CTC ADN - Medications in Obstetrics for Nursing Students

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Newborn	Erythromycin 1% ointment		Antibiotic	Prevention of neonatorum ophthalmia
Prevention blindness from gonorrhea, Chlamydia. Should be given within first hr of life. State Law
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
Newborn	Promethazine	Phenergan	Antiemetic	Prevention/tx of n/v Synergistic with narcotics	Can cause extrapyramidal effects. Use lowest dose
Antepartum	Hydralazine	Apresoline	Antihypertensive	BP control
Given IVP for acute hypertension.
Antepartum	Methyldopa	Aldomet	Antihypertensive	BP control
DOC for antihypertension maintenance
Antepartum	Nifedipine	Procardia	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	Lorazepam	Ativan	CNS Agent	Anticonvulsant Tx
Used during seizure. Must be kept refrigerated.
Intrapartum	Oxycodone/Acetaminophen	Percocet	Combination analgesic	Pain relief	Sedation
Antepartum	Ca Gluconate		Electrolyte replacement	Antidote for hypermagnesium
Usual dose: 1g IV over 3-5 mins
Intrapartum	Rho(D) Immune Globulin	Rhogam	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.
Postpartum	Ferrous sulfate	Feosol	Iron replacement	Prevention/tx of anemia	May turn stools dark.
Take with Vit C to increase absorption
Intrapartum	Bupivicane	Marcaine	Local anesthetic	Epidural anesthesia	Complications r/t hypotension episode with epidural
Most have BP monitored frequently (q 15 mins) with epidural anesthesia.
Newborn	Xylocaine		Local anesthetic	Episotomy
w/o epinephrine
Newborn	Beractant	Survanta	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
Intrapartum	Morphine Sulfate	Duramorph Morphine	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.
Newborn	Butorphanol	Stadol	Narcotic analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Fentanyl citrate	Sublimaze	Narcotic analgesic	Synergistic effect with epidural	Not absorbed systemically. Adverse effects r/t hypotension w/epidural
Small amts added to epidural anesthesia.
Newborn	Meperidine	Demerol	Narcotic Analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Nalbupine	Nubain	Narcotic Analgesic	Pain relief	Sedation. Can cause transient loss of FHR variability. Neonatal resp if given close to delivery
Newborn	Naloxone	Narcan	Narcotic antagonist	Reversal of resp depression r/t narcotics
Given IM. Must assure neonatal dosage.
Intrapartum	Naproxen Sodium	Anaprox	NSAID	Pain relief
Postpartum	Ibuprofen	Motrin	NSAID	Pain relief
Postpartum	Methylergonovine maleate	Methergine	Oxytocic	PPH	May increase BP
2nd line of drug for PPH (IV). Can be continued PO.
Newborn	Oxytocin	Pitocin	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
Postpartum	Medroxyprogesterone acetate	Depoprovera	Progestin	Birth Control
Given q 3 months IM
Antepartum	Dinoprostone	Prostin E2	Prostaglandin	Termination of pregnancy	n/v/d, fever
May be premedicated with Tylenol, antidiarrheal and antiemetic
Newborn	Misoprostol	Cytotec	Prostaglandin	Cervical ripening	Can cause uterine hyperstimulation
Approved as antiulcer. Off-label use in OB. Also used as abortifacient in 2nd trimester.
Postpartum	Carboprost	Hemabate	Prostaglandin	Severe PPH
3rd line of drug for PPH
Antepartum	Celestone	Betamethosone	Steriod	Lung maturity	Increase fetal lung maturity
12.5mg IM q 24 hrs x 2 doses. Given to mom when PTL (24 - 34 wks)
Postpartum	Docusate Sodium	Colace	Stool softner	Prevention of constipation
Antepartum	Ritodrine	Yutopar	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	Brethine	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
Newborn	Hep B vaccine	Recombivax HB	Vaccine	Prevention of HepB
Recommended within 1st 12 hrs after birth. Series of vaccines.
Postpartum	Meruvax II	Rubella vaccine	Vaccine	Prevention of rubella
Give PP only.
Newborn	Phytonadione	Aqua Mephyton	Vitamin K	Prevention of hemorrhagic dx of the newborn
Given IM within 1st hr of life.