Maternity Important Meds Exam 1 Flashcards
Pitocin/Oxytocin
Route: IV or IM
Dose:
- IV: 20-60 units diluted in 500ml to 1000 ml
- IM: 10 units 1x after placenta delivery OR 20milliunits/min IV after placenta delivery until uterus firmly contracted. (mix 10-40units/L IV fluid)
Class: Binds to oxytocin receptors increasing intracellular Ca and stimulating uterine contractions
Action: Stimulates uterine contractions; used to “firm” uterus when hemorrhaging or prevent hemorrhaging
Side effects:
- Hyperstimulation
- Uterine rupture
- Abruptio placenta
Hemabate
Route: IM
Dose: Postpartum hemorrhage [250 mcg IM x1] max 2 mg total dose
Class: oxytotic prostaglandin
Action: Prostaglandin to control bleeding after birth; stimulates smooth muscle and uterine contractions (synthetic prostaglandin)
Side effects:
- N/V
- Diarrhea
- H/A (headache?))
Cytotec
Route: Oral, Vaginal, rectal
Dose: 1/4 of 25mg tablet (intravaginally for labor) 800-1000mcg rectally for pp hemorrhage
Class: Prostaglandin cytokine
Action: Induction of labor, pp hemorrhage, gastric protectant; produces uterine contractions
Side effects:
- Cramping (keep woman in bed for one hour after admin)
- Uterine hyper stimulation
Methergine
Route: PO/IM
Dose: 0.25mg IM
0.2mg PO tid-qid up to 1 week
Class: ergot derivative with vasoconstrictive properties
Action: Stimulates uterine contractions to control bleeding after birth
Side effects:
- Will increase BP
Sodium citrate
Route: PO
Dose: 10-30mL PO q6-8 hr pro; max 4 doses/day. Dilute with water
Class: antacid
Action: Pre-op to neutralize stomach contents prior to OR. Oxidizes sodium bicarbonate, raises pH
Side effects:
- Diarrhea
- N/V
- water retention
Ampicillin
Route: IV
Dose: 2gm initial dose; 1-2gm Q4 until birth
Class: Antibiotic
Action: tx for positive GBS (Strep B)
Side effects:
- GI disturbances
- Allergy
- Rash
- Anaphylaxis
Ancef
Route: IV
Dose: 1-2gm IV admin 30-60min prior to start of surgery
Class: First generation cephalosporin antibiotic
Action: Pre-op for cesarean birth to prevent infection
Side effects:
- Genital itching
- White patches in mouth
- Loss of appetite
- Heartburn
- Gas
- N/V
- Diarrhea
- Headache
Vitamin K
Route: IM
Dose: 0.5-1mg IM once
Class: Vitamin
Action: prevention of hemorrhagic disease of the newborn (HDN)
Side effects:
- Transfer to milk is low, need supplement
Betamethasone
Route: IM
Dose:
12mg IM q 24 hours, 2 doses
Class: Long acting corticosteroid
Action: to induce fetal lung maturation in expectant mothers between 24-34 weeks gestation at high risk of premature delivery
Side effects:
- Sodium and fluid retention
- Hypokalemia
- BP elevated
- edema
- Diaphoresis
- Rash
- Dyspepsia
- Headache
Magnesium Sulfate
Route: IV
Dose: 4-6gm bolus once, then 1-3 g/hour x 12-24 hours; Max: 40g/24hr x5-7 days
Class: alkaline earth metal sulfate; saline laxative and anticonvulsant
Action: Preterm as a neuro protectant for the fetus; decrease CNS irritability and prevention of seizures in hypertensive and preeclampsia conditions; relaxes the uterus to stop uterine contractions in preterm labor
Side effects: Serious - Resp paralysis - Hypothermia Common - depressed reflexes - Hypotension
Calcium gluconate
Route: IV push
Dose: 1-2 g IV
Class: mineral
Action: Given as the antidote to magnesium
Side effects:
- N/V
- Decreased appetite
- Constipation
- Dry mouth
- Increased thirst
- Increased urination
Terbutaline (Brethine)
Route: SQ/IV, PO
Dose:
- 0.25mg SQ
- 2.5-5mg q4-6hr PO
Class: Beta-2 adrenergic
Action: Relaxes uterus in preterm labor or with a titanic uterine contraction during an induction or for fetal distress
Side effects:
- Tachycardia (both mother and fetus)
- Uncomfortable for women
Duramorph/Morphine
Route: SC, IV, IM, Epidural, Intrathecal
Dose:
- Initial dose 10mg q4hr PRN
- Range: 5-20mg q4hr PRN
- 2mg/70kg body weight IV
Class: Narcotic analgesic
Action: Systemic narcotic analgesic that provides pain relief for extended periods without attendant loss of motor, sensory, or sympathetic function
Side effects:
- Sedation
- Constipation
Naloxone (Narcan)
Route: SC, IM
Dose: 0.4mgSC/IM q2-3min prn
Class: narcotic antagonist
Action: opioid overdose; occupies opiate receptor sites; displaces opioids already at opiate receptor sites
Side effects:
- Tachycardia
- Hypertension
- Hypotension
- N/V
- Withdrawal symptoms
- Diaphoresis
- Pulmonary edema
- Dyspnea
Fentanyl
Route: IV
Dose: 100mg (2-20mg/kg) IV
Class: Potent narcotic analgesic; opioid
Action: Labor pain; binds with stereospecific receptors at many sites within CNS; increases pain threshold, alters pain reception, inhibits ascending pain pathways
Side effects:
- Apnea
- Resp depression
- Muscle rigidity
- Hypotension
- Bradycardia
