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247 > DRUGS > Flashcards

DRUGS Flashcards

1
Q

Oxytocin - Class and indication

A

Oxytocics

Induction, post hem bleed after placenta, threatened abortion

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2
Q

Methylergonovine - Class and indication

A

Oxytocics

Prevent/treat PP hemorrhage caused by uterine atony or subinvolution
abnormal uterine bleed

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3
Q

Dinoprostone - Class and indication

A

Oxytocic + Cervical ripening

Induction and cervical ripening
PP hemorrhage

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4
Q

Misoprostol - Class and indication

A

Abortificants + prostaglandin

Termination of preg less than 45 days
Induction and cervical ripening
PP hemorrhage
*prevent NSAID induced ulcers

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5
Q

Nifedipine - Class and indication

A

Tocolytic + HTN

Stop labor before 37 weeks
HTN

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6
Q

Magnesium Sulfate - Class and indication

A

Tocolytic

Stop preterm labor
Prevent seizures in pre and eclampsia
Neuroprotection to fetus

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7
Q

Transexamic acid - Class and indication

A

Increase clotting factors

Prevent/stop PP hemorrhage by increasing clotting factors
heavy menstural

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8
Q

Carboprost - Class and indication

A

Oxytocic + abortificant

Labor induction
Term preg 13-20 weeks
PP hemorrhage from uterine atony not managed by other methods

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9
Q

Terbutaline - Class and indication

A

Tocolytic / beta 2 agonists

Prevent preterm labor / decrease contractions

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10
Q

Hydralazine - Class and indication

A

HTN
HTN emergencies - preeclampsia and eclampsia

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11
Q

Labetalol - Class and indication

A

HTN
HTN emergencies - preeclampsia and eclampsia

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12
Q

Ketorolac - Class and indication

A

Pain control

Short term management of pain control post c-section

NSAID

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13
Q

Calcium gluconate - Class and indication

A

Antidote

Reversale med for mag toxicity
Hypocalcemia
Hyperkalemia
Reduce pre-eclampisa
Stop preterm birth

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14
Q

Medroxyprogesterone - Class and indication

A

Birth control / decrease bleeding by hormone imbalance

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15
Q

Phytonadione - Class and indication

A

Antidote / vitamin K

Treat and prevent bleeding in neonate / increase coagulation

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16
Q

Oxytocin - Route and Dose

A

IV & IM
Induce: IV - 0.5-1mu/min, ^ 1-2mu/min
Post hemm: IV 10-40U, IM 10u
Abortion: IV 10u @10-20mu/min

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17
Q

Methylergonovine - Roust and Dose

A

PO, IM, IV

0.2mg

*After delivery of shoulder, placenta or puerperium - IM q 2-4hrs as needed
*Life threatening = IV over 1 min + PO 3-4X a day for 7 days

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18
Q

Dinoprostone - Route and Dose

A

Vag gel or insert / intraamniotic

Gel 0.5mg X2 q 6hr
Insert 10mg

MAX 1.5mg/24hr

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19
Q

Misoprostol - Route and Dose

A

PO, Vag, Rectally

Abortion - 800 PO, buccally, sublingual + 400mcg PO, buccally or rectally after 24-48hrs
Induction - 25mcg q3-6hrs vag/rec
PP hemorrhage - 600-1000 mcg rectally

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20
Q

Nifedipine - Route and Dose

A

PO

HTN- 30mg
Preterm - 10-20mg q 4-6hrs

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21
Q

Magnesium sulfate - Route and Dose

A

IV

Eclampsia - loading 4-6g over 15-20mins + maintenance 1-3g/hr

Preterm - loading 4-6g over 20-30mins + maintenance 1-3g/hr

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22
Q

Tranexamic acid - Route and Dose

A

IV

1g IV over 10 mins

Heavy menses - 1-1.5g 3x day up to four days prior or period

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23
Q

Phytonadione - Route and Dose

A

IM SubQ

0.5-1mg w/in 1 hr of birth - left vastus lateralis
May repeat in 6-8hrs if needed

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24
Q

Ketorolac - Route and Dose

A

IV

15-30mg IV q 6 hrs

Not to exceed 5 days!

