Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Drugs in Obstetrics & Gynecology
Ashok Kumar, Krishna Agarwal, Sudha Prasad
SECTION I: PRINCIPLES OF DRUG THERAPY
CHAPTER 1:
Rational Drug Therapy
INTRODUCTION
Definition
Epidemiology
Magnitude of Irrational Drug Use
Impact on Morbidities, Mortality, Economic Burden and Hospital Stay
Common Forms of Irrationality in Drug Use
The Antimicrobials
Analgesics
Supplements
Hormones
Drugs Used in Pre-eclampsia and Eclampsia
Drugs During Labor
Antenatal Steroids
Drugs Used for Ovulation-induction
Measures for Promoting Rational Drug Use
Defining Patient's Problem
Defining Effective and Safe Treatment (Drugs and Nondrugs)
Selecting Appropriate Drug(s), Dose and Duration
Writing the Prescription
Providing Adequate Information to the Patient
Planning for Evaluation of Treatment Response
Regulatory Body for Promotion of Rational Use
Central Drug Standard Control Organization (CDSCO)
Pharmacovigilance
SECTION II: EMERGENCY DRUGS
CHAPTER 2:
Drugs Used in Medical Emergencies
INTRODUCTION
Drugs Used in Shock
Adrenaline (Epinephrine)
Noradrenaline (Norepinephrine)
Dopamine
Dobutamine
Drugs Used in Treatment of Convulsions
Diazepam
Phenytoin
Midazolam
Drugs Used is Electrolyte Imbalance
Potassium Chloride
Sodium Bicarbonate
Drugs Used in Hypocalcemia
Calcium Gluconate
Drug Used in Bradycardia
Atropine
Drugs Used in Anaphylactic Shock
Hydrocortisone Sodium Succinate
Chlorpheniramine Maleate and Pheniramine Maleate
SECTION III: ANTIMICROBIALS USED IN DIFFERENT CLINICAL CONDITIONS
CHAPTER 3:
Antibiotic Classification
CHAPTER 4:
Antibiotic Prophylaxis in Obstetrics and Gynecology
INTRODUCTION
Principles of Antibiotic Prophylaxis
Use of Antibiotic Prophylaxis in Obstetrics
Cesarean Section
Cefazolin
Clindamycin
Erythromycin
Cefoxitine
Use of Antibiotic Prophylaxis in Gynecological Surgeries
Hysterectomy
Surgical Abortion (Induced and Therapeutic Abortion)
CHAPTER 5:
Preterm Premature Rupture of Membranes and Chorioamnionitis
INTRODUCTION
WHAT STUDIES HAVE TO SAY?
ANTIBIOTIC TREATMENT IN PPROM AND CHORIOAMNIONITIS
CHAPTER 6:
Puerperal Infection
CHAPTER 7:
Human Immunodeficiency Virus During Pregnancy
INTRODUCTION
DRUGS FOR HIV POSITIVE PREGNANT WOMEN
Co-trimoxazole in Pregnancy
Tenofovir Disoproxil Fumarate4
Lamivudine (3TC)5
Efavirenz (EFV)6
Zidovudine (AZT)7
Nevirapine (NVP)8
Ritonavir (RTV)9
CHAPTER 8:
Pelvic Inflammatory Disease
TREATMENT FOR PELVIC INFLAMMATORY DISEASE
CHAPTER 9:
Vaginitis/Vulvitis
VAGINAL DISCHARGE
Bacterial Vaginosis
Alternative Regimen1,3
Follow-up
Management of Sexual Partner
Bacterial Vaginosis in Pregnancy
Candidiasis1,3
Classification of Vulvovaginal Candidiasis
Recommended Regimens: Uncomplicated (CDC 2015)3
Complicated Candidiasis (CDC 2015)3
Vulvovaginal Candidiasis in Pregnancy
Management of Sexual Partners
Trichomonas vaginalis Infection1,3
Recommended Regimen
Alternative Regimen
Management of Sexual Partners
Other Sexually Transmitted Infections3
Clindamycin4
Benzathine Penicillin4
Azithromycin4
Active Against
Erythromycin4
Ceftriaxone4
Active Against
Doxycycline4
Fluconazole4
Acyclovir4
CHAPTER 10:
Tuberculosis
INTRODUCTION
CLASSIFICATION OF CURRENTLY USED ANTITUBERCULAR DRUGS1
First-line Drugs
Isoniazid (INH or H)
Rifampicin (R or RMP)
