Endocrine Drugs and Medications Q 35
Which of the following drugs poses the greatest threat to an insulin-dependent diabetic who is pregnant?
A. Ritodrine hydrochloride
B. Oxytocin
C. Prostaglandin
D. Ergotrate
Correct Answer: A. Ritodrine hydrochloride
The only drug that poses a threat to diabetics who are pregnant is ritodrine. Tocolytic therapy in Japan consists of two main drugs, ritodrine hydrochloride and magnesium sulfate, unlike many Western countries. Ritodrine, the main traditional drug in Japan, is a beta-2 stimulant that causes maternal hyperglycemia. Using both ritodrine and glucocorticoid could cause maternal hyperglycemia.
Option B: Oxytocin can be a good choice to decrease the blood glucose level and increase the insulin level. The hypoglycemic effect of OT can be explained by increasing glucose uptake via insulin-like signaling pathway (20, 21).
Option C: Both arachidonic acid and prostaglandin E2 reverse the teratogenic effects of high glucose concentrations on neural tube development in mouse embryos in culture. Arachidonic acid supplementation also protects against diabetes-induced neural tube defects in vivo.
Option D: This medication is used after childbirth to help stop bleeding after delivery of the placenta (afterbirth). Ergonovine maleate belongs to a class of drugs known as ergot alkaloids. It works by increasing the stiffness of the uterus muscles after the last stage of labor.