1. Drugs Used In Obstetric and Gynecology
Shadman H. Abdullah
University of Sulaimani
Faculty of Medical Sciences
School of Medicine

3. Contraceptive Methods

5. Name of the drug : Mirena
Component : intrauterine device ( levonorgestrel releasing IUD)
Mechanism of action : endometrial shedding , cervical mucus thickening
Usage : 1-long-term contraception (up to 5 years) .
2-dysmenorrhoea.
3-menorrhagia.
4-decrease incidence and severity of PID.
Dosage : release 20mcg/24 hours. Inserted in first 7 days of cycle.
Side effects :
1-headache,acne.
2-perforation (during insertion).
3-expulsion (first month).
4- 1% failure = ectopic.

6. Name of the drug :
Component : intrauterine device ( copper bearing IUD)
Mechanism of action : 1-inflammatory reaction (inhibit implantation).
2-toxic effect on sperm motility (inhibit fertilization).
Usage : long-term contraception (up to 5 years) .
Dosage : contain 380 mm copper. Inserted in first 7 days of cycle.
Side effects :
1-copper allergy.
2-dysmenorrhoea.
3-menorrhagia.
4-not protect against PID.
2-perforation (during insertion).
3-expulsion (first month).
4- 1% failure = ectopic.

7. Name of the drug : Yasmin.
Component : 30 mcg ethinylestradiol + 3mg drospirenone.
Mechanism of action : combined oral contraceptive pill (OCP).
Usage : contraception , severe menorrhagia.
Dosage :
1 tab/day for 21 days (5 – 25 of cycle) + 7 days tab free (3 weeks on, 1 week off)
Side effects :

8. Name of the drug : Primolut
Component : norethisterone 5mg
Mechanism of action : Progesterone.
Usage : contraception , severe menorrhagia , dysmenorrhoea , endometriosis.
Dosage : 1capsule /day for 3 months (250mg)
Side effects :
1-Fluid retention.
2-Breast discomfort.
3-Dizziness.
4-Depressed mood.

9. Name of the drug : Depo Provera
Component : Medroxyprogesterone acetate
Mechanism of action : Progesterone .
Usage : contraception , severe menorrhagia , dysmenorrhoea , endometriosis.
Dosage : 150 mg IM injection every 3 months.
Side effects :
1-Fluid retention.
2-Breast discomfort.
3-Dizziness.
4-Depressed mood.

10. Name of the drug :
Component : 11 white tablets (2mg estradiol)
10 brown tablets (2mg estradiol with 0.5mg norgestrel)
Mechanism of action : estrogen and progesterone.
Usage : HRT in menopause of premature ovarian failure.
Dosage :
1 tab/day for 21 days (5 – 25 of cycle) + 7 days tabfree (3 weeks on, 1 week off)
Side effects :
Weight gain or loss
Headache
lower abdominal pain

11. Name of the drug : Diane 35
Component : Cyproterone acetate (2 mg) + Ethinylestradiol (0.035 mg)
Mechanism of action : anti-androgen effect and estrogenic effect.
Usage : Hirsutism of PCOS , contraception.
Dosage :
1 tab/day for 21 days (5 – 25 of cycle) + 7 days tab free (3 weeks on, 1 week off)
Side effects :
1-abdominal cramping, bloating.
2-appetite changes.
3-breast pain, tenderness, swelling.

12. Drugs used in Infertility

13. Name of the drug :
Component : copy of the natural human FSH
Mechanism of action : stimulates the maturation of ova.
Usage : 1-ovulation induction
2-assisted reproductive techniques (IVF)
3- patient not respond to treatment with clomiphene citrate
Dosage :
Side effects : 1-ovarian cyst.
2-ovarian hyperstimulation syndrome (OHSS)

14. Name of the drug :
Component : choriogonadotropin alfa : copy of the human hCG.
Mechanism of action : trigger ovulation (like LH hormone).
Usage : ovulation induction
2-assisted reproductive techniques (IVF)
Dosage :
250 micrograms SC given 24 to 48 hours after the ovaries have produced follicles that are mature to ovulation.
Side effects : 1-ovarian cyst.
2-ovarian hyperstimulation syndrome (OHSS)

15. Name of the drug : Clomid
Component : clomiphene citrate.
Mechanism of action : estrogen receptor antagonist.
Usage : ovulation induction (Amenorrhoea , PCOS).
Dosage : 50mg/day for 5 days(day 2-6 of cycle) , try 100mg/day if ineffective.
Side effects :
1-hot flush.
2-abdominal discomfort
3-ovarian hyperstimulation syndrome
4-ectopic pregnancy…

16. Name of the drug : Diclair
Component : gonadotrophin.
Mechanism of action : human chorionic gonadotrophin.
Usage : ovulation induction.
Dosage : SC in 2-6 days of cycle (for 5 days).
Side effects :

17. Name of the drug : Fempro
Component : Letrozole.
Mechanism of action : aromatase inhibitor (inhibit estrogen formation)
Usage : premature ovarian failure.
Dosage : 2.5 mg tablet , used in 2-6 days of the cycle (for 5 days).
Side effects :

18. Name of the drug : DOSTINEX
Component : cabergoline
Mechanism of action : dopamine receptor agonist
Usage : hyperprolactinemia (infertility – galactorrhoea)
Dosage : 2 tabs/week for 4 weeks (0.5mg)
Side effects :
1-Nausea.
2-Sleepiness.