Ethambutol (EMB or E)
Pyrazinamide (PZA or Z)
Streptomycin (SM or S)
Second-line Drugs
Ofloxacin (Ofl)
Levofloxacin (Lfx)
Para-aminosalicylic Acid (PAS)
Ethionamide (Eto)
Cycloserine (Cs)
Kanamycin (Km)
Clofazimine
New Drugs
Newer Fluoroquinolones
Rifabutin
Macrolides
Bedaquiline
PA-824
Oxazolidinones
TREATMENT OF TUBERCULOSIS
Treatment of Active TB in Pregnancy
Treatment of New Cases (former Categories I and III)
Previously Treated Cases(Former Category II)
Treatment of Latent TB in Pregnancy
Treatment of Drug-resistant Tuberculosis during Pregnancy
Treatment of Genital TB
ANTITUBERCULOSIS TREATMENT AND CONTRACEPTION
DOTS AND DOTS-PLUS6,7
CHAPTER 11:
Urinary Tract Infection
INTRODUCTION
Antibiotic Treatment in Urinary Tract Infection
Nitrofurantoin
SECTION IV: DRUGS USED DURING LABOR, DELIVERY AND PUERPERIUM
CHAPTER 12:
Labor Analgesia
CHAPTER 13:
Cervical Ripening Agents
INTRODUCTION
Prostaglandins
Dinoprostone (PGE2)
Misoprostol
Relaxin and Nitric Oxide
CHAPTER 14:
Oxytocics
INTRODUCTION
Oxytocics Used in Obstetrics
Oxytocin
Ergometrine and Methylergometrine
Prostaglandins
Carboprost Tromethamine
CHAPTER 15:
Galactagogues and Lactation Suppressants
INTRODUCTION
Galactagogues
Metoclopramide
Domperidone
Other Drugs which May Increase Lactation
Lactation Suppressant
Cabergoline
Pyridoxine (Vitamin B6)
Various other Drugs Used in Past for Lactation Suppression
CHAPTER 16:
Preterm Labor
INTRODUCTION
Maternal Aspect Drugs
Progesterone
Tocolytic Therapy
Calcium-channel Blockers
Magnesium Sulfate
Oxytocin Antagonist
Prostaglandin Inhibitors (Cox-2 Inhibitors)
Beta Agonists
Nitric Oxide Donors
Fetal Aspect Drugs
Corticosteroids
SECTION V: DRUGS USED IN MEDICAL DISORDERS OF PREGNANCY
CHAPTER 17:
Anemia
INTRODUCTION
Iron Therapy
Oral Iron Therapy
Treatment
Parenteral Iron
Calculation of the Dose
Iron Sorbitol Citric Acid
Iron Dextran
Iron Sucrose
Sodium Ferric Gluconate Complex
Newer Injectable Iron Preparations19
Ferric Carboxymaltose
Ferumoxytol
Iron Isomaltose
Vitamins in treatment of Anemia
Folic Acid
National Nutritional Anemia Control Program (NNACP)
National Iron Plus Initiative (NIPI)7
WHO Recommendations
Vitamin C
Vitamin B12 (Cyanocobalamin)
Preparation
Antihelminths
Albendazole
Mebendazole
Miscellaneous
Recombinant Human Erythropoietin (Epoietin Alpha)20
Pyridoxine
CHAPTER 18:
Hypertensive Disorders of Pregnancy
HYPERTENSIVE DISORDERS
Treatment
Methyldopa
Labetalol
Hydralazine
Nifedipine
Magnesium Sulfate
Monitoring for Magnesium Toxicity
Management of Toxicity 16
Antihypertensive Treatment for Acute Management of Severe Hypertension11
Pregnant Women with Chronic Hypertension
Preeclampsia
CHAPTER 19:
Diabetes in Pregnancy
DRUGS USED FOR CONTROLLING BLOOD SUGAR LEVELS
INSULIN
Current Evidence
Dosage
Routes of Administration
Contraindications
Adverse Drug Reaction
Allergic Reaction
Drug Interactions
Safety During Pregnancy
Preparation
ORAL HYPOGLYCEMIC AGENTS
GLYBURIDE
Pharmacology
Mechanism of Action
Pharmcokinetics
Current Evidence
Contraindications
Dosage
Adverse Drug Reactions
Side Effects of Glyburide
Drug Interactions
Preparations
Safety During Pregnancy
METFORMIN
Pharmacology
Mechanism of Action
Pharmacokinetics
Current Evidence
Contraindications
Dosage
Adverse Drug Reactions
Drug Interactions
Preparations
