Other Genitourinary agents

Genitourinary agents.

Bethanechol

Clotrimazole (cream, pessaries)

Conjugated oestrogens

Dinoprostone

Ergometrine

Oxytocin

Mifepristone

Direct parasympathomimetic

• No nicotinic agonism

• Resistant to AChE

• Postoperative and neurogenic ileus and urinary retention: ↑ bladder smooth muscle tone

• Hyperthyroidism. 

• Peptic ulcer. 

• Latent or active bronchial asthma. 

• Coronary artery disease (CAD). 

• Epilepsy. 

• Parkinsonism. 

• Pronounced bradycardia or hypotension.

• Vasomotor instability.

• Condition in which the strength or integrity of the GI or bladder wall is in question or when increased muscular activity of GI tract or urinary bladder might prove harmful (e.g., recent urinary bladder surgery, GI resection and anastomosis) or when there is possible obstruction of GI tract or bladder neck, spastic GI disturbances, acute inflammatory GI tract lesions, peritonitis, or marked vagotonia. 

• Known hypersensitivity to the drug or any ingredient in the formulation. 

Imidazole derivate (antifungal)

• Primarily topical fungal infections

  • Vaginal candidiasis

  • Tinea infections

• Oropharyngeal candidiasis

• Local burning sensation

• Pruritus

Cox 1 and 2 inhibitor.

• Relaxes vascular smooth muscle → vasodilation

• Increases uterine tone and softens the cervix during labor

• Constricts (via EP1 and EP3 receptors) or dilates (via EP2 receptors) bronchi [39]

• Inflammation

  • Raises body temperature

  • Increases sensitivity to pain

• Metabolism

  • Inhibits lipolysis

• Stomach

  • Decreases gastric acid secretion

  • Increases HCO3- and mucus secretion

Use: Cervical ripening (cervix softening for labor indcution)

• Postpartum hemorrhage in presence of uterine atony

• Labor induction

• Augmention of labor

• Postpartum control uterine bleeding

• Termination of pregnancy

• Substantial cephalopelvic disproportion. 

• Unfavorable fetal position or presentation (e.g., transverse lies) undeliverable without conversion before delivery. 

• Obstetric emergencies where maternal or fetal risk-to benefit ratio favors surgery. 

• Fetal distress when delivery is not imminent. 

• Umbilical cord prolapse. 

• Uterine activity fails to progress adequately. 

• Hyperactive or hypertonic uterus. 

• Vaginal delivery is contraindicated (e.g., invasive cervical carcinoma, active genital herpes infection, total placenta previa, vasa previa, cord presentation or prolapse). 

• Uterine or cervical scarring from previous cesarean section or major cervical or uterine (e.g., transfundal) surgery. 

• Unengaged fetal head. 

• History of hypersensitivity to oxytocin or any ingredient in the formulation. 

Adverse effects usually are dose related. 

Uterine hyperstimulation and subsequent fetal heart rate deceleration most common. (See Uterine Hyperactivity under General Precautions.)

Maternal nausea, vomiting, sinus bradycardia, premature ventricular complexes; probably related to labor and not the drug. 

Neonatal hyperbilirubinemia, jaundice, retinal hemorrhage, low Apgar scores at 5 minutes.

Antiprogestin

Blocks progesterone receptors in the corpus luteum, leading to its dehiscence

Use: Pregnancy termination

Adverse effects:

• Nausea

• Abdominal pain

• Headache

• Weakness