19. Name of the drug : Colette
Component : cabergoline.
Mechanism of action : dopamine receptor agonist.
Usage : hyperprolactinemia (infertility – galactorrhoea)
Dosage : 2tabs/week for 4 weeks (0.5mg)
Side effects :
1-Nausea.
2-Sleepiness.

20. Name of the drug : Dopergin
Component : Lisuride
Mechanism of action : partial dopamine receptor agonist..
Usage : hyperprolactinemia (infertility – galactorrhoea)
Dosage : 3 tab/day for 14 days (0.2mg) .
Side effects :
1-Nausea.
2-Sleepiness.

21. Name of the drug : PIOPHAGE
Component : metformin.
Mechanism of action : decrese peripheral insulin resistance.
Usage : insulin resistance in PCOS.
Dosage :
Side effects :

22. Drugs used for menstrual abnormality

23. Name of the drug : Regelle
Component : norethisterone.
Mechanism of action : progesterone.
Usage : regulate menstruation , endometriosis , dysmenorrhoea.
Dosage : 3 tabs /day for 10 days (5mg)
Side effects :
1- breakthrough bleeding, spotting.
2- changes in liver function.
3- depression, headache, dizziness.
4- fluid retention, bloating, weight gain.

24. Name of the drug : Zoladex.
Component : goserelin .
Mechanism of action : GnRH analogue (agonist).
Usage : menorrhagia , endometriosis.
Dosage : 3.6mg
Side effects :

25. Name of the drug : AMINOR.
Component : 5mg norethisterone acetate.
Mechanism of action : progesterone.
Usage : regulate menstruation , endometriosis , dysmenorrhoea.
Dosage : 1 tablet/day for 20 days.
Side effects :

26. Name of the drug : EXACYL
Component : tranexamic acid (cyklokapron).
Mechanism of action : anti-fibrinolytic , reversibly inhibit plasminogen activator.
Usage : menorrhagia.
Dosage : 1 tablet/day for 20 days.
Side effects :
1-nausea , vomitting.
2-rarely thrombosis.

27. Drugs used in pre-eclampsia

28. Name of the drug : MAGNESIUN SULFATE Component : magnesium sulfate.
Mechanism of action : physiologic calcium antagonist.
Usage : prophylaxis and treatment of eclamptic fit.
Dosage :
4 g over 5–15 minutes followed by IV infusion , 1 g/hour for at least 24 hours.
Side effects :
1- respiratory depression.
2-drowsiness, confusion, loss of tendon reflexes
3-oliguria.
Require
Calcium Gluconate!

29. Name of the drug : Calcium Gluconate 10%
Component : calcium
Mechanism of action : antidote of magnesium sulfate toxicity.
Usage : used for magnesium sulfate overdose.
Dosage : 1g IV single dose slowly.
Side effects :
1- tingling sensations.
2-arrhythmia.

30. Name of the drug : Apresoline
Component : hydralazine hydrochloride
Mechanism of action : vasodilator.
Usage : pre-eclampsia.
Dosage : 5-10 mg slow IV injection, repeated after 20 minutes if necessary.
Side effects :
1- palpitation.
2-headache.
3-flushing.
4- dizziness,.

31. Drugs used in labor

32. Name of the drug : Syntocinon
Component : oxytocin.
Mechanism of action : stimulate the smooth muscle contraction of the uterus.
Usage :
1-induction and augmintation of labor : 5IU in 500ml fluid.
2-third stage of labor : 5IU when the anterior shoulder is delivered
3-post-partum hemorrhage : 10 IU bolus then 40IU infusion maintain.
Dosage : discussed above.
Side effects :
1- tachycardia.
2- headache.
3-nause,vomitting.

33. Name of the drug : Methrgine
Component : methylergonovine maleate.
Mechanism of action : increases the tone, rate of uterine contraction.
Usage : prevent PPH following delivery of the placenta, uterine atony.
Dosage : IV 0.2 mg, administered slowly.
Side effects :
1- abdominal pain.
2- hypertension.
3-seizure.

34. Name of the drug :
Component : Enoxaparine : low molecular weight heparin (LMWH)
Mechanism of action :
activate anti-thrombin III , heigher anti-factor Xa to antifactor IIa activity ratio.
Usage : prevention ,treatment of venous thromboembolic disease (DVT,PE)
In prolong bedridden and surgical prophylaxis.
Dosage : 1mg/kg twice daily SC injection for 10 days (60 mg Sc q 2).
Side effects :
1- bleeding (epistaxis , gum bleed).
2- painful rash at the injection site.

35. With success