Safety During Pregnancy
OTHER DRUGS
Corticosteroids
Dosage
KEY POINTS
CHAPTER 20:
Cardiovascular Disorders of Pregnancy
INTRODUCTION
Cardiovascular Drugs
Adenosine
Beta-blockers: Metoprolol
Nitrates/Nitroglycerin
Digoxin
Diuretics
Furosemide
Spironolactone
Diltiazem
Lidocaine Hydrochloride
Pulmonary Vasodilators
Sildenafil
Anticoagulation in Pregnancy
Warfarin
Unfractionated Heparin
Low Molecular Weight Heparins
Antibiotic Prophylaxis
Antibiotics Recommendations by American Heart Association
CHAPTER 21:
Thyroid Disorders in Pregnancy
DRUGS USED IN THYROID DISORDERS
Hypothyroidism
Levothyroxine
Mechanism of Action
Hyperthyroidism
Propylthiouracil (PTU)
Pharmacology
Methimazole
Pharmacology
Mechanism of Action
Carbimazole
Preparation
Beta Blockers
CHAPTER 22:
Gastrointestinal and Hepatic Disorders of Pregnancy
DIARRHEA
Intrahepatic Cholestasis of Pregnancy
Ursodeoxycholic Acid
CHAPTER 23:
Respiratory Disorders
ASTHMA IN PREGNANCY
Bronchodilators
Sympathomimetics
Salbutamol (Albuterol)
Salmeterol
Formeterol
Methylxanthines
Theophylline
Anticholinergics
Ipratropium Bromide
Tiotropium Bromide
Leukotriene Receptor Antagonists
Zafirlukast
Montelukast
Leukotreine Inhibitors
Zileuton
Mast Cell Stabilizers
Cromolyn Sodium
Inhaled Corticosteroids
Beclomethasone and Budesonide
Fluticasone Propionate
Ciclesonide
Systemic Steroid Therapy
Prednisolone
Methylprednisolone
Hydrocortisone
Monoclonal Antibody
Omalizumab
PNEUMONIAS IN PREGNANCY
Therapy for Pneumonia During Pregnancy
Supportive Care
CHAPTER 24:
Neurological and Psychiatric Disorders of Pregnancy
HEADACHE
Drugs Used in Headache
Naproxen4–6
Ibuprofen
Ergotamine
Sumatriptan4,5,7
SEIZURE DISORDERS
Preconception Counseling
Antiepileptic Drugs
Phenytoin
Carbamazepine
Valproic Acid
Lamotrigine
Levetiracetam
Ethosuximide
Gabapentin
Lorazepam
Treatment of Status Epilepticus (SE)
PSYCHIATRIC DISEASES
Drugs Used in Psychiatric Diseases
Benzodiazepines1,3-5
Selective Serotonin Reuptake Inhibitors1–5
Tricyclic Antidepressants1–5
Serotonin-Norepinephrine Reuptake Inhibitors (Duloxetine)3–5
Mixed Action Drugs-Amoxapine1,3-5
Monoamine Oxidase Inhibitor-Phenelzine
Chlorpromazine
Trifluoperazine
Haloperidol
Clozapine
Lithium1–5
SECTION VI: FAMILY PLANNING DRUGS
CHAPTER 25:
Medical Termination of Pregnancy
INTRODUCTION
Drugs Used in Medical Abortion
Mifepristone and Misoprostol for Medical Termination of Pregnancy
Ethacridine Lactate
Prostaglandin F2 Alpha
Concentrated Oxytocin Infusion
CHAPTER 26:
Newer Contraceptive Drugs
INTRODUCTION
New Oral Contraceptive Pills
Low-dose Combined Oral Contraceptives
Combined Oral Contraceptives Containing Newer Progestogens: Drospirenone Containing COCs
Continuous or Extended COCs
Newer Progestin-only Contraceptives: Desogestrel-only Mini-pill
Mini-pills Containing Other Progestine
Contraceptive Patch
Ortho Evra
Newer Low-dose Patch
Injections
Combined Injections
Progesterone-only Injections
Implants
Nonbiodegradable Implants: Implanon
Biodegradable Implants
Contraceptive Vaginal Ring
NuvaRing
Vaginal Rings Under Trial
Newer Intrauterine Contraceptive Device
Skyla
GyneFix
SECTION VII: GENERAL GYNECOLOGY
CHAPTER 27:
Fibroid and Endometriosis
INTRODUCTION
Nonsteroidal Anti-inflammatory Drugs
Antifibrinolytics
Tranexamic Acid
Combined Contraceptives
