OB question

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sublimaze

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10+ Year Member
CA-2 here, got a question for the residents out there (attg's can chime in, too):

what's a good reference with a list of some of those wacky drugs you only see on OB? I'm talking oxytocin, methergine, 15-methyl-PG-F2-alphaROFLMAO, etc.

I've tried reading barash, m&m, and a couple different sources and creating my own list but it's getting tedious.

thx in advance 👍
 
sublimaze said:
CA-2 here, got a question for the residents out there (attg's can chime in, too):

what's a good reference with a list of some of those wacky drugs you only see on OB? I'm talking oxytocin, methergine, 15-methyl-PG-F2-alphaROFLMAO, etc.

I've tried reading barash, m&m, and a couple different sources and creating my own list but it's getting tedious.

thx in advance 👍
Click to expand...


You've memorized dozens of drugs for general anesthesia, but a few more is stumping you? 😕 The only one I've given is Pit, the nurses always gave the methergine...
 
btbam said:
You've memorized dozens of drugs for general anesthesia, but a few more is stumping you? 😕 The only one I've given is Pit, the nurses always gave the methergine...
Click to expand...

Idio is right, it really is only a handful of drugs and once you have those down, there's nothing too confusing about it....

but for me,the best OB text out there is Chestnut...it's huge, full of tons of information, but good, relevant, and you can tease out the information that you are looking for...the answers are in there, you just have to find them
 
Chestnut is a great reference.

But as others have said there are only a few fairly unique to OB that you might be asked to give: oxytocin (a.k.a. Pitocin, Syntocin or some similar sounding name in Europe), Methergine (methylergonovine), Hemabate (prostaglandin F2alpha).

Additionally OB may use misoprostol (Cytotec) or dinoprostone (Cervidil). Misoprostol can be used for both cervical ripening as well as a uterotonic.

Labetalol, hydralazine, and magnesium sulfate are the most common drugs used in preeclampsia. Occasionally they may go to nicardipine. But all these drugs are used outside of OB also.

Nitroglycerin (SL spray or IV, personally I prefer IV) or more commonly terbutaline (IM -- a.k.a. Brethine) for acute tocolysis. I haven't really seen terbutaline used anywhere else, but it's just a beta agonist. NTG obviously is used outside of OB also.

Then there are your neuraxial local anesthetics and narcotics, but again these are used outside of OB also. Except maybe chloroprocaine -- I've only used that in OB. In OB the locals are usually lidocaine, chloroprocaine, ropivacaine, or bupivacaine. The neuraxial narcotics are usually fentanyl, sufentanil, or morphine. Parenteral narcotics tends to be morphine, meperidine, fentanyl, remifentanil, and your mixed agonist-antagonists (Nubain and Stadol).

Then there are your antiemetic agents and aspiration prophylaxis agents, the most common of which is Bicitra (sodium citrate). While Bicitra is most commonly used in OB, this is obviously not exclusive.

Then there are your standard IV induction agents, muscle relaxants, and inhalational agents. But nothing unique to OB.

I think that's a fairly exhaustive list for my post-call brain. Did I miss anything?
 
The only question I remember from my oral boards now is:
What is the mechanism of action of methergine?

I replied "its an ergot amine and constricts the smooth muscle"...

and the examiner replied back

"yes, but what is the mechanism of action...."

My reply:
"I don't know"

drccw
 
drccw said:
The only question I remember from my oral boards now is:
What is the mechanism of action of methergine?

I replied "its an ergot amine and constricts the smooth muscle"...

and the examiner replied back

"yes, but what is the mechanism of action...."

My reply:
"I don't know"

drccw
Click to expand...

"multifactorial" 😎
 
drccw said:
The only question I remember from my oral boards now is:
What is the mechanism of action of methergine?

I replied "its an ergot amine and constricts the smooth muscle"...

and the examiner replied back

"yes, but what is the mechanism of action...."

My reply:
"I don't know"

drccw
Click to expand...

Surely you had passed at that point and the examiner was just killing time. 🙂
 
you can't even find the answer on wikipedia. lame question.

drccw said:
The only question I remember from my oral boards now is:
What is the mechanism of action of methergine?

I replied "its an ergot amine and constricts the smooth muscle"...

and the examiner replied back

"yes, but what is the mechanism of action...."

My reply:
"I don't know"

drccw
Click to expand...
 
drccw said:
The only question I remember from my oral boards now is:
What is the mechanism of action of methergine?

I replied "its an ergot amine and constricts the smooth muscle"...

and the examiner replied back

"yes, but what is the mechanism of action...."

My reply:
"I don't know"

drccw
Click to expand...

per A Practical Approach to Obstetric Anesthesia By Brenda Bucklin, David R. Gambling, David Wlody

Methergine's mechanism of action is a dose dependent increase in uterine traction and tone via activation of tryptaminergic, dopaminergic and alpha adrenergic receptors, with the a-adrenergic receptors playing the biggest role


I wouldn't have know that either...and who knows if that answer would've even satisfied the examiner??
 
DreamLover said:
per A Practical Approach to Obstetric Anesthesia By Brenda Bucklin, David R. Gambling, David Wlody

Methergine's mechanism of action is a dose dependent increase in uterine traction and tone via activation of tryptaminergic, dopaminergic and alpha adrenergic receptors, with the a-adrenergic receptors playing the biggest role


I wouldn't have know that either...and who knows if that answer would've even satisfied the examiner??
Click to expand...

Well if the examiner was anything like the writtens this year, you'd need to know which 2nd messenger was involved.
 
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