Medications Affecting Labor and Delivery Flashcards
What is parenteral oxytocin (Pitocin), a uterine stimulant, used for?
IV to initiate and promote labor contractions (induce) and to prevent postpartum hemorrhage.
induced if post-term, has premature rupture of membranes, or has a complication like preeclampsia, can enhance natural labor, can be used for delivery of placenta or for miscarriage, as well as stress testing
Is oxytocin titrated for effect when inducing labor?
YES YES YES
What type of monitoring needs to be done when use uterine stimulants?
contractions and fetal heart tones (electronic fetal monitoring)
Monitor BP for hypertensive crisis (HA, n/v, very high BP)
Monitor for uterine rupture (risk factors: multiple deliveries)
How long should contractions last?
No longer than 1 minute
How often should contractions occur?
no less than 2-3 minutes
What is considered hyperstimulation?
contractions lasting longer than 1 minute and occurring every 2-3 minutes and resting uterine pressure if greater than 15 mm/hg
What would you want to have on standby during labor in case of complications?
magnesium sulfate
When are uterine stimulants contraindicated?
patients taking vasopressors (can lead to HTN)
What is the therapeutic action of Terbutaline, a tocolytic?
smooth muscle relaxer, asthma drug, uterine smooth muscle relaxation
What should you monitor for in patient taking terbutaline?
tachycardia
palpitations
chest pain
may also see tremors, anxiety, HA
What is nifedipine (Procardia), a calcium channel blocker, used for in labor and delivery?
smooth muscle relaxer that prevents pre-term labor
What is magnesium-sulfate used for in labor and delivery?
prevent seizures in pre-eclampsia
How long can SQ terbutaline be used for?
48 hours to delay pre-term labor
What are some adverse effects of magnesium sulfate?
increases fetal mortality risk
toxicity in mother: flaccidity, depressed reflexes, respiratory depression
What is the antidote for magnesium toxicity?
Calcium Gluconate
