OB Test 4 Chapter 17 Flashcards
When to give sedatives
Prolonged latent phase
Undesirable side effects of barbiturate
- resp depression
- casino for depression
When to avoid barbiturates
If birth is anticipated w/in 12-24 hrs
What will happen if a barbiturate is given w/out an analgesic
Pain will magnify
Which sedatives are seldom used during labor
Barbiturates
Sedative that doesn’t relieve pain
Phenothiazine (Phenergan)
What does Phenergan impair
Analgesic efficacy of opioids
What to give instead of Phenergan
Metoclopramide (Reglan)
A sedative that when given w/ an opioid analgesic seems to enhance pain relief and reduce N/V
Benzos
What do benzos do to the mother
Maternal amnesia
If a mother has amnesia during labor and she is taking a benzo, what do you do
Stop it
What do benzos do to the fetus
Disrupts their thermoregulation
A benzo antagonist that can be given to reverse benzo-induced sedation and resp depression
Flumazenil (Romazicon)
Encompasses analgesia, amnesia, relaxation, and reflex activity
Anesthesia
Alleviation of the sensation of pain
Analgesia
Analgesics that can be administered IV, IM, or PCA
Systemic
Medications that provide sedation, euphoria, pain relief
Analgesia
When are analgesia best used
Active labor
Adverse effects of opