Med Cards Flashcards
Betamethasone (Celestone)
ACTION
Has potent anti-inflammatory actions & suppresses immune response
Betamethasone (Celestone)
CLASS
Corticosteroids
Betamethasone (Celestone)
USE
ACCELERATION OF FETAL LUNG MATURITY to reduce incidence & severity of RDS
Reduce incidence of IVH & neonatal death in the preterm infant
Betamethasone (Celestone)
DOSE
IM, GIVEN 24 HR BEFORE BIRTH OF PRETERM INFANT
Betamethasone (Celestone)
C/I
Active Infection
Betamethasone (Celestone)
SIDE EFFECTS
PULMONARY EDEMA
REBOUND HYPOGLYCEMIA
Temporary rise in WBC for 72 hrs
Betamethasone (Celestone)
CONSIDERATIONS
If mom has diabetes, therapy may increase infusion requirements & frequent monitoring WBC >20 may indicate infection Report CP, dyspnea May cause nervousness, insomnia Assess lung sounds & s/s of infection
Calcium Gluconate
CLASS
MINERAL & ELECTROLYTE REPLACEMENT
Calcium Gluconate
USE
HYPERMAGNESEMIA
Calcium Gluconate
DOSE
IV
Calcium Gluconate
C/I
Hypercalcemia Renal/Cardiac disease Renal calculi V. fib Digitalis therapy Severe respiratory insufficiency
Calcium Gluconate
CONSIDERATIONS
Monitor BP, pulse, ECG
Monitor s/s of hypercalcemia (N/V, anorexia, thirst, severe constipation, bradycardia)
Pt should remain recumbent 30-60 min after administration
Solution should be warmed to body temp
Misoprostol (Cytotec)
CLASS
PROSTAGLANDIN
Misoprostol (Cytotec)
ACTION
INCREASE UTERINE CONTRACTION
Misoprostol (Cytotec)
USE
- PREINDUCTION CERVICAL RIPENING
- LABOR INDUCTION
- PP HEMORRHAGE
- ABORTION
Misoprostol (Cytotec)
DOSE
INTRAVAGINAL
PO
RECTAL
Misoprostol (Cytotec)
C/I
Asthma Glaucoma Ischemic heart disease Pulmonary, hepatic, or renal disease Previous C-section or other uterine surgery
Misoprostol (Cytotec)
SIDE EFFECTS
TACHYSYSTOLE UTERINE RUPTURE BLEEDING HYPERGLYCEMIA (MOM) HYPOGLYCEMIA (BABY)
Misoprostol (Cytotec)
CONSIDERATIONS
NEVER GIVE FOR AUGMENTATION
ASSESS FHR
For uterine tachysystole: place in side-lying position, apply O2 8-10L/min, administer tocolytic
Erythromycin (Ilotycin)
CLASS
ANTIBIOTIC
Erythromycin (Ilotycin)
ACTION
Inhibits protein synthesis in bacteria
Erythromycin (Ilotycin)
USE
PREVENT OPHTHALMIA NEONATORUM IN CASE MOTHER INFECTED WITH GONORRHEA
REQUIRED BY LAW
Erythromycin (Ilotycin)
DOSE
APPLY TO LOWER CONJUNCTIVAL SAC WITHIN 1 HOUR AFTER BIRTH
Erythromycin (Ilotycin)
SIDE EFFECTS
Temporarily blur vision
Burning
Itching
Erythromycin (Ilotycin)
CONSIDERATIONS
Cleanse eye before application
Administer from inner canthus to outer canthus
May wipe away excess after 1 minute
Fentanyl (Sublimaze)
CLASS
OPIOID ANALGESIC
Fentanyl (Sublimaze)
ACTION
Produce CNS depression & decrease pain
Fentanyl (Sublimaze)
USE
ADJUNCT TO EPIDURAL ANALGESIA DURING LABOR
Fentanyl (Sublimaze)
C/I
Caution with pregnancy & lactation
Fentanyl (Sublimaze)
SIDE EFFECTS
CAN PASS INTO THE BABY & CAUSE RESPIRATORY DEPRESSION
n/v
Dizziness
Fentanyl (Sublimaze)
CONSIDERATIONS
Monitor RR
ACCOMPANY MOM DUE TO FALL RISK
Fentanyl (Sublimaze)
ANTIDOTE
NARCAN
HAVE READY FOR FETAL INTERVENTION
Carboprost tromethamine (Hemabate) CLASS
Prostaglandin, OXYTOCIC
Carboprost tromethamine (Hemabate) ACTION
Stimulate contraction of uterus
Carboprost tromethamine (Hemabate) USE
- TREATMENT OF PP HEMORRHAGE CAUSED BY UTERINE ATONY
2. ABORTION
Carboprost tromethamine (Hemabate) C/I
ACUTE PELVIC INFLAMMATORY DISEASE
CARDIAC, PULMONARY, RENAL, OR HEPATIC DISEASE
Hx OF ASTHMA, hyper/hypotension, anemia, jaundice, diabetes, epilepsy, previous uterine surgery
Carboprost tromethamine (Hemabate) SIDE EFFECTS
DIARRHEA
n/v, fever, chills, facial flushing, HA, tachycardia, hyper/hypotension, pulmonary edema, excessive dose may cause tetanic contraction & laceration or uterine rupture, uterine hypertonus
Carboprost tromethamine (Hemabate) CONSIDERATIONS
NOT FIRST CHOICE DRUG DO NOT ALLOW DRUG TO COME IN CONTACT WITH SKIN ANTIEMETICS/ANTIDIARRHEALS AS ORDERED Keep refrigerated Aspirate to avoid IV Rotate sites
Hep B Vaccine
CLASS
Vaccine
Hep B Vaccine
ACTION
Create antibodies
Hep B Vaccine
USE
Prevent chronic infection of newborn whose mother is HBsAg-positive
Hep B Vaccine
DOSE
GIVEN WITH 12 HOURS OF BIRTH
Nalbuphine (Nubain)
CLASS
OPIOID ANALGESIC/ANTAGONIST
Nalbuphine (Nubain)
ACTION
Binds to opiate receptors
Nalbuphine (Nubain)
USE
Decreases pain r/t labor
Nalbuphine (Nubain)
DOSE
IV
Nalbuphine (Nubain)
C/I
PATIENTS PHYSICALLY DEPENDENT ON OPIOIDS
& have not detoxed
Nalbuphine (Nubain)
SIDE EFFECTS
n/v Respiratory depression Dizziness Confusion Dry mouth Clammy skin Sweating Pruritus
Nalbuphine (Nubain)
CONSIDERATIONS
DON’T GIVE TO OPIATE DEPENDENT PATIENTS
Record baseline maternal vitals & FHRP before, during, & after administration
Monitor for respiratory depression
Nalbuphine (Nubain)
ANTIDOTE
NARCAN
Nifedipine (Procardia, Adalat)
CLASS
CCB, TOCOLYTIC
Nifedipine (Procardia, Adalat)
ACTION
Decreases muscular contraction by acting as a calcium antagonist
Nifedipine (Procardia, Adalat)
USE
STOP PRETERM LABOR
Nifedipine (Procardia, Adalat)
DOSE
PO
Nifedipine (Procardia, Adalat)
SIDE EFFECTS
FLUSHING HA TACHYCARDIA Dizziness Transient maternal & fetal tachycardia Orthostatic hypotension
Nifedipine (Procardia, Adalat)
CONSIDERATIONS
REPORT MATERNAL PULSE GREATER THAN 120
Teach pt side effects & to sit & stand slowly & call for assistance if needed
Naloxone (Narcan)
CLASS
Opiate antagonist