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25
Q

Calcium gluconate - Route and Dose

A

IV
7-9g(5-10ml) of 10% over 5-10mins
(MAX 3g)

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26
Q

Medroxyprogesterone - Route and Dose

A

IM

150mg Q 3 months - given with in 5 days PP or after 6 weeks if breastfeeding

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27
Q

Labetalol - Route and Dose

A

PO, IV

PO -100mg twice daily, can increase q 2-3days (maintence dose 200-800/day in divided doses)

IV - 20mg over 2 min, additional dose q 10 min

(max 300mg)

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28
Q

Hydralazine - Route and Dose

A

PO, IV

5-10mg q 4-6 hrs
5-10mg IV admin slow over 2-5mins additional dose in 20-30mins

(max 25mg)

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29
Q

Carboprost - Route and Dose

A

IM

Abortion - 800mcg PO, buccally, sublingual + 400mcg PO, buccually, anally after 24-48hrs

**Induce/ripen **- 25mcg q 3-6 hours vaginally

PPhem - 600-1000mcg rectally

Max 12mg or continous 2 days

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30
Q

Terbutaline - Route and Dose

A

IV

2.5-10mcg, can increase by 5 q 10 mins until contractions stop

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31
Q

Oxytocin - Adverse effects

A

Water intox (coma, seizure, death), Uterine rupture, uterine tachysystole, Placental abrupto

Fetus - Asphyxia, intracranial hemorrhage, arrthymias

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32
Q

Methylergonovine - Adverse effects

A

Dyspnea

(Seizure, stroke with IV, MI HTN, cramp, nausea, vomit, decreased BP and increased RR - parethesia)

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33
Q

Dinoprostone - Adverse effects
Maternal?
Fetal?

A

Amniotic fluid embolism, uterine hyperstimulation, uterine rupture
(Fever, GI, Warm vagina)
FETUS: **HR abnormality **

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34
Q

Misoprostol - Adverse effects
Maternal?
Fetal?

A

Uterine rupture, hemorrhage, uterine hyperstimulation, hypotension
(nausea, vomit, diarrhea, diaphoresis)

FETAL: Abnormal FHR by restricting placental blood flow

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35
Q

Nifedipine - Adverse effects

A

Hypotension and decreased blood flow to fetus
(headache, dizzy)
gingival hyperplasia, constipation, flank pain

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36
Q

Ketorolac - Adverse effects

Maternal?
FEtal?

A

Gi Bleed
Renal, Cardiovascular, CNS, hematologic effects

FETUS - increased risk of miscarriage, premature closure of ductus arterious, harm to developing kidneys. AVOID In preg esp after 30 weeks

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37
Q

Calcium gluconate - Adverse effects

A

Cardiac arrest, bradycardia

Hypercalcemia, bradycardia, hypotension

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38
Q

Medroxyprogesterone - Adverse effects

A

DVT, PE, Breast cancer
Weight/mood changes
bone density loss

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39
Q

Magnesium Sulfate - Adverse effects

A

Toxicity! Loss of deep tendon reflexes, respiratory depression, cardiac arrest, neurological effects, muscle weakness

FETUS - hyptonia and respiratory depression

**Can cause fetal abnormalities if given beyond 5-7 days

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40
Q

Tranexamic acid - Adverse effects

A

Seizures, imparied color vision, GI upset,
Rare - excessive clotting, DVT, PE
Skin rash, diff breathing

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41
Q

Hydralazine - Adverse effects

A

Increased ICP, orthostatic hypotension, headaches, tachycardia
Maternal/fetal lupus like syndrome, hypospasias in boy fetus, thrombocytopenia

May cause fetal toxicity

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42
Q

Labetalol - Adverse effects

A

**Arrhythmias, HF, bradycardia, pulmomary edema

FETUS: Fetal growth restriction, hypoglycemia, bradycardia, hypotension, respiratory depression**

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43
Q

Oxytocin - Contraindications

A

Dino - wait 30min vag, 6-12hrs gel
Miso - do not use

X - when vag is contraindicated: fetal distress, prematurity, ob emergency, hypertonic uterus, fetal malpresentation, unripe cervix, history of uterine surgery

Vasopressors = severe HTN

44
Q

Methylergonovine - Contraindications

A

HTN (vasocontricts), CAD, PAD (smoking, obesity, DM), MI, sepsis, liver disease

Grapefruit increases vasospasm

45
Q

Dinoprostone - Contraindications

A

Hypersensitivty to prostaglandin
Active cardiac, pulmonary, renal or hepatic disease
Pelvic inflammatory disease
When prolonged uterine contract is inappropriate - placent previa, herpes, multipara, fetal distress
Do not use with other oxytocics

CAUTION: Asthma, kidney/liver dysfunction, ruptured membranes, glucoma

46
Q

Misoprostol - Contraindications

A

Pelvic infection, sepsis
Inflammatory bowel disease (chrons disease or ulcerative colitis)
Active cardiovascular disease (HF or CAD) - bc of changes in bp and hr
Chronic renal failure
When vag delivery is contra - Placent previa, OB emergency, past csection, multiparity

*Avoid use with other oxytocic

47
Q

Nifedipine - Contraindications

A

Hypotension, hemodynamical unstable
Avoid in HF pts
Breastfeeding

48
Q

Ketorolac - Contraindications

A

Do not take more than 5 days
Increased bleeding with garlic, ginger, ginko
Not used during labor = inhibit contractions and affect fetal circulation

NSAIDS can cause fetal renal dysfunction

Avoid w/ peptic ulcer, severe renal impairment, asthma, urticaria and w/ other NSAIDS

49
Q

Calcium gluconate - Contraindications

A

Cacrdiac arrest, bradycardia
hypercalcemia, hypotension

50
Q

Medroxyprogesterone - Contraindications

A

DVT, PE, Breast cancer, pregnancy

Thromembolitic disease, breast/genital cancer, cerebral vascular disease, depression

51
Q

Magnesium sulfate - Contraindications

A

When prolonging preg poses a risk
Before 20wks or after 34 wks
Heart block
Hypocalcemia, respiratory depression
Premature rupture of membranes
Myasthenia gravis

Caution: MI, renal disease

52
Q

Tranexamic acid - contraindications

A

Clotting disorder, CAD, DVT, PE, thromoembolism, impaired color vision, concurrent use of hormonal contraceptives
Severe renal dyfunction

52
Q

Hydralazine - Contraindications

A

CAD, rheumatic heart disease, hypersensitive to aspirin, hypotension, acute MI, glucoma, breastfeeding

Monitor slow position changes, HR

53
Q

Labetalol - Contraindications

A

Asthma, heart disease, CHF, Severe bradycardia, HF, pulmonary edema, cardiogenic shock

54
Q

What to monitor with Oxycotin?

A

I&O!!

If max dose 20mu/min - internal monitoring REQ

Discontinue if 3 conq decels or 1-2 min contractions

55
Q

What to monitor with Methylergonovine?

A

Bp, pulse, contractions may continue up to 45mins after IV and 3 hours after PO, IM

Check Ca level prior to admin, low Ca decrease effectiveness

56
Q

What to monitor with Dinoprostone?

A

Uterine activity, fetal status, cervix
*remove at onset of labor

57
Q

What to monitor with Misoprostol?

A

Remove after 12 hours or onset of labor

58
Q

What to monitor with Nifedipine?

A

Look for decrease in FHR variability and decels!!
Fall risk
Watch for signs of HF, monitor BP and pulse

59
Q

What to monitor with Calcium gluconate?

not checked

A

Monitor electrolyte levels, signs of hypercalcemia (confusion, coma)

60
Q

What to monitor with Medroxyprogesterone

not checked

A

BP, I&O,

May decrease glucose in DM

DO not use more than 2 years can cause osteroporosis

61
Q

What to monitor with Magnesium sulfate

A

I&O. Output should be 100ml during 4 hr period
Monitor renal function, RR, EKG, mag levels

Calcium gluconate is antidote for mag toxicity

62
Q

What to monitor with Tranexamic acid

not checked

A

Monitor renal function

63
Q

What to monitor with hydralazine

not checked

A

Slow position changes
Monitor BP, HR, weight

64
Q

What to monitor with labetalol

not checked

A

pulse,BP I&o weight

65
Q

Hep B - Class and indication?

A

Vaccine
Hep B prevention

66
Q

Tdap - Class and indication?

A

Vaccine
Prevention of tetanus, pertussis and diptheria

67
Q

Phytonadione - Class and indication?

not checked

A

Antidote
Prevent bleeding in neonates (increase coagulation)

68
Q

Hep B - Route and Dose

A

IM
Pregnancy - 20mcg/dose X3 IM deltoid
Neonate - 5mcg X 3 IM in vastus lateralus(series of 3)

69
Q

TDAP - - Route and Dose

A

IM
0.5ML

Given to mom at 27-36wks or PP

70
Q

Phytonadione - Route and Dose

A

IM, SUBQ
0.5-1mg w/in 1 hour of birth, may repeat in 6-8hrs if needed

71
Q

What to monitor with hep b?

A

If mom is hep + - give neonate a bath then Hep B PLUS H bIG
If mom is hep B - = just give hep b

72
Q

TDAP - contraindications

A

Some contain latex, confirm allergies

73
Q

Carboprost - Adverse

A

Uterine rupture, excessive bleeding, respiratory distress, septic shock, bronchospasms, hypotension, bradycardia

74
Q

Carboprost - contraindications

A

ASTHMA, hypersensitivity, acute pelvic inflammatory disease, active pulmonary, renal, hepatic or cardiovascualr disease

75
Q

Terbutaline - adverse effects

A

Tachycardia, arrhythmias, hypotension, hypokalemia, hyperglycemia, pulmonary edema, chest tightness, seizures

Fetal - tachycardia

76
Q

What 4 symptoms do you hold terbutaline for?

