Sunday, March 10, 2019

LMR(Last minute revision) Stuff

Hello Awesomites!

In LMR sessions, I will share final year MBBS Viva things on drugs and specimen.You can add your list in the comments below. 
Today I will share the Obstetric and gynaecology viva on drugs. 
Lets get started.

1.Tranexamic acid and mefanemic acid combination

Tranexamic acid:
  • anti-fibrinolytic
  • Amino caproic acid derivative 
  • CONVERTS plasmin to plasminogen
  • given during menstruation
  • Adverse effect:- Intracranial thrombosis

Mefanemic Acid:
  • COX inhibitor.
  • Given during menstruation
  • Adverse effect:- dyspepsia,gastric ulcer
USE:-
  • Ovulatory cycles of DUB
  • Post IUCD bleeding
  • Post sterilization mennorhagia
  • Fibroid
2.Doxylamine and Vitamin B6 combination

Doxylamine is anti histaminics that has effects on acetylcholine and serotonin release. And you know their receptor is present on CTZ centers.
Vitamin B6 is pyridoxine.
In pregnancy and poor diet the amount decreases.

USE:- Emesis during pregnancy at bedtime (not more than 2 tablet in a day).

3.Dinoprostone gel
  • Prostaglandin E2
  • 500 micro gram into the cervical canal below the level of internal os
  • Or 1-2 mg in the posterior fornix 
  • maximum 3 doses 6 hourly
  • Applied in posterior fornix when membrane is ruptured
  • applied in internal os when membrane is intact
  • USE- Cervical ripening in IOL.
  • Before and after CTG monitoring is must.
  • C/I- Previous CS, Impending scar rupture,fetal distress,asthma,severe heart disease
S/E- hyperstimulation of uterus,fetal distress

4.L-Arginine+Folic acid+isothiocyanidin
  • L-Arginine is precursor for Nitric oxide generation that will lead to vasodialtion
  • USE: In IUGR, Severe oligohydroamnios, preventing pre-eclampsia
5.Misoprostol

  • PGE1
  • ROUTE= sublingual,vaginal,rectal (never parentral)
  • S/E:Fever,chills,shivering
  • Teratogenic: Mobius syndrome (Category X drug)
  • USES:-
  1. OBSTETRIC USES:
  • Termination of pregnancy
  • PPH prevention and treatment.
     2.GYNECOLOGICAL USE:
  • Pe hysterectomy
  • IUI
  • Cervical pregnancy
    3.GIT USE:
  • Treatment of peptic ulcer caused by NSAIDs.
6.Frusemide:
  • Loop diuretic.
  • prior to blood transfusion in severe anemia
  • congestive cardiac failure
  • used in complications not as anti hypertensives
  • PIH with massive edema
7.Clindamycin+Clotrimazole 
  • USE: Mixed bacterial and fungal vaginosis 
8.Omeprazole+Ondansetron:
  • USE: GERD, peptic ulcer
9.Heparin:
  • Injectable Anti-coagulant
  • In 1st trimester
  • Antidote: Protamine sulfate
  • USE: DVT, APLA, PE, recurrent abortion (Prophylaxis:ASPIRIN+HEPARIN)
10.Iron folic acid:
  • Prophylactic: 100mg elemental iron+500 micro gram folic acid daily from 2nd trimester throughout pregnancy +6 month postpartum
  • Treatment: Oral  iron 200 mg elemental iron daily
  • Folic acid deficiency lead to abortions, abruptio, IUGR, NTD
  • In folic acid deficiency dose is 4000mg
11.Anti-D Immunoglobulin:
  • IgG, intramuscular
  • 300 micro gram=15 ml of D positive red cell/ 30 ml of fetal whole blood 
  • If ICT -VE at 28 weeks
12.Hydrocortisone:
  • 2 doses 12 mg betamethasone i/m 24 hours apart
  • 4 doses 6 mg dexamethasone 12 hours apart
13.Sodium Bicarbonate:
  • IV for Heart resuscitation, poor kidney function, Cocaine toxicity
  • Poisoning cases
  • Reviving newborn
  • Preventing chemotherapy side effects
  • Hyperkalemia
  • metabolic acidosis
14.Diazepam:
  • Central Muscle relaxant and anti convulsant, Tranquilizer
  • S/E:- Maternal (Hypotension) and Fetal (Respiratory depression, hypotonia)
15.Nifedipine:
  • Direct arteriolar vasodilator
  • Calcium channel blocker
  • USE:Tocolytics
  • A/E: Flushing, Hypotension, headache, Inhibition of labor
16.Labetalol:
  • Anti-hypertensive
  • combined alpha and beta blocker
  • orally 100mg tid to 2.4 g daily
  • USE: Hypertension and hypertensive crisis
  • S/E:tremor, headache, CCF.
  • C/I: Hepatic disorder, asthma, CCF
17.Magnesium Sulphate:
  • Anti-spasmodic (PDE-4 Inhibitor)
  • Enhance cervical dilatation during childbirth
  • USE: Acute renal colicky, augment labor.
19.Oxytocin:

20.Methergine:

21.Prostaglandins:


More is coming up !
-Upasana Y. :)

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