CTC ADN - Medications in Obstetrics for Nursing Students

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Antepartum	Ca Gluconate			Antidote for hypermagnesium
Usual dose: 1g IV over 3-5 mins
Antepartum	Celestone	Betamethosone		Lung maturity	Increase fetal lung maturity
12.5mg IM q 24 hrs x 2 doses. Given to mom when PTL (24 - 34 wks)
Antepartum	Dinoprostone	Prostin E2		Termination of pregnancy	n/v/d, fever
May be premedicated with Tylenol, antidiarrheal and antiemetic
Antepartum	Hydralazine	Apresoline		BP control
Given IVP for acute hypertension.
Antepartum	Lorazepam	Ativan		Anticonvulsant Tx
Used during seizure. Must be kept refrigerated.
Antepartum	Magnesium Sulfate			Anticonvulsant Tx; Tx of PTL	During loading dose: Facial flushing, warmth. During tx: hypermagnesium (loss of reflexes, resp arrest, cardiac arrest)
First choice during seizure and anti-seizure; Also used for PTL. DTRs 1st sign of hypermagnesia; Therapeutic level 4-8 mg/dl. Given thru infusion pump
Antepartum	Methyldopa	Aldomet		BP control
DOC for antihypertension maintenance
Antepartum	Nifedipine	Procardia		Tocolytis; BP Control	Hypotension, tachycardia, facial flushing, h/a
Off-label use for tocolysis. Co-administration with Ritodrine or Terbutaline OK. Do not give with MgSO4. Check BP prior to administering
Antepartum	Ritodrine	Yutopar		Tocolysis	Hypotension, tachycardia, palpitations, pulmonary edema, facial flushing. Fetal tachycardia.
Given IV thru infusion pump titration first. Then moved to PO. Not used much anymore.
Antepartum	Terbutaline	Brethine		Tocolysis	Hypotension, tachycardia, palpitations, pulmonary edema, facial flushing. Fetal tachycardia.
Given IV thru infusion pump titration. Then moved to PO. May use SQ doses for acute, short-term use. Used 2nd most after MgSO4
Intrapartum	Bupivicane	Marcaine		Epidural anesthesia	Complications r/t hypotension episode with epidural
Most have BP monitored frequently (q 15 mins) with epidural anesthesia.
Intrapartum	Morphine Sulfate	Duramorph Morphine		Pain relief (surgical)	Sedation
Duramorph placed in epiddural line for continued pain relief up to 24 hrs. Morphine usual drug in PCA. Also given in RR for pain relief.
Intrapartum	Naproxen Sodium	Anaprox		Pain relief
Intrapartum	Oxycodone/Acetaminophen	Percocet		Pain relief	Sedation
Intrapartum	Rho(D) Immune Globulin	Rhogam		Prevention of development of antibodies to fetus's Rh-positive blood
Given antepartum to mom who is Rh negative: at 28 wks and after amnio or abortion; and to Rh negative mom at delivery who's baby is Rh positive.
Newborn	Beractant	Survanta		Improve lung surfactant to decrease incidence of RDS
Given intratracheal only within 15 mins of birth; rescue given within 8 hrs of age. Indicated for infants 600-1750g
Newborn	Butorphanol	Stadol		Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Erythromycin 1% ointment			Prevention of neonatorum ophthalmia
Prevention blindness from gonorrhea, Chlamydia. Should be given within first hr of life. State Law
Newborn	Fentanyl citrate	Sublimaze		Synergistic effect with epidural	Not absorbed systemically. Adverse effects r/t hypotension w/epidural
Small amts added to epidural anesthesia.
Newborn	Hep B vaccine	Recombivax HB		Prevention of HepB
Recommended within 1st 12 hrs after birth. Series of vaccines.
Newborn	Meperidine	Demerol		Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Misoprostol	Cytotec		Cervical ripening	Can cause uterine hyperstimulation
Approved as antiulcer. Off-label use in OB. Also used as abortifacient in 2nd trimester.
Newborn	Nalbupine	Nubain		Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Naloxone	Narcan		Reversal of resp depression r/t narcotics
Given IM. Must assure neonatal dosage.
Newborn	Oxytocin	Pitocin		Labor induction; Prevention of PPH	R/T hyperstimulation
Given IV thru infustion pump titration. 1st line of drug for prevention t/x of PPH
Newborn	Phytonadione	Aqua Mephyton		Prevention of hemorrhagic dx of the newborn
Given IM within 1st hr of life.
Newborn	Promethazine	Phenergan		Prevention/tx of n/v Synergistic with narcotics	Can cause extrapyramidal effects. Use lowest dose
Newborn	Xylocaine			Episotomy
w/o epinephrine
Postpartum	Carboprost	Hemabate		Severe PPH
3rd line of drug for PPH
Postpartum	Docusate Sodium	Colace		Prevention of constipation
Postpartum	Ferrous sulfate	Feosol		Prevention/tx of anemia	May turn stools dark.
Take with Vit C to increase absorption
Postpartum	Ibuprofen	Motrin		Pain relief
Postpartum	Medroxyprogesterone acetate	Depoprovera		Birth Control
Given q 3 months IM
Postpartum	Meruvax II	Rubella vaccine		Prevention of rubella
Give PP only.
Postpartum	Methylergonovine maleate	Methergine		PPH	May increase BP
2nd line of drug for PPH (IV). Can be continued PO.