a calcium-calmodulin complex Signup and view all the answers

What is the role of tocolysis in the peripartum period?

Inhibiting preterm labour and uterine hypertonus Signup and view all the answers

What is the mechanism of smooth muscle contraction in the myometrium at term?

Activation of myosin light-chain kinase by a calcium-calmodulin complex Signup and view all the answers

Which agents are responsible for causing uterine contractions prior to birth and acting as antihemorrhagics after birth?

Prostaglandins and oxytocin Signup and view all the answers

What is the primary mechanism by which inhibition of smooth muscle contraction is achieved?

Phosphorylation of MLCK by PKA Signup and view all the answers

What results from the cleavage of phosphatidylinositol 4,5-bisphosphate (PIP 2 )?

Inositol triphosphate (IP 3 ) and diacylglycerol (DAG) Signup and view all the answers

What is the role of inositol triphosphate (IP 3 ) in smooth muscle contraction?

Binds to and allows calcium release from the sarcoplasmic reticulum Signup and view all the answers

What is the effect of decreased cytoplasmic cyclic adenosine monophosphate (cAMP) on smooth muscle contraction?

Leaves more calcium in the cytoplasm to stimulate contractions Signup and view all the answers

What is the primary mechanism by which extracellular calcium can enter smooth muscle cells?

Opening of voltage-sensitive calcium channels Signup and view all the answers

What is the consequence of stimulation of the oxytocin receptor and EP1 receptor?

Increased intracellular IP 3 and DAG Signup and view all the answers

What is the role of phospholipase C (PLC) in smooth muscle contraction?

Facilitates the cleavage of PIP 2 Signup and view all the answers

What is the consequence of decreased cytoplasmic cyclic adenosine monophosphate (cAMP) on the activity of PKA?

Reduces activation of phosphokinase A (PKA) Signup and view all the answers

Which drug can be used for tocolysis in preterm labor?

Magnesium sulphate Signup and view all the answers

What is the primary effect of tocolysis for preterm labor on perinatal outcomes?

Little or no effect Signup and view all the answers

Which of the following is not a clinically used tocolytic agent?

Paracetamol Signup and view all the answers

Which of the following is a clinically used tocolytic agent?

Nitric oxide donors Signup and view all the answers

What is the primary effect of tocolysis for preterm labor on perinatal outcomes?

Little or no effect on perinatal outcomes Signup and view all the answers

Which of the following agents is responsible for causing uterine contractions prior to birth and acting as antihemorrhagics after birth?

Oxytocin Signup and view all the answers

What is the primary purpose of tocolytics in preterm labor?

Relief of uterine hypertonus Signup and view all the answers

Which of the following is a clinically used tocolytic agent?

Adrenergic receptor agonists Signup and view all the answers

What is the effect of tocolysis for preterm labor on perinatal outcomes?

Has little or no effect on perinatal outcomes Signup and view all the answers

Which of the following is a clinically used tocolytic agent?

Oxytocin receptor antagonists Signup and view all the answers

What is the primary effect of tocolysis for preterm labour on perinatal outcomes?

Little or no effect Signup and view all the answers

What is the primary purpose of tocolytics in preterm labor?

Relief of uterine hypertonus Signup and view all the answers

Study Notes

Domperidone

Primarily used to stimulate milk production in lactating women
Mechanism of action: increases prolactin levels by blocking dopamine receptors in the pituitary gland
Recommended duration for maximal effect on milk production: 3-4 weeks
Significant concern: potential cardiac arrhythmias and QT prolongation in infants
Metabolism concern: oral bioavailability is low (approximately 15-20%) due to extensive first-pass metabolism
Adverse effect: cardiac arrhythmias and QT prolongation in infants

Ergonovine Maleate

Primary purpose: to reduce uterine bleeding and cramping after childbirth
Side effects: hypertension, nausea, vomiting, and allergic reactions
Concern: can cause hypertension in pregnant women

Misoprostol

Primary purpose: to prevent gastric ulcers and promote wound healing
Adverse effect: diarrhea, abdominal pain, and miscarriage
Advantage: inexpensive and effective in preventing gastric ulcers

Final Exam

Date: not specified
Format: not specified
Point value: approximately 100 points
Content: material covered since Test #2 (percentage not specified)
Writing location: not specified

Studying That Suits You

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Description

Test your knowledge of galactagogues, oxytocics, and tocolytics for labor and postpartum hemorrhage with this quiz. Covering readings from chapters 28 and 29 in Pharmacology Revealed by Dr. E. Cates, Fall 2023, this quiz includes essential information for understanding these pharmacological agents.