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0
Q

Betamethasone (Celestone)

ACTION

A

Has potent anti-inflammatory actions & suppresses immune response

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1
Q

Betamethasone (Celestone)

CLASS

A

Corticosteroids

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3
Q

Betamethasone (Celestone)

USE

A

ACCELERATION OF FETAL LUNG MATURITY to reduce incidence & severity of RDS
Reduce incidence of IVH & neonatal death in the preterm infant

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4
Q

Betamethasone (Celestone)

DOSE

A

IM, GIVEN 24 HR BEFORE BIRTH OF PRETERM INFANT

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5
Q

Betamethasone (Celestone)

C/I

A

Active Infection

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6
Q

Betamethasone (Celestone)

SIDE EFFECTS

A

PULMONARY EDEMA
REBOUND HYPOGLYCEMIA
Temporary rise in WBC for 72 hrs

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7
Q

Betamethasone (Celestone)

CONSIDERATIONS

A 
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
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8
Q

Calcium Gluconate

CLASS

A

MINERAL & ELECTROLYTE REPLACEMENT

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9
Q

Calcium Gluconate

USE

A

HYPERMAGNESEMIA

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10
Q

Calcium Gluconate

DOSE

A

IV

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11
Q

Calcium Gluconate

C/I

A 
Hypercalcemia
Renal/Cardiac disease
Renal calculi
V. fib
Digitalis therapy
Severe respiratory insufficiency
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12
Q

Calcium Gluconate

CONSIDERATIONS

A

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

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13
Q

Misoprostol (Cytotec)

CLASS

A

PROSTAGLANDIN

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14
Q

Misoprostol (Cytotec)

ACTION

A

INCREASE UTERINE CONTRACTION

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15
Q

Misoprostol (Cytotec)

USE

A
  1. PREINDUCTION CERVICAL RIPENING
  2. LABOR INDUCTION
  3. PP HEMORRHAGE
  4. ABORTION
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16
Q

Misoprostol (Cytotec)

DOSE

A

INTRAVAGINAL
PO
RECTAL

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17
Q

Misoprostol (Cytotec)

C/I

A 
Asthma
Glaucoma
Ischemic heart disease
Pulmonary, hepatic, or renal disease
Previous C-section or other uterine surgery
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18
Q

Misoprostol (Cytotec)

SIDE EFFECTS

A 
TACHYSYSTOLE
UTERINE RUPTURE
BLEEDING
HYPERGLYCEMIA (MOM)
HYPOGLYCEMIA (BABY)
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19
Q

Misoprostol (Cytotec)

CONSIDERATIONS

A

NEVER GIVE FOR AUGMENTATION
ASSESS FHR
For uterine tachysystole: place in side-lying position, apply O2 8-10L/min, administer tocolytic

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20
Q

Erythromycin (Ilotycin)

CLASS

A

ANTIBIOTIC

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21
Q

Erythromycin (Ilotycin)

ACTION

A

Inhibits protein synthesis in bacteria

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22
Q

Erythromycin (Ilotycin)

USE

A

PREVENT OPHTHALMIA NEONATORUM IN CASE MOTHER INFECTED WITH GONORRHEA
REQUIRED BY LAW

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23
Q

Erythromycin (Ilotycin)

DOSE

A

APPLY TO LOWER CONJUNCTIVAL SAC WITHIN 1 HOUR AFTER BIRTH

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24
Q

Erythromycin (Ilotycin)

SIDE EFFECTS

A

Temporarily blur vision
Burning
Itching

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25
Erythromycin (Ilotycin) | CONSIDERATIONS
Cleanse eye before application Administer from inner canthus to outer canthus May wipe away excess after 1 minute
26
Fentanyl (Sublimaze) | CLASS
OPIOID ANALGESIC
27
Fentanyl (Sublimaze) | ACTION
Produce CNS depression & decrease pain
28
Fentanyl (Sublimaze) | USE
ADJUNCT TO EPIDURAL ANALGESIA DURING LABOR
29
Fentanyl (Sublimaze) | C/I
Caution with pregnancy & lactation
30
Fentanyl (Sublimaze) | SIDE EFFECTS
CAN PASS INTO THE BABY & CAUSE RESPIRATORY DEPRESSION n/v Dizziness
31
Fentanyl (Sublimaze) | CONSIDERATIONS
Monitor RR | ACCOMPANY MOM DUE TO FALL RISK
32
Fentanyl (Sublimaze) | ANTIDOTE
NARCAN | HAVE READY FOR FETAL INTERVENTION
33
``` Carboprost tromethamine (Hemabate) CLASS ```
Prostaglandin, OXYTOCIC
34
``` Carboprost tromethamine (Hemabate) ACTION ```
Stimulate contraction of uterus
35
``` Carboprost tromethamine (Hemabate) USE ```
1. TREATMENT OF PP HEMORRHAGE CAUSED BY UTERINE ATONY | 2. ABORTION
36
``` 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
37
``` 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
38
``` 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 ```
39
Hep B Vaccine | CLASS
Vaccine
40
Hep B Vaccine | ACTION
Create antibodies
41
Hep B Vaccine | USE
Prevent chronic infection of newborn whose mother is HBsAg-positive
42
Hep B Vaccine | DOSE
GIVEN WITH 12 HOURS OF BIRTH
43
Nalbuphine (Nubain) | CLASS
OPIOID ANALGESIC/ANTAGONIST
44
Nalbuphine (Nubain) | ACTION
Binds to opiate receptors
45
Nalbuphine (Nubain) | USE
Decreases pain r/t labor
46
Nalbuphine (Nubain) | DOSE
IV
47
Nalbuphine (Nubain) | C/I
PATIENTS PHYSICALLY DEPENDENT ON OPIOIDS | & have not detoxed
48
Nalbuphine (Nubain) | SIDE EFFECTS
``` n/v Respiratory depression Dizziness Confusion Dry mouth Clammy skin Sweating Pruritus ```
49
Nalbuphine (Nubain) | CONSIDERATIONS
DON'T GIVE TO OPIATE DEPENDENT PATIENTS Record baseline maternal vitals & FHRP before, during, & after administration Monitor for respiratory depression
50
Nalbuphine (Nubain) | ANTIDOTE
NARCAN
51
Nifedipine (Procardia, Adalat) | CLASS
CCB, TOCOLYTIC
52
Nifedipine (Procardia, Adalat) | ACTION
Decreases muscular contraction by acting as a calcium antagonist
53
Nifedipine (Procardia, Adalat) | USE
STOP PRETERM LABOR
54
Nifedipine (Procardia, Adalat) | DOSE
PO
55
Nifedipine (Procardia, Adalat) | SIDE EFFECTS
``` FLUSHING HA TACHYCARDIA Dizziness Transient maternal & fetal tachycardia Orthostatic hypotension ```
56
Nifedipine (Procardia, Adalat) | CONSIDERATIONS
REPORT MATERNAL PULSE GREATER THAN 120 | Teach pt side effects & to sit & stand slowly & call for assistance if needed
57
Naloxone (Narcan) | CLASS
Opiate antagonist
58
Naloxone (Narcan) | USE
REVERSE SEVERE RESPIRATORY DEPRESSION IN NEWBORN WHEN MOTHER RECEIVED NARCOTICS WITHIN 4 HRS OF BIRTH
59
Naloxone (Narcan) | DOSE
IV im ett
60
Naloxone (Narcan) | C/I
NEVER GIVE TO MOTHER OR BABY IF MOM ABUSES OPIATES
61
Naloxone (Narcan) | CONSIDERATIONS
