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Gynaecology & Obstetrics Pharmacology in Gynaecology ec405251

Dose of Carbetocin used for PPH is:

A
50 microgram IV
B
100 microgram IM
C
150 microgram IV
D
200 microgram IV
High-Yield Explanation
Ans. b. 100 microgram IM (Ref: Goodman Gillman 12/1851; Dutta 7/e p412; Williams 24/e p547, 595; http://en.Wikipedia. org/wiki/Carbetocin)Carbetocin (long acting Oxytocin) 100 microgram IM is very useful to prevent post-partum hemorrhage."Carbetocin (long acting Oxytocin) 100 microgram is very useful to prevent post-partum hemorrhage, recently developed with longer half life, used to control postpartum hemorrhage and bleeding after giving birth, particularly following cesarean section.""Uterotonics are the most important factor to decrease postpartum blood loss. Choices include oxytocin (Pitocin), misoprostol (Cytotec), carboprost (Hemabate) and the ergots, namely ergometrine (Ergotrate) and methylergometrine (Methergine). Also, carbetocin (Duratocin), a long-acting oxytocin analogue, is available and effective for hemorrhage prevention daring cesarean delivery. "--Williams 24/e p547"Carbetocin, a longer-acting derivative of oxytocin, is tinder evaluation in clinical trials to prevent or treat postpartum hemorrhage; a dose of 100 fig is given intravenously (Leung et al., 2006)."--Goodman Gillman 12/1851"Carbetocin: It can he administered intravenously or intramuscularly, resulting in different pharmacokinetic action. In both cases, the recommended dose for an average adult female is 100 microgram, administered slowly over a minute. Contractile effects of the uterus are apparent within two minutes andean he observed for approximately one hour, though maximum binding occurs about 30 minutes after intramuscular injection. Administration is performed immediately following parturition to minimize risk of postpartum hemorrhage by inducing uterine contractions, increasing muscle tone and thickening the blood. "--http://en.wikipedia.org/wiki/CarbetocinUterine StimulantsHormones of posterior pituitaryErgot alkaloidsProstaglandins* Oxytocin* Desamino-oxytocin (buccal formulation of oxytocin)* Carbetocin (longer half life)Q* Ergometrine (Ergonovine)* Mehtylergometrine* PGE2 (dinoprostone)Q* PGF2-alpha (dinoprost)Q* 15-methyl PGF2-alpha (Carboprost)QCarbetocinLong acting oxytocin analogueMechanism of action: Binds to oxytocin receptors present on smooth musculature of the uterus, resulting in rhythmic contractions of the uterus, increased frequency of existing contractions and increased uterine toneQPharmacokinetics:Bioavailability is 80% following IM injectionHalf-life: 40 minutesDosage and Action:100 microgram in 1 ml slow injection over one minuteQUses:PPH and bleeding during pregnancyQ

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