16. Common medications

Question 1

Name indications/comments of drug: betamethasone valerate (Celestone®)

Answer 1

Enhancement of fetal pulmonary maturity for preterm labour

Question 2

Describe dosing schedule: betamethasone valerate (Celestone®)

Answer 2

12 mg IM q24h x 2 doses

Question 3

Name indications/comments of drug: carboprost (Hemabate®)

Answer 3

Treatment of uterine atony

Question 4

Describe dosing schedule: carboprost (Hemabate®)

Answer 4

• 0.25 mg IM/IMM q15min
• Max 2 mg

Question 5

Name indications/comments of drug: cefazolin

Answer 5

Group B Streptococcus prophylaxis (penicillin allergic and not at risk for anaphylaxis)

Question 6

Describe dosing schedule: cefazolin

Answer 6

2 g IV then 1 g q8h

Question 7

Name indications/comments of drug: clindamycin

Answer 7

Used in endometritis

Question 8

Describe dosing schedule: clindamycin

Answer 8

900 mg IV q8h

Question 9

Name indications/comments of drug: dinoprostone (Cervidil®: PGE2 impregnated thread)

Answer 9

• Induction of labour
• Advantage: can remove if uterine hyperstimulation

Question 10

Describe dosing schedule: dinoprostone (Cervidil®: PGE2 impregnated thread)

Answer 10

• 10 mg PV (remove after 12 h)
• Max 3 doses

Question 11

Name indications/comments of drug: doxylamine succinate (Diclectin®)

Answer 11

• Each tablet contains 10 mg doxylamine succinate with vitamin B6
• Used first-line for N/V in pregnancy, including hyperemesis gravidarum

Question 12

Describe dosing schedule: doxylamine succinate (Diclectin®)

Answer 12

• 2 tabs qhs + 1 tab qam + 1 tab qpm
• Max 8 tabs/d

Question 13

Name indications/comments of drug: erythromycin

Answer 13

GBS prophylaxis (penicillin allergic and at risk for anaphylaxis)

Question 14

Describe dosing schedule: erythromycin

Answer 14

500 mg IV q6h

Question 15

Name indications/comments of drug: folic acid

Answer 15

Prevention of open neural tube defect ONTD

Question 16

Describe dosing schedule: folic acid

Answer 16

0.4-1 mg PO OD x 1-3 mo preconception and T1 5 mg PO OD with past Hx of NTD/risks for NTD

Question 17

Name indications/comments of drug: methotrexate

Answer 17

For ectopic pregnancy or medical abortion

Question 18

Describe dosing schedule: methotrexate

Answer 18

50 mg/mL IM or 50 mg PO x 1 dose

Question 19

Name indications/comments of drug: methylergonavine maleate (Ergotamine®)

Answer 19

Treatment of uterine atony

Question 20

Describe dosing schedule: methylergonavine maleate (Ergotamine®)

Answer 20

• 0.25 mg IM/IMM q15min up to 1.25 mg
• or IV bolus 0.125 mg

Question 21

Name indications/comments of drug: misoprostol (Cytotec®)

Answer 21

• For treatment of postpartum hemorrhage PPH
• For medical abortion/retained products of conception

Question 22

Describe dosing schedule: misoprostol (Cytotec®)

Answer 22

• 600-1000 µg PR x 1 dose
• 400 µg PO/SL x 1 dose
• or 800 µg PV x 1 dose 3-7 d after methotrexate

Question 23

Name indications/comments of drug: oxytocin (Pitocin®)

Answer 23

• Augmentation of labour (also induction of labour)
• Prevention of uterine atony
• Treatment of uterine atony

Question 24

Describe dosing schedule: oxytocin (Pitocin®)

Answer 24

• 0.5-2.0 mU/min IV or 10 U/L NS increase by 1-2 mU/min q20-60min
• Max 36-48 mU/min
• 10 IU IM at delivery of anterior shoulder and of placenta 20 IU/L NS or RL IV continuous infusion

Question 25

Name indications/comments of drug: Penicillin G

Answer 25

GBS prophylaxis

Question 26

Describe dosing schedule: Penicillin G

Answer 26

5 million IU IV, then 2.5 million IU IV q4h until delivery

Question 27

Describe dosing schedule: PGE2 gel (Prostin® gel)

Answer 27

Induction of labour

Question 28

Describe dosing schedule: PGE2 gel (Prostin® gel)

Answer 28

• 0.5 mg PV q6-12h
• max 3 doses

Question 29

Name indications/comments of drug: Rh IgG (Rhogam®)

Answer 29

• Given to Rh-negative women
• Routinely at 28 wk GA
• Within 72 h of birth of Rh+ fetus
• Positive Kleihauer-Betke test
• With any invasive procedure in pregnancy
• Ectopic pregnancy
• Antepartum hemorrhage
• Miscarriage or therapeutic abortion (dose: 50 µg IM only)

Question 30

Describe dosing schedule: Rh IgG (Rhogam®)

Answer 30

300 µg IM x 1 dose