When depression from opiates is expected, prepare syringe before birth Monitor response & prepare to give repeat dose if necessary
62
Methylergonovine (Methergine) | CLASS
ERGOT ALKALOID | UTERINE STIMULANT
63
Methylergonovine (Methergine) | ACTION
STIMULATES SUSTAINED CONTRACTION OF THE UTERUS & CAUSES ARTERIAL VASOCONSTRICTION
64
Methylergonovine (Methergine) | USE
PREVENTION & TREATMENT OF POSTPARTUM OR POSTABORTION HEMORRHAGE CAUSED BY UTERINE ATONY OR SUBINVOLUTION
65
Methylergonovine (Methergine) | DOSE
po, im
66
Methylergonovine (Methergine) | C/I
``` DURING PREGNANCY (never use to induce labor) HTN severe hepatic or renal disease thrombophlebitis cad, pvd hypocalcemia sepsis ```
67
Methylergonovine (Methergine) | SIDE EFFECTS
``` HTN HA FLUSHING n/v uterine cramping dizziness dyspnea cp palpitations peripheral ischemia seizures ```
68
Methylergonovine (Methergine) | CONSIDERATIONS
DO NOT BREASTFEED DURING TREATMENT OR 12 HOURS AFTER LAST DOSE Give over at least 1 min Closely monitor bp & pulse Caution mother to avoid smoking
69
Oxytocin (Pitocin) | CLASS
Oxytocic
70
Oxytocin (Pitocin) | ACTION
Stimulates uterine smooth muscle resulting in increased strength, duration, & frequency of contractions Contains vasoactive & antidiuretic properties
71
Oxytocin (Pitocin) | USE
1. INDUCTION OR AUGMENTATION OF LABOR 2. MAINTAIN FIRM UTERINE CONTRACTION AFTER BIRTH TO CONTROL PP BLEEDING 3. MANAGE INCOMPLETE ABORTION 4. HEMORRHAGE
72
Oxytocin (Pitocin) | DOSE
IV, im
73
Oxytocin (Pitocin) | C/I
``` Placenta previa Vasa previa Nonreassuring FHRP Abnormal fetal presentation Prolapsed umbilical cord Uterine incision Active herpes ```
74
Oxytocin (Pitocin) | SIDE EFFECTS
``` HYPERTONIC UTERINE ACTIVITY (If given for a long time, uterine can get tired & atony can occur) INCREASED BS H2O TOXICITY UTERINE RUPTURE TETANIC CONTRACTIONS Hemorrhage Impaired uterine blood flow fetal asphyxia apruptio placentae ```
75
Oxytocin (Pitocin) | INTERACTIONS
VASOPRESSORS
76
Oxytocin (Pitocin) | CONSIDERATIONS
ASSESS FHR AT LEAST 20 MIN BEFORE INDUCTION | OBSERVE FOR HYPERTONIC UTERINE ACTIVITY
77
Rho (D) Immune Globulin (RhoGAM) | CLASS
Concentrated immunoglobulin directed toward RBC antigen Rho(D)
78
Rho (D) Immune Globulin (RhoGAM) | ACTION
Prevent production of Rh antibodies in Rh negative women who have been exposed to Rh positive blood by suppressing the immune reaction to the antigen in Rh positive blood
79
Rho (D) Immune Globulin (RhoGAM) | USE
``` IF MOTHER & BABY BLOOD MIX PROTECTING MOM'S NEXT PREGNANCY Delivering Rh+ infant Transfusion of Rh+ blood Intra-abdominal trauma ```
80
Rho (D) Immune Globulin (RhoGAM) | DOSE
IM | AT 28 WEEKS & WITHIN 72 HOURS OF DELIVERY
81
Rho (D) Immune Globulin (RhoGAM) | C/I
PREVIOUSLY SENSITIZED TO Rho(D) | Rh+ WOMEN
82
Rho (D) Immune Globulin (RhoGAM) | SIDE EFFECTS
Local pain at IM site | Fever
83
Rho (D) Immune Globulin (RhoGAM) | CONSIDERATIONS
NEED COOMB'S TEST BEFORE ADMINISTRATION/ANTIBODY SCREEN
84
Rubella Vaccine | CLASS
LIVE ATTENUATED VACCINE
85
Rubella Vaccine | ACTION
