Contraceptive Drugs

and Abortifacients,
Fertility Drugs, and
Drug Therapy related to
Pregnancy, Labor,
Delivery and
Postpartum Period
 Contraceptive Drugs
Contraceptive drugs: Are medications
used to prevent pregnancy.
Contraceptive devices: Are non-drug
methods of pregnancy prevention such as
intrauterine devices (IUDs), male and
female condoms and cervical diaphragms.
Contraceptive drug
therapy only prevents
pregnancy and in NO WAY
protects people from
sexually transmitted
diseases like AIDS and
 ORAL CONTRACEPTIVES
The most effective form of birth control
currently available
Often referred to as the PILL, oral
contraceptives contains esrtogen-progestin
combination.
The most common estrogenic component is
ethinyl estradiol.
What are the available oral contraceptive?

Biphasic drugs: Contain a fixed estrogen dose; a low

progestin dose for the first 10 days, and a higher dose for
the rest of the cycle.

Triphasic: contain three different estrogen-progestin

dose ratios that are administered sequentially during the
cycle and are provided in 21 or 28 day packages.

Monophasic: (And triphasic oral contraceptives) are the

most numerous and widely prescribed
Mechanism of Action & Drug Effects
Contraceptive drugs prevent ovulation by
inhibiting the release of gonadotropins
and increasing uterine mucous viscosity.
It inhibits the implantation of a fertilized
egg into the endometrial lining
It also decreases sperm movement
and fertilization of ovum is less likely.
 Indications
They are mainly for prevention of pregnancy, but they
are also used to treat endometriosis and
hypermenorrhea, and to produce cyclic withdrawal
bleeding in patients with amenorrhea.
 Contraindications
The use of contraceptives are contraindicated in
know drug allergies to a specific product,
pregnancy, and a know high risk or history of
thromboembolic events such as mycardial
infarction, venous thrombosis, pulmonary
embolism, or stroke.
Drug Interactions
Combining drugs that produce
vasoconstriction, such as
sympathomimetics with oxytoxic
drugs, can result in severe
hypertension.
Adverse Effect
Hypertensions
Thromboembolism
Alterations in carbohydrate and lipid metabolism
Increases in serum hormone concentrations
Alterations in serum metal and plasma protein
levels
 Drug Name Pharmacologic Usual Dosage Indications
(Brand Name) Class Range
(Pregnancy
Category)
Norethindrone and Bipasi:fixed Follow patient Prevention of
ethinyl estradoil estrogen-variable infotmstion pregnancy
(Ortho-Novum , progestin; 21-or 28- product insert not
Necon, day products to exceed 24h and
Jenest,others) the instruction of
(X) prescriber
Norethindrone and Monophasic: fixed Follow patient Prevention of
ethinyl estradoil estrogen-progestin infotmstion pregnancy
(Loestrin, combinations, 21- product insert not
Modicon , or 28-day to exceed 24h and
Necon, others) products; 28-day the instruction of
(X) products contain 7 prescriber
inert tabs
Norethindrone and Truphasic: 3 or 3 Follow patient Prevention of
ethinyl estradoil monthly phases of infotmstion pregnancy
(Ortho-Novum , variable estrogen product insert not
7/7/7 , Estrostep and progestin to exceed 24h and
, Tri-Nornyl, combinations; 21- the instruction of
others) (X) or 28 day products prescriber
containing 7 insert
 Drug Name (Brand Pharmacologic Usual Dosage Indications
Name) (Pregnancy Class Range
Category)

Injectable Progestin only IM: 150mg q 3 mo Prevention of

contraceptives: pregnancy
medroxyprogesterone
(Depo-Provera) (X)

Transdermal Fixed 1 Transdermal Prevention of

Contraceptives: combination patch applied pregnancy
norelgestromin and estrogen- weekly x3 wk each
ethinnyl estradoil ) progestin month; schedules
(X) around mense in
wk4
Intravaginal Fixed 1 ring inserted into Prevention of
Contaceptives: combination vagina and left in pregnancy
etenogestrel-ethinyl estrogen- place for 3 wks
estradoil vaginal ring progestin followed by 1 wk
(Nuvaring ) (X) removal; new ring
is inserted 1 wk
Drugs For Labor,
Delivery, And
Postpartum Use
 Uterine Active Medications
Either promote or prevent the
start or progression of labor.
Immediately after delivery,
they are also used to promote
rapid shrinkage of the uterus
to reduce the risk of
postpartum hemorrhage
 Uterine Stimulants
There are four types of drugs
used to stimulate uterine
contractions: ergot alkaloids,
prostaglandins, the
progesterone antagonist
mifepristone (RU486), and
the hormone oxytoxin.
They act on the uterus , a
highly muscular organ with a
Mechanism of Action and
Drug Effect

The uterus undergoes several

changes during normal gestation and
childbirth that make it more resistant
or more susceptible to various
hormones and drugs.
During lactation, it promotes the
movement of milk from the
mammary glands to the nipples.
Contraindications
The use of uterine stimulants are
known aleergy to a specific product ,
pelvic inflammatory disease, cervical
stenosis, uterine fibrosis , high-risk
intrauterine fetal position before
delivery, placenta privia, hypertonic
uterus, uterine prolapse, or any
condition where vaginal delivery is
 Adverse Effect
Hypotension/Hypertensio
n
Chest pain
Headache and dizziness
Fainting
Nausea and vomiting
Diarrhea
Vaginitis
Vaginal pain
Leg cramps joint swelling
chills
Fever
Weakness
Drug Interactions

Combining drugs that

produce vasoconstriction,
such as symphatonimetics
with oxytocic dugs can
result in severe
hypertension
 Drug Name Pharmacologic Usual Dosage Indications
(Brand Name) Class Range
(Pregnancy
Category)

Methylergonovine Oxytocic Used after

(Methergine) Ergotalkaloid delivery of infant
(X) and placenta to
prevent
postpartum
uterine atony

Oxytoxin (Ptocin Oxytocic

, Syntocinon ) hypothalamic Used for labor
(X) hormone induction at or
near full term
gestation
MEME TIME!!!!
Uterine Relaxants
When uterine contraction
begin before term, it is
necessary to stop labor
because premature birth
increases the risk of neonatal
death.
MOA and Drug Effect
Acts by directly relaxing the
uterine smooth muscle and
stopping the uterus from
contracting.

The Drug Effects of terbutaline

are related to their B-Adrenergic
effects
Contraindications
Drug allergy
Cardiac
dysrhythmias
Pheochromocytoma
 Adverse
Effect
Palpitations
Tachycardia
Hypertension
Altered maternal and
FHT & Blood Pressure
 Drug Name Pharmacologic Usual Dosage Indications
(Brand Name) Class Range
(Pregnancy
Category)

Ritodrine B2- selective IV infusion: 50- Prevention of

(Yutopar) (B) adrenergic 100 mcg/min preterm labor
antagonist titrated dose

Terbutaline B2- selective IV Ifusion: 2.5 Prevention of

(Brethine ) (B) adrenergic mg/min titrated preterm labor
antagonist to effect
PO: 2.5-10mg q
4-6 h for as long
as needed and
tolerated by pt