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    Week 11 - 12 ANTIANGINAL DRUGS - Drugs Used in Obstetric

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    Rahaf Ali

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    Week 11 - 12 ANTIANGINAL DRUGS - Drugs Used in Obstetric

    Uploaded by

    Rahaf Ali
    5 views12 pages

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    Week 11_12 ANTIANGINAL DRUGS _ Drugs Used in Obstetric(1)

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    5 views12 pages

    Week 11 - 12 ANTIANGINAL DRUGS - Drugs Used in Obstetric

    Uploaded by

    Rahaf Ali

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 12

    ANTIANGINAL DRUGS

    Drugs used in obstetric

    Assistant Professor

    DR.FAZIL AHMAD
    [email protected]

    1
    Angina Pectoris (Chest Pain)
    üAngina pectoris is the result of myocardial ischemia caused by an
    imbalance between myocardial blood supply and oxygen demand
    üThis usually happens because one or more of the heart's arteries
    is narrowed or blocked, also called ischemia

    2
    Types of Angina
    1.Chronic stable angina (also called classic or effort angina)
    ü Occurs when your heart is working hard
    ü Serious heart disease,need angioplasty or coronary bypass surgery
    2.Unstable angina(also called preinfarction angina)
    ü Which is new chest pain or chest pain that is getting worse
    ü Requires emergency treatment
    3.Vasospastic angina(also called Prinzmetal’s or variant angina)
    ü Rare type of angina caused by a spasm in the coronary arteries
    ü Cardiac chest pain at rest that occurs in cycles
    ü Treated by drug therapy

    CLASSIFICATION OF ANTIANGINAL
    DRUGS
    1.Nitrates: Nitroglycerin, Isosorbide dinitrate
    2.Beta blockers: Atenolol,Propranolol
    3.Calcium channel blockers:
    Verapamil,Diltiazem,Nifedipine 3
    1.Nitrates
    ü Cause vasodilation due to relaxation of smooth muscles
    MOA:
    ØNitrates →nitrite ions → nitric oxide (NO) → activates guanylyl-cyclase
    → ↑cGMP(smooth muscles) → ↑ dephosphorylation(myosin light chain), →
    relaxation of smooth muscle
    Used
    üLong-term prophylaxis of angina
    Side Effects
    üTachycardia, postural hypotension

    4
    2.Beta Blockers
    Mechanism of Action
    • Blockade of b1-adrenoreceptors of heart: decreasing of power and frequency
    of heart contractions, decrease demand,Decrease the HR,
    Therapeutic Uses
    Antianginal, Antihypertensive
    Side Effects
    Cardiovascular bradycardia, hypotension
    Metabolic Altered glucose and lipid
    metabolism

    3.Calcium Channel Blockers


    Mechanism of Action
    • Cause peripheral arterial vasodilation,Reduce myocardial contractility
    Therapeutic Uses
    üFirst-line agents for treatment of angina, hypertension, and
    supraventricular tachycardia
    Side Effects
    üMay cause hypotension, palpitations 5
    Mechanism of Action Calcium Channel Blockers

    6
    Drugs used in obstetric

    DR.FAZIL AHMAD
    Assistant Professor
    [email protected]

    7
    Drugs in Pregnancy
    FIRST TRIMESTER :congenital malformations(teratogenesis)

    SECOND & THIRD TRIMESTER :affect growth & fetal


    development or toxic effects on fetal tissues
    NEAR TERM :adverse effects on Labour or neonate after
    delivery

    8
    Pregnancy Categories
    Category Risk
    The safest drugs to take during pregnancy.
    eg- Antibiotics(penicillin, Ampicillin, Amoxicillin, Cloxacillin,
    Category A
    Erythromycin Stearatecephalosporin) Vitamin And Mineral Thyroxin
    and Humanized Insulin
    No risks have been found in humans. Metronidazole, Tinidazole,
    Category B
    Azithromycin,nystatin, Paracetamol, Ranitidine, Ritodrine

    Not enough research has been done to determine if these drugs are
    Category C safe. Trimethoprim, Anti Tuberculosis Drugs, Norfloxacin, Ciprofloxcin,
    lfloxacin, Aminophylline, Quinine, Acyclovir

    Adverse reactions have been found in humans.


    Category D Tetracycline's, streptomycin, kanamycin,phenytoin,
    phenobarbitone,valproicacid, alprazolam,chlordiazepoxide
    Should never be used by a pregnant woman.
    Category X Androgens,clomiphene,diethylstilboestrol,oestrogens,antimalignancy
    Drugs, Heroin,opium,lysergic Acid Diethylamide
    9
    Mechanism of myometrium contractions
    • Myometrium has alpha and beta adrenoreceptors
    • Stimulation of alpha-receptors causes uterus contraction
    • Stimulation of beta-receptors causes uterus relaxation

    OXYTOCIN
    Uterotonics-oxcyticin
    üCommon medication used to achieve uterine contraction
    üFirst-line agent to prevent and treat Post partum hemorrhage
    üLarge doses- sustained contraction(↓ placental blood flow & fetal
    hypoxia/death)
    10
    MAGNESIUM SULPHATE
    Clinical use: First line for Prevention & treatment of seizure
    in eclampsia
    Side effects:, Hypotension, Respiratory Depression,
    Eclampsia: convulsions occur
    in a pregnant woman suffering
    from high blood pressure

    METHYLDOPA
    Uses: Mild /Moderate Hypertension
    Side effects: Headache,dizziness,dry mouth ,
    ØACE inhibitors are contraindicated in pregnancy

    TRANEXAMIC ACID
    - Uses:Antifibrinolytic,reduces bleeding by 50%
    - Side effects: nausea,vomiting,diarrhoea, thrombo embolic event

    11
    MIFEPRISTONE
    Clinical use: Medical termination of pregnancy, Medical management of
    miscarriage
    Side effects: Gastro intestinal cramps, rash,
    Contraindication: severe asthma
    METHOTREXATE
    Cinical use: Medical management of ectopic pregnancy
    Side effects:Nausea and Indigestion.

    MEFENAMIC ACID
    - Uses:Menorrhagia / dysmenorrhea
    - Side effects: Gastro-intestinal discomfort nausea, diarrhoea,
    bleeding/ulceration

    PROGESTERONE
    Usage : contraception , severe menorrhagia , dysmenorrhoea ,
    Side effects :Fluid retention,Dizziness.Depressed mood.
    12

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