Produces modified rubella infection that is not communicable, causing the formation of antibodies
86
Rubella Vaccine | USE
Given to women whose antibody screen shows they are not immune to rubella Prevents infection during subsequent pregnancy
87
Rubella Vaccine | DOSE
SUBCUT TO THE MOTHER | 1 MONTH BEFORE PREGNANCY
88
Rubella Vaccine | C/I
PREGNANCY Immunosuppressed Current illness
89
Rubella Vaccine | SIDE EFFECTS
BIRTH DEFECTS IF GIVEN DURING PREGNANCY | Lactating women may still get vaccinated
90
Rubella Vaccine | CONSIDERATIONS
TEACH ABOUT AVOIDING PREGNANCY AT LEAST 4 WEEKS AFTER ADMINISTRATION Use within 8 hours of reconstitution Keep refrigerated
91
Magnesium Sulfate | CLASS
MISC. ANTICONVULSANT | TOCOLYTIC
92
Magnesium Sulfate | ACTION
Depresses CNS to act as anticonvulsant | Decreases frequency & intensity of UC
93
Magnesium Sulfate | USE
PREVENT & CONTROL SEIZURES IN SEVERE PREECLAMPSIA | PREVENTION OF UC IN PRETERM LABOR
94
Magnesium Sulfate | DOSE
IV TO CONTROL IMMEDIATELY
95
Magnesium Sulfate | C/I
Myocardial damage Heart block Myasthenia graves Impaired renal perfusion
96
Magnesium Sulfate | SIDE EFFECTS
``` Flushing Sweating Hypotension Decreased DTR CNS & resp. depression Fetal neonate effects: Decreased FHR variability, hypotonia ```
97
Magnesium Sulfate | S/S Mg TOXICITY
``` THIRST MENTAL CONFUSION OLIGURIA HA FLUSHING RESPIRATORY DEPRESSION DECREASE IN REFLEXES ```
98
Magnesium Sulfate | CONSIDERATIONS
PTL: BP during therapy, place resuscitation equipment in room Tocolytic: Monitor contraction pattern, check for OD Before therapy: RR at least 12/min, O2 95%, presence of DTR, Output 30mL/hr During: LISTEN TO LUNGS FOR PULMONARY EDEMA WHEN GIVING FOR SEIZURES, CHECK CLONUS Continue to monitor above
99
Magnesium Sulfate | ANTIDOTE
CALCIUM GLUCONATE
100
Hep. B Immune Globulin (HBIG) | CLASS
Immunoglobulin
101
Hep. B Immune Globulin (HBIG) | USE
To prevent chronic infection of a newborn whose mother is KNOWN TO BE HBsAg POSITIVE
102
Hep. B Immune Globulin (HBIG) | DOSE
IM WITHIN 12 HOURS OF BIRTH VASTUS LATERALIS
103
Hep. B Immune Globulin (HBIG) | C/I
If mother is not HBsAg positive
104
Hep. B Immune Globulin (HBIG) | CONSIDERATIONS
Clean skin well to prevent contamination from mother's blood Breastfeeding is safe if newborn has been vaccinated Teach preventable measures to reduce risk of HBV
105
Butorphanol (Stadol) | CLASS
Opioid agonist/antagonist
106
Butorphanol (Stadol) | ACTION
Binds to opiate receptors in CNS | PARTIAL ANTAGONIST PROPERTIES
107
Butorphanol (Stadol) | USE
Labor pain
108
Butorphanol (Stadol) | C/I
PATIENT PHYSCIALLY DEPENDENT ON OPIATES
109
Butorphanol (Stadol) | SIDE EFFECTS
``` Respiratory depression Hypotension Palpitations Nausea Sweating ```
110
Butorphanol (Stadol) | CONSIDERATIONS
MOVE SLOWLY DUE TO O.H. | TURN COUGH & DEEP BREATH
111
Butorphanol (Stadol) | ANTIDOTE
NARCAN
112
Terbutaline (Brethine) | CLASS
Beta adrenergic
113
Terbutaline (Brethine) | ACTION
Block action in SNS resulting in decreased blood vessel contraction, smooth muscle relaxant
114
Terbutaline (Brethine) | USE
TOCOLYSIS TO STOP PTL
115
Terbutaline (Brethine) | DOSE
SUBCUT, PO
116
Terbutaline (Brethine) | C/I
DIABETIC MOTHER | HYPERTENSION
117
Terbutaline (Brethine) | SIDE EFFECTS
``` FEELS LIKE THEY'RE HAVING ANIETY ATTACK HYPERGLYCEMIA Chest pain Tremors Restlessness Flushing HA, N/V Maternal & fetal tachy Hypokalemia ```
118
Terbutaline (Brethine) | CONSIDERATIONS
ASSESS MATERNAL APICAL HR & lung sounds before each dose
119
Terbutaline (Brethine) | ANTIDOTE
PROPANOLOL
120
``` Vitamin K (AquaMEPHYTON) CLASS ```
Fat soluble vitamin, antihemorrhagic
121
``` Vitamin K (AquaMEPHYTON) ACTION ```
Promotes formation of CLOTTING FACTORS by the liver
122
``` Vitamin K (AquaMEPHYTON) USE ```
Provides Vit. K to prevent/treat Vit. K deficiency bleeding since babies are born with sterile bowels
123
``` Vitamin K (AquaMEPHYTON) DOSE ```
IM, vastus laterals WITHIN 1 HOUR AFTER BIRTH
124
``` Vitamin K (AquaMEPHYTON) SIDE EFFECTS ```
``` HYPERBILIRUBINEMIA Erythema Pain Edema Hemolysis ```
125
``` Vitamin K (AquaMEPHYTON) CONSIDERATIONS ```
OBSERVE FOR S/S OF VIT. K DEFICIENCY (ECCHYMOSIS, BLEEDING) | Protect from light
126
Ibuprofen (Motrin, Advil) | CLASS
NSAID, antipyretic, nonopioid analgesic
127
Ibuprofen (Motrin, Advil) | ACTION
Inhibits prostaglandin synthesis decreasing pain & inflammation
128
Ibuprofen (Motrin, Advil) | USE
Fever Mild-moderate pain Closure of clinically significant PDA in neonates weighing 500-1500 g & <32 weeks GA GIVEN PP FOR RISK OF DVT
129
Ibuprofen (Motrin, Advil) | C/I
AVOID AFTER 30 WEEKS GA CAN DECREASE FLUID AROUND THE BABY Caution during lactation
130
Ibuprofen (Motrin, Advil) | CONSIDERATIONS
Every PP is bound to be on motrin Assess s/s of GI bleed Teach mom to avoid alcohol Can cause premature closure of ductus arteriosis
131
Hydrocodone/Acetaminophen (Norco) | CLASS
OPIOID AGONIST/NONOPIOID ANALGESIC
132
Hydrocodone/Acetaminophen (Norco) | ACTION
Binds to opiate receptors in CNS decreasing severity of moderate pain Generalized CNS depression
133
Hydrocodone/Acetaminophen (Norco) | USE
Management of moderate-severe pain
134
Hydrocodone/Acetaminophen (Norco) | DOSE
PO
135
Hydrocodone/Acetaminophen (Norco) | C/I
SEVERE HEPATIC/RENAL DISEASE | Avoid chronic use during lactation
136
Hydrocodone/Acetaminophen (Norco) | SIDE EFFECTS
``` RESPIRATORY DEPRESSION Confusion, sedation Ortho hypotension Consitpation n/v Urinary retention ```
137
Hydrocodone/Acetaminophen (Norco) | INTERACTIONS
maoi
138
Hydrocodone/Acetaminophen (Norco) | CONSIDERATIONS
Assess BP, pulse, & RESPIRATORY RATE before & throughout Assess bowel function Assess level of CNS depression Caution patient about drowsiness during therapy
139
Hydrocodone/Acetaminophen (Norco) | ANTIDOTE
Narcan
140
Simethicone (Mylicon) | CLASS
Antiflatulent
141
Simethicone (Mylicon) | USE
MAINLY FOR WOMEN WHO HAVE C-SECTION
142
Simethicone (Mylicon) | C/I
Infant colic | Caution with abdominal pain of unknown cause
143
Simethicone (Mylicon) | CONSIDERATIONS
Take after meals & bedtime Shake liquid well Assess bowel sounds, abdominal pain, & distention

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