Dosage
Progestins
Dienogest
Intrauterine Progesterone
LNG-IUS
Progesterone Antagonists
Mifepristone
Contraindications
Dosage
Antigonadotropic Agents
Danazol
Gestrinone
Gonadotropin-releasingHormone Agonist
Leuprolide
Goserelin
Nafarelin
Add Back Therapy
GnRH Antagonists
Cetrorelix and Ganirelix
Aromatase Inhibitors
Letrazole and Anastrozole
Selective Estrogen Receptor Modulators
Raloxifene
Selective Progesterone Receptor Modulators
Asoprisnil
Ulipristal Acetate
Newer Drugs
Cabergoline
Pirfenidone23
CHAPTER 28:
Menstrual Disorders
INTRODUCTION
ADOLESCENT
Amenorrhea
Turner Syndrome
Growth Hormone
Estrogen Supplementation
Progesterone Supplementation
REPRODUCTIVE AGE GROUP
Anovulatory Cycles
Progestin Therapy
Estrogen-Progesterone Therapy
Estrogen Only
Insulin Sensitizers
Biguanides
Thiazolidinediones
Heavy Menstrual Bleeding
Dysmenorrhea
NSAIDs
Oral Contraceptives
Intrauterine Devices
Menstrual Migraine
Triptans
a. Combined Oral Contraceptive Formulations
Estrogen Only
b. Nonhormonal Therapy
Premenstrual Syndrome and Premenstrual Dysphoric Disorder
Serotonin Reuptake Inhibitors
Alprazolam
Gonadotropin-releasing Hormone Agonists
Oral Contraception or Progesterone
Secondary Amenorrhea
Premature Ovarian Failure
Prolactinoma
SECTION VIII: REPRODUCTIVE ENDOCRINOLOGY
CHAPTER 29:
Polycystic Ovary Syndrome, Hirsutism and Hyperprolactinemia
WEIGHT REDUCTION
TREATMENT OF MENSTRUAL DYSFUNCTION
Infertility
Clomiphene Citrate
Aromatase Inhibitors
Exogenous Gonadotropins
In Vitro Fertilization
PREVENTION OF METABOLIC SYNDROME
Insulin Sensitizers
Metformin
Thiazolidinediones
Myo-inositol/Myoinositol and D-chiro-inositol Combination
Statins
TREATMENT OF ANDROGEN-RELATED SYMPTOMS
Hirsutism (Table 29.2)
Estrogen-Progestin Contraceptives
Antiandrogens
Spironolactone
Cyproterone Acetate
Flutamide
Finasteride
Insulin-Sensitizing Drugs
OTHER DRUGS
Gonadotropin-Releasing Hormone Agonists
Glucocorticoids
Eflornithine Hydrochloride
ACNE
HYPERPROLACTINEMIA
HYPOTHALAMIC DISORDERS
PITUITARY DISORDERS
Lactotroph Adenomas (Prolactinomas)
Expectant Management
Medical Treatment
Cabergoline
Bromocriptine
CHAPTER 30:
Ovulation Induction Drugs
INTRODUCTION
Ovulation Disorders
Treatment of Ovulatory Dysfunction
OVULATION INDUCTION DRUGS
1. Drugs for Follicular Stimulation2–5
A. Clomiphene Citrate (Siphene, Clomid)
Clomiphene Resistance
Clomiphene Failure
B. Tamoxifen: “Off Label Use”4
Indications: “Off Label Use”
C. Aromatase Inhibitors1,6
Letrozole (Letsi, Letroz)
Anastrazole (Adova)
D. Gonadotropins
Preparations Available
Principles of Gonadotropin Stimulation
FSH Treatment Principles
Recombinant Corifollitropin Alpha (FSH-CTP)—injection
Recombinant Human Luteinizing Hormone
Human Chorionic Gonadotropin (hCG)
E. Pulsatile Gonadotropin-Releasing Hormone
Synthetic Gonadotropin Releasing Hormone (GnRH)
Drugs to Prevent Gonadotropin Surge and Premature Ovulation in Assisted Reproductive Technology Cycles
A. GnRH Releasing Hormone Agonist (GnRHa) Protocols
Commonly used Synthetic GnRH Analogs
B. GnRH Releasing Hormone Antagonist (GnRH Antagonist)
Drugs
GnRH Agonist Protocols
Administration: Subcutaneous Injections
Multiple Dose Regimen
Single Dose
Agonist versus Antagonist Protocols
3. Triggers of Final Oocyte Maturation
When to Trigger?
A. Urinary/Recombinant Human Chorionic Gonadotropin (Fertigyn/Ovitrelle)
B. GnRH Releasing Hormone Agonist (GnRHa) Trigger
hCG versus Agonist Trigger9
C. Dual/Double Trigger10
D. Recombinant LH (rLH)
THE FUTURE
CONCLUSION
OVULATION INDUCTION IN ART CYCLES
CHAPTER 31:
Postmenopausal Drug Therapy
INTRODUCTION
POSTMENOPAUSAL HORMONE THERAPY
ESTROGENS
Pharmacology
PROGESTERONES
Progesterones used for HRT
Pharmacology
TIBOLONE
Pharmacology
NONHORMONAL DRUGS FOR MENOPAUSAL SYMPTOMS
SELECTIVE SEROTONIN REUPTAKE INHIBITORS: PAROXETINE
Pharmacology
SELECTIVE NOREPINEPHRINE REUPTAKE INHIBITORS
Pharmacology
Indications
GABAPENTIN
Pharmacology
CLONIDINE
Pharmacology
COMPLEMENTARY/ALTERNATIVE MEDICINES
MEDICATIONS TO PREVENT OR TREAT OSTEOPOROSIS
SELECTIVE ESTROGEN RECEPTOR MODULATOR
TERIPARATIDE
Strontium Ranelate
Calcitonin
Calcium
Vitamin D
SECTION IX: ANTICANCER DRUGS
CHAPTER 32:
Chemotherapy in Gynecological Cancers
ALKYLATING AGENTS
Pharmacology (Table 32.1)
Mechanism
ALKYLATING-LIKE AGENTS
ANTITUMOR ANTIBIOTICS (TABLE 32.3)
Pharmacology
Mechanism
ANTIMETABOLITES (Table 32.4)
Pharmacology
Mechanism
PLANT ALKALOIDS (Table 32.5)
Pharmacology
Mechanism
TOPOISOMERASE-1 INHIBITORS
Topotecan, Irinotecan
COMPLICATIONS AND SIDE EFFECTS OF CHEMOTHERAPY
Hematological Toxicity
Neutropenia
Evaluation and Treatment
Gastrointestinal Toxicity
Dermatologic Reactions
Genitourinary Toxicity
Neurotoxicity
Hepatotoxicity
Pulmonary Complications
Cardiac Toxicity
Vascular and Hypersensitivity Reactions
Secondary Malignancies
Gonadal Dysfunction
Metabolic Abnormalities
Chemotherapy in Pregnancy
CASE SCENARIOS
Different Regimes12 for Concurrent Chemoradiation
Neoadjuvant Chemotherapy in Locally Advanced Cancer Cervix
First Line Combinations11,14,15
CHEMOTHERAPY FOR GERM CELL TUMORS
CHEMOTHERAPY IN ENDOMETRIAL CANCERS
UTERINE SARCOMA
GESTATIONAL TROPHOBLASTIC NEOPLASIA
Chemotherapy for Low-risk GTN
Chemotherapy for High-risk GTN
VULVAR CANCER
SECTION X: MISCELLANEOUS
CHAPTER 33:
Fetal Therapy
CARDIAC ARRHYTHMIAS
Fetal Tachycardia
Digoxin
Flecainide
Amiodarone
Sotalol
Monitoring for Antiarrhythmic Drugs
Fetal Bradycardia
THYROID DISORDERS
Fetal Hyperthyroidism
Monitoring
Fetal Hypothyroidism
Intra-amniotic T4, Intra-amniotic T3 and 3,3’, 5-triiodothyroacetic Acid (Triac)
ADRENAL DISORDERS
Congenital Adrenal Hyperplasia
Dexamethasone
CHAPTER 34:
Vaccines
INTRODUCTION
Vaccines in Adolescent Girls and During Pregnancy
Human Papilloma Virus Vaccine
Tetanus Toxoid
Td and Tdap
CHAPTER 35:
Analgesics
INTRODUCTION
Non-opioid Analgesics
Paracetamol (Acetaminophen)
Diclofenac Sodium
Mefenamic Acid
Pentazocine
INDEX
TOC
Index
×
Chapter Notes
Save
Clear