Induce labor or prevent PPH Flashcards
6 drugs
1 dinoprostone 2 oxytocin 3 misoprostol 4 carboprost tromethamine 5 methylergonovine 6 tranexamic acid
dinoprostone
brand name
Cervidil
oxytocin
brand name
Pitocin
misoprostol
brand name
Cytotec
carboprost tromethamine
brand name
Hemabate
methylergonovine
brand name
Methergine
tranexamic acid
brand name
TXA
dinoprostone [Cervidil]
indication
cervical ripening
- induce abortn (12-20 wk)
- induce labor
- remove remaining placental material fr miscarriage
dinoprostone [Cervidil]
MOA
naturally occurring prostaglandin
-stim myometrium to produce contractions
dinoprostone [Cervidil]
CI
- uterine scarrine
- spont delivery or vaginal delivery
- oxytocin
- amniotic fluid embolism
dinoprostone [Cervidil]
teaching
- stay supine/lateral for 2 hours
- remove after 12 hr
- oxytocin should be delayed 30-60min after removal
dinoprostone [Cervidil]
S/E
- NVD
- report severe dizzy + ab pain
oxytocin [Pitocin]
indication
standard: given to all moms after delivery of placenta
- induce labor
- strengthen UC
- decr bleeding
- let-down of milk
oxytocin [Pitocin]
MOA
stim smooth muscle> uterine contraction
oxytocin [Pitocin]
CI
- hypertonic or hyperactive uterus
- non-vaginal delivery
oxytocin [Pitocin]
education
- has antidiuretic effect so monitor fluid/electrolyte balance
- cramping is similar to mentrual cramping
- bolus 350 after delivery
misoprostol [Cytotec]
indication
- induce labor or abortion
- incr UC to prevent PPH
other use: prevents stomach ulcers r/t NSAIDs
misoprostol [Cytotec]
moa
prostaglandin analogue> stim uterine to contract
misoprostol [Cytotec]
CI
- hx of C section
- uterine scarring
- dont give to others for abortion
- hypersensitivity to oxytocin
misoprostol [Cytotec]
teaching
in combo w oxytocin, notify HCP if rash, chest pain, diarrhea
-oxytocin should be delayed for 4 hrs
carboprost tromethamine
[Hemabate]
indication
- PPH
- induce UC for abortion
carboprost tromethamine [Hemabate]
MOA
prostaglandin> UC> reduce bleeding
carboprost tromethamine
[Hemabate]
CI
- ASTHMA*
- pulmo disease
- renal disease
- hepatic disease
carboprost tromethamine
[Hemabate]
teaching/side effects
- explosive diarrhea (medicate w antidiarrheal/antiemetic)
- monitor for s/s of hemorrhage (tachycard, hypotnsn)
methylergonovine [Methergine]
indication
- PPH
- subinvolution
methylergonovine [Methergine]
moa
ergot alkaloid acts on smooth muscle to incr contraction
-shortens labor, reduce blood loss
methylergonovine [Methergine]
CI
- HTN
- hrt problems
- no breastfeeding
tranexamic acid [TXA]
indication
- PPH
- heavy menstruation
tranexamic acid [TXA]
moa
inhibit activation of plasminogen to plasmin
tranexamic acid [TXA]
CI
- embolism/thrombo
- acquired defective color vision
- hormonal contraceptives
tranexamic acid [TXA]
teaching
- stop med w any vision changes
- report flushing, one side weaknss, seizure, clot like chest pain
