Pharmacology & Medications in Midwifery Flashcards

What is the specific antidote administered when a patient displays signs of magnesium sulfate toxicity?

Answer: Calcium gluconate 1 g IV

Calcium gluconate 1 g IV given over 3 minutes directly antagonizes magnesium's effects and is the established antidote for magnesium toxicity.

Which cervical ripening agent is classified as a prostaglandin E2 (PGE2) analog and is available as a controlled-release vaginal insert?

Answer: Dinoprostone

Dinoprostone (Cervidil) is a prostaglandin E2 analog approved for cervical ripening and is available as a controlled-release vaginal insert that can be removed if needed.

A patient with an epidural in place develops circumoral tingling and a metallic taste. What is the most likely cause?

Answer: Systemic local anesthetic toxicity (LAST)

Circumoral numbness and metallic taste are classic early CNS signs of local anesthetic systemic toxicity (LAST), indicating intravascular absorption of the epidural medication.

Which oral iron formulation contains the highest percentage of elemental iron and is often preferred for treating iron-deficiency anemia in pregnancy?

Answer: Ferrous fumarate

Ferrous fumarate contains approximately 33% elemental iron, the highest among common oral ferrous salts, making it an efficient option for correcting iron deficiency in pregnancy.

A postpartum patient with uterine atony is prescribed methylergonovine (Methergine). Which pre-existing condition is an absolute contraindication?

Answer: Hypertension

Methylergonovine causes significant vasoconstriction and is absolutely contraindicated in patients with hypertension because it can precipitate a life-threatening hypertensive crisis.

Which antibiotic is the ACOG-recommended prophylaxis for cesarean birth and should be administered 60 minutes before skin incision?

Answer: Cefazolin

Cefazolin (first-generation cephalosporin) is the ACOG-preferred antibiotic prophylaxis for cesarean birth, with additional azithromycin recommended for non-elective cases.

Terbutaline is used as a tocolytic agent. What is its primary mechanism of action in the uterus?

Answer: Beta-2 adrenergic receptor agonist

Terbutaline is a beta-2 adrenergic agonist that binds uterine smooth muscle receptors, increasing cAMP and causing uterine relaxation to inhibit preterm contractions.