Log book pharmacology: Obs & Gyne

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Obstetric drugs

Abortions- mifepristone then Misoprostol

  • Dose: 200mg PO then 24hrs later 800mcg PV
  • MOA: high affinity for the progesterone receptor and thus inhibits the action of endogenous progesterone, which is essential for the maintenance of pregnancy.
  • SEs: PV bleeding, cramps, diarrhoea
  • Effectiveness: if given in combo 95% effective

Labour induction - Oxytocin (syntocin) by slow IV infusion

Prevention of PP heamhorrage - Ergometrine and Oxytocin IM

Prevention of premature labour - Atosiban oxytocin receptor antagonist, inhibition of uncomplicated premature labour between 24 and 33 weeks

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Obstetric Drugs

  • Uses of drugs in obstetrics
  • effectiveness and regime for medical termination
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Emergency contraception

Morning after pill - levonorgestrel

  • Dose: 1.5 mg as a single dose ASAP max 72hours
  • MOA: inhibits ovulation
  • SEs: menstrual cycle disruption
  • Efficacy: 0-24hrs - 95%, 24-48hrs 85%, 48-72hrs 60%

Copper implant - intrauterine device

  • MOA: prevent implantation of fertilised egg.
  • SEs: pain & bleeding on insertion, mentrual cycle disruption, lower abdominal cramps perforation, displacement, expulsion; pelvic infection,
  • Efficacy: more effective than the morning after pill, can be implanted up to 5 days after sex
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Emergency contraception

  • 2 basic types of emergency contraception
  • name effectiveness
  • name pro's and cons
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Vulval & Vaginal Infections

Fungal Infections - clotrimazole

  • Most commonly candidisis
  • Dose: 500 mg pessary, single dose

Bacterial infections - metronidazole (clindamyacin)

  • Baterial vaginosis & trichomoniasis: 2g single dose PO metronidazole
  • Bacteroides fragillis: metronidazole PO 800mg initially then 400mg every 8 hours

Viral infections - aciclovir

  • mainly HSV type 2
  • used to reduce blistering and length of attack
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Vulval & Vaginal infections

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