Pharmacology of Tocolysis and Pregnancy

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Questions and Answers

What is the primary function of progesterone in pregnancy?

To reduce maternal cardiovascular risks

To induce preterm labor

To stimulate uterine contractions

To promote uterine relaxation and suppress contractions (correct)

What is the name of the type of drugs used for tocolysis that also affects maternal cardiovascular and metabolic physiology?

Beta-adrenergic agonists (correct)

Calcium channel blockers

Prostaglandin synthetase inhibitors

Magnesium sulfate

What is the term used to describe the prevention of the immune system's attack on the fetus during pregnancy?

Maternal immune response

Gestational immune tolerance (correct)

Fetal immune system

Pregnancy immunology

What is the benefit of periodontal treatment during pregnancy?

Reducing the risk of preterm labor Signup and view all the answers

What is the name of the organ that produces progesterone during pregnancy?

Corpus luteum Signup and view all the answers

What is the name of the type of drug that inhibits the production of prostaglandins?

Prostaglandin synthetase inhibitors Signup and view all the answers

Why is there no clear choice for a tocolytic?

Because of the varying presentations of labor Signup and view all the answers

What is the term used to describe the administration of a drug to prevent preterm labor?

Tocolysis Signup and view all the answers

What is a common side effect of beta-adrenergic agonists?

Hypotension Signup and view all the answers

What is the primary use of magnesium sulfate in obstetrics?

Treatment of preeclampsia Signup and view all the answers

What is the effect of progesterone on preterm labor?

It reduces the risk of preterm birth Signup and view all the answers

What is the recommended loading dose of magnesium sulfate?

4-6 g IV Signup and view all the answers

What is the mechanism by which progesterone may be effective in reducing preterm birth?

Immune suppression Signup and view all the answers

What is a potential benefit of using magnesium sulfate over beta-adrenergic agonists?

Fewer side effects Signup and view all the answers

What is a common indication for the use of tocolytic drugs?

Preterm labor Signup and view all the answers

What is the maintenance dose of magnesium sulfate after the loading dose?

1-4 g/hr Signup and view all the answers

What is the mechanism of action of nifedipine in the treatment of PTL?

Arterial vasodilation Signup and view all the answers

What is a common side effect of nifedipine administration?

Headache Signup and view all the answers

What is a contraindication for the use of nifedipine in pregnant women?

Multiple pregnancy Signup and view all the answers

What is a potential benefit of coadministering nifedipine and terbutaline or ritodrine?

Improved treatment of PTL Signup and view all the answers

What is a potential risk of coadministering magnesium sulfate and nifedipine?

Maternal cardiovascular collapse Signup and view all the answers

What is a nursing diagnosis that may apply to the woman with PTL?

Readiness for Enhanced Knowledge related to PTL Signup and view all the answers

What is the comparative effectiveness of nifedipine in the treatment of PTL?

As effective as beta-adrenergic drugs Signup and view all the answers

What is a potential risk factor for the development of PTL?

All of the above Signup and view all the answers

Study Notes

Tocolysis and Pregnancy

Tocolysis is used to delay preterm birth, which can lead to low birth weight infants, gum disease, and other complications.
Current tocolytic drugs include beta-adrenergic agonists (β-mimetics), magnesium sulfate, calcium channel blockers (nifedipine), and prostaglandin synthetase inhibitors.

Progesterone and Pregnancy

Progesterone has been investigated for its ability to improve pregnancy outcomes since the 1950s.
Progesterone promotes uterine relaxation, suppresses contractions, and prevents gestational immune tolerance.
It is essential for maintaining early pregnancy and is produced by the corpus luteum and the placenta.

Nifedipine and β-Mimetics

Nifedipine is well absorbed orally or sublingually, has fewer side effects, and is at least as effective as comparative agents.
Common side effects of nifedipine include hypotension, tachycardia, facial flushing, and headache due to arterial vasodilation.
β-Mimetics can significantly affect maternal cardiovascular and metabolic physiology.
Co-administration of nifedipine and terbutaline or ritodrine may be beneficial in treating PTL.

Contraindications and Precautions

Nifedipine is contraindicated in women with heart disease, cardiovascular compromise, intrauterine infection, multiple pregnancy, and maternal hypertension.
Co-administration of magnesium sulfate and nifedipine has been implicated in serious maternal side effects.

Nursing Diagnoses and Plan

Nursing diagnoses for PTL may include readiness for enhanced knowledge, fear, ineffective coping, and anxiety related to preterm birth.
The nursing plan should address these diagnoses by providing education, support, and close monitoring of the woman during pregnancy.

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Description

This quiz covers the use of various medications, including beta-adrenergic agonists and magnesium sulfate, to prevent preterm birth and reduce pregnancy complications.