文稿chf-du20151.等多个文件drugs affecting uterine smooth muscles.pptxVIP

Drugs Affecting Uterine Smooth Muscles;DRUGS PRODUCING UTERINE CONTRACTIONS( Oxytocic Drugs ) ;OXYTOCIN (缩宫素)(SyntocinonR);Pharmacokinetics of oxytocin;Role of oxytocin;Oxytocin causes contraction of the fundus only.; Immature uterus is resistant to oxytocin. Causes the contraction of at-term uterine smooth muscles only. Sensitivity increases to 8 fold in the last 9 weeks and 30 times in early labor. In clinic, oxytocin is given when uterine cervix is soft and dilated. ; before labor ?the cervix is closed Oxytocin isn’t used at this stage;Mechanism of action;Therapeutic Uses of Oxytocin 1. Induction augmentation of labour (only slow IV drip) low dosage: 2~5 U oxytocin ! 2. Postpartum uterine hemorrhage large dosage: 5-10 U to induce tetanic contraction of uterine subcutaneous or intramuscular injection 3. Impaired milk ejection One puff in each nostril 2-3 min before nursing;Side effect:;Multiple pregnancy;Cephalopelvic disproportion(头盆不称）;malposition; Effects on the Uterus Ergometrine contracts urerus more powerfully than oxytocin; therefore induce TETANIC CONTRACTION of uterus without relaxation (unlike the normal physiologic contractions) It causes contractions of the whole uterus including fundus and cervix (tends to compress rather than expelling the fetus) Not used for labor augmentation. ;Sites of ergot contraction ;Ergot alkaloids (pharmacokinetics);Clinical uses;Contraindications: Induction of labour 1st and 2nd stage of labor vascular disease Severe hepatic and renal impairment Severe hypertension ; PROSTAGLANDINS (PGE2 PGF2α) Therapeutic uses 1. Induction of abortion (pathological)** ( because the uterus is sensitive to PGs in early stages). 2. Induction of labour (fetal death in uterus) 3. Postpartum hemorrhage;Difference B/W Oxytocin and Prostaglandins;Difference b/w Oxytocin and Ergometrine; UTERINE RELAXANTS (Tocolytic Drugs);DRUGS PRODUCING UTERINE RELAXATION (Tocolytic