Common Medications in Midwifery Flashcards
Flucloxacillin
Antibiotic for CS wound infection, PO, 500mg 4 x a day for mild infection and 1g 4 x a day for moderate infection. Safe in breastfeeding and pregnancy. Not suitable if allergic to penicillin. Side effects: Diarrhoea, nausea, skin reactions, vomiting.
Co-amoxiclav
Antibiotic for CS wound infection, PO, 625mg 3 x a day for serious infection. Not suitable for penicillin allergy. Safe in breastfeeding. Side effects: diarrhoea, hypersensitivity, nausea, skin reactions, vomiting.
Vancomycin
Antibiotic for CS wound when allergic to penicillin. 125mg every 6 hours for 10 days. Side effects: Dizziness, very low white cells, nausea, drug fever, hypersensitivity.
Paracetamol
Relief of mild-moderate pain and pyrexia. PO. 500mg x 2. 4 times a day. Side effects: Hypersensitivity reactions
Diamorphine
Analgesia for moderate to severe pain. Given IM, 5-10mg every 4 hours. Side effects: nausea/vomiting, bradycardia, drowsiness, dizziness, respiratory depression.
Diclofenac Tabs
Analgesia for moderate to severe pain for up to 48 hours, especially following C/S. PO 50mg T.D.S. Side effects: Abdominal pain, dyspepsia, nausea, headaches, diarrhoea/constipation, allergic reactions, rash.
Diclofenac Suppositories
Analgesia and anti-inflammatory post perineal suturing. PR 100mg once only. Side effects: Abdominal pain, dyspepsia, nausea, headaches, diarrhoea/constipation, allergic reactions, rash.
Prochlorperazine
Antiemetic to go with opioid analgesia or excessive emesis. IM 12.5mg once only or 6-8hrly. Side effects: Tremor, dystonia, akathisia, drowsiness, dizziness, gastrointestinal disturbance, constipation, pallor, hypothermia. Can cause prolonged labour so withhold until 3-4cm dilated.
Ibuprofen
Analgesia for mild to moderate pain, particularly perineal. 400mg up to 3 times a day. Side effects: gastrointestinal discomfort, diarrhoea, rash, headache dizziness.
Folic Acid
Prevention of neural tube defects. 400mcg PO once a day until 12 weeks gestation. Side effects: rarely gastrointestinal disturbance.
Lactulose
Treatment for constipation. 5ml starting dose, then 15ml B.D PO. Side effects: flatulence, abdominal cramps, discomfort.
Micralax Enema (Sodium Citrate)
Treatment for constipation. One 5ml enema PR. Side effects: Diarrhoea and excessive fluid loss
Peptac
For reflux. PO 10-20ml after meals and at bedtime.
Peppermint water
Relief of abdominal colic and distention, IBS. PO 1-2 capsules 3 x a day. Side effects: Ataxia, bradycardia, gastro discomfort, reflux disease, headache, nausea. Not to broken or chewed as peppermint oil can irritate the mouth.
Phytomenadione (Vitamin K for neonate)
Prophylaxis and treatment for VKDB. 1mg IM at birth or 2mg orally. a further 2mg dose at 4-7 days. BF babies should be given a 3rd dose at 1 month.
Clotrimazole 1% cream
Treatment of vaginal and vulval candidiasis. Use 2-3 times a day. Side effects: local irriation, rash, burning, pruritus.
Clotrimazole 500mg pessary
Treatment of vaginal candidiasis. One pessary inserted at night PV. Side effects: local irritation, rash, pruritus.
Adrenaline (1mg/ml)
Treatment for acute anaphylaxis. IM. 500mcg (0.5ml). Can be repeated after 5-15 mins according to BP,pulse and resp function. Side effects: anxiety, temor, tachycardia, arrythmias, headache, cold extremities, hypertension, pulmonary oedema, nausea, vomiting, sweating, weakness, dizziness, hyperglycaemia.
Anti-D immunoglobulin
Routine antenatal prophylaxis of haemolytic disease of the newborn caused by Rh D antibodies in Rh D negative mothers, where fetus is known to be RhD positive or status is unknown. 1500 units stat as single dose at 28 weeks or 29-30 weeks gestation.
Sensitising event in Rh D negative mothers - 1500 units
Postnatally - 1500 units IM, plus additional depending on FMH result (foeto-maternal haemorrhage/kelihauer test)
Side effects: local pain at site of injection. Sometimes fever,headache, cutaneous reactions, chills.
Anusol cream
Symptomatic relief of haemorrhoids and anal pruritus. Use am and pm, and following BO until symptoms resolved. Side effects: rarely localised burning at site.
Diprobase cream
Symtomatic relief of red inflamed, damaged or dry skin. Use as required (PRN). Side effects: local irritation, pruritus, rash.
Entonox
Pain relief in labour, inhalational, as required self administered. Side effects: euphoric effects. No longer than 24 hours use.
Ergometrine
Emergency treatment of PPH associated with uterine atony. IM or slow IV, 500mcg single dose. Side effects: nausea, vomiting, abdominal pain, chest pain, arrythmias
Ferrous sulphate 200mg tabs
treatment of iron deficiency anaemia. PO. 200mg once or twice a day. Can cause nausea, dyspepsia, constipation, black stools
Fybogel orange sachets
Relief of constipation. PO, one sachet a day. Side effects: bloating and flatulence.
Gaviscon advance.
Treatment of reflux, indigestion, heartburn. PO 5-10ml after meals and bedtime. Side effects: hypersensitivity rare.
Hartmann’s solution
IV infusion. Used in maternal resuscitation, expanding circulatory volume and fluid/electrolyte replenisher and prior to epidural. 1000ml once only.
Hepatitis B vaccine.
For immunity to Hep B infection in neonates born to Hep B surface antigen positive mothers. IM - anterolateral thigh 10mcg at birth. Side effects: pain, redness at site, irritability, fever, diarrhoea and vomiting.
Hepatitis Immunoglobulin
Prevention of transmission of Hep B at birth. IM into upper outer quadrant of buttock in neonates. 200 units asap after birth simultaneous to vaccine but in different site. Side effects: red, redness at site of injection
Lidocaine 1%
For perineal infiltration prior to episiotomy or perineal suturing. 5-20ml once only. Side effects: drowsiness, restlessness, dizziness, blurred vision, nausea, vomiting, muscle twitching, tremor, convulsions.
Nystatin
Treatment of oral and intestinal thrush in adults and infants. PO, 1ml 4 x a day. Side effects: Oral irritation, gastro disturbance in overdose.
Oxytocin (Syntocinon)
To expedite 3rd stage of labour in hypertensive patients, IM, 10 units once only.
For emergency treatment for PPH up to max of 4 hrs post delivery. IV infusion, 50mls in 500mls hartmanns solution at a rate of 125ml/hr.
Side effects: nausea, vomiting, arrythmia, headache
Pethidine Hydrochloride
Pain relief in labour. IM 50-100mg repeated 3/4hours later if necessary. Max 200mg in 24 hours. Side effects: nausea, vomiting, constipation, dry mouth and more
Sodium Chloride 0.9%
Following IV cannulation, IV flush, 5ml
Syntometrine (ergometrine/oxytocin)
To expedite 3rd stage of labour. IM injection. 1ml amp once only. Side effects: nausea, vomiting, abdo pain, uterine spasm, uterine hyperstimulation, chest pain, arrythmias
Intramuscular Injection
90 degree angle
Subcutaneous injection
45 degree angle
Intravenous injection
25 degree angle
intradermal injection
10-15 degree angle