A

FHR greater than 180
RR greater than 30
Sp02 less than 95%
Maternal RH greater than 120

77
Q

What to monitor with Carbopost

A

pretreat with antiemetics and antidiarrheals
monitor BP

78
Q

Terbutaline - contraindications

A

Known cardiac disease
unmanaged DM
Hyperthyroid
TO delay preg = risk: preeclampsia, intrauterine infection, active vag bleeding,
Before 20wks after 34wks
Premature rupture of membrane

FEtal = abnormal FHR, fetal death, leathal amonalies

79
Q

WHat to monitor with terbutaline?

A

Maternal respiratory status, hypoglycemia, hypokalemia
*increased RR, crackles, frothy sputumn, anxiety, chills, drowieness, weakness, U wave arrhythmias

80
Q

Phytonadione - adverse

A

hypotension, thromboembolic events, skin changes

81
Q

Phytonadione - contraindications

A

Severe liver disease, thromboembolic disorder, hemolytic anemia

82
Q

Tdap - Class and indication

A

Vaccine

Tetanus (stiff muscle,spasm), Pertussis (Whooping cough), diptheria (thick coat in throat = decreased breathing)

83
Q

Tdap - Route and dose

A

IM

0.5ML

Given to mom at 27-36 weeks or PP

84
Q

TDAP - contraindications

A

Some contain laxtex - confirm allergies

85
Q

Hep B - Class and indication

A

Vaccine

Hep B prevention

86
Q

Hep B - Route and Dose

A

Pregnany women - IM deltoid, 20mcg/ dose X3
Neonate - IM vastus lateralus 5 mcg/dose X3

87
Q

Hep B - what to monitor

A

If mom is hep B + = give baby a bath and give hep B and H big
If mom is Hep B - = just give Hep b

88
Q

RhoGam - - Class and indication

A

Vaccine

Given to mom who is Rh negative who has Rh + baby or exposure to Rh+ blood

89
Q

RhoGam - Route and dose

A

IM
Before delivery - 300mcg @26-28weeks and again following delivery 300mcg w/in 72hrs

Termination of preg with rh+ = IM 300mcg w/in 72hrs

90
Q

RhoGam - adverse

A

Disseminated vascular coagulation (DIC)
Intravascular hemolysis
Back pain, shaking, fever, hemogloburiria

91
Q

RhoGAM - Contraindication

A

Do not give to infant!

Do not give to Rh+ or people already previously sensitized to antigen

Hemolytic anemia, igA deficiency with antibodies against, acute thrombocytopenia

92
Q

Rubella - - Class and indication

A

Vaccine
Prevent MMR

93
Q

Rubella - Route and dose

94
Q

Rubella - Contraindications

A

AFter vaccine do not conceive for 3 months causes birth defects

Can breastfeed

95
Q

Betamethosone - Class and indication

A

Corticosteroid

Fetal lung maturation
Prevention of intraventricular hemorrhage (bleeding in brain)
Prevention of necrotizing enterocolitis (lifethreatening GI)

96
Q

Betamethosone - Route and Dose

A

IM

12mg daily for 2-3 days before delivery

97
Q

Betamethosone - adverse

A

Maternal - Hyperglycemia, hypertension, fluid retention, mood changes
FETAL - Growth restriction, adrenal suppression, immunomodulation (increasing infection), hypoglycemia

98
Q

Betamethosone - contraindications

A

Maternal -Active infections, uncontrolled DM
Fetal - FEtal distress,, known fetal anomalies,

99
Q

Betamethosone - what to monitor

A

Give to mom gestational 24-34wks
Monitor I&O, dyspnea

100
Q

Penicillin - G - Class and indication

A

Antibiotic

Intrapartum for GBS prophylaxis
treatment of syphillis

101
Q

Penicillin G - Route and dose

A

GBS - IV 5MU followed by 2.5MU q 4hrs until delivery or 4 doses
Syphillus - IM 2.4MU

102
Q

Penicillin - adverse

A

Superinfection, renal and neurotoxicity
May alter normal colon flora and more susceptible to Cdiff

103
Q

Penicillin G - contra

A

Cannot give to women with cephalosporin sensitivities
Renal, GI or neurologic disorders

104
Q

Erythromycin - Class and indication

A

Antibiotics

to prevent ophthalmia neonatorum (blindness) caused by maternal STD

105
Q

Erythromycin - Route and dose

A

Topical

0.5-1cm in length w/in 1st hour of delivery

federally required

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