CTC ADN - Medications in Obstetrics for Nursing Students

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Antepartum	Ca Gluconate		Electrolyte replacement	Antidote for hypermagnesium
Usual dose: 1g IV over 3-5 mins
Antepartum	Celestone		Steriod	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		Prostaglandin	Termination of pregnancy	n/v/d, fever
May be premedicated with Tylenol, antidiarrheal and antiemetic
Antepartum	Hydralazine		Antihypertensive	BP control
Given IVP for acute hypertension.
Antepartum	Lorazepam		CNS Agent	Anticonvulsant Tx
Used during seizure. Must be kept refrigerated.
Antepartum	Magnesium Sulfate		Anticonvulsant	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		Antihypertensive	BP control
DOC for antihypertension maintenance
Antepartum	Nifedipine		Calcium-channel blocker	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		Tocolytic	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		Tocolytic	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		Local anesthetic	Epidural anesthesia	Complications r/t hypotension episode with epidural
Most have BP monitored frequently (q 15 mins) with epidural anesthesia.
Intrapartum	Morphine Sulfate		Narcotic analgesic	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		NSAID	Pain relief
Intrapartum	Oxycodone/Acetaminophen		Combination analgesic	Pain relief	Sedation
Intrapartum	Rho(D) Immune Globulin		Immunoglobulin	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		Lung surfactant	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		Narcotic analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Erythromycin 1% ointment		Antibiotic	Prevention of neonatorum ophthalmia
Prevention blindness from gonorrhea, Chlamydia. Should be given within first hr of life. State Law
Newborn	Fentanyl citrate		Narcotic analgesic	Synergistic effect with epidural	Not absorbed systemically. Adverse effects r/t hypotension w/epidural
Small amts added to epidural anesthesia.
Newborn	Hep B vaccine		Vaccine	Prevention of HepB
Recommended within 1st 12 hrs after birth. Series of vaccines.
Newborn	Meperidine		Narcotic Analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Misoprostol		Prostaglandin	Cervical ripening	Can cause uterine hyperstimulation
Approved as antiulcer. Off-label use in OB. Also used as abortifacient in 2nd trimester.
Newborn	Nalbupine		Narcotic Analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Naloxone		Narcotic antagonist	Reversal of resp depression r/t narcotics
Given IM. Must assure neonatal dosage.
Newborn	Oxytocin		Oxytoxic	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		Vitamin K	Prevention of hemorrhagic dx of the newborn
Given IM within 1st hr of life.
Newborn	Promethazine		Antiemetic	Prevention/tx of n/v Synergistic with narcotics	Can cause extrapyramidal effects. Use lowest dose
Newborn	Xylocaine		Local anesthetic	Episotomy
w/o epinephrine
Postpartum	Carboprost		Prostaglandin	Severe PPH
3rd line of drug for PPH
Postpartum	Docusate Sodium		Stool softner	Prevention of constipation
Postpartum	Ferrous sulfate		Iron replacement	Prevention/tx of anemia	May turn stools dark.
Take with Vit C to increase absorption
Postpartum	Ibuprofen		NSAID	Pain relief
Postpartum	Medroxyprogesterone acetate		Progestin	Birth Control
Given q 3 months IM
Postpartum	Meruvax II		Vaccine	Prevention of rubella
Give PP only.
Postpartum	Methylergonovine maleate		Oxytocic	PPH	May increase BP
2nd line of drug for PPH (IV). Can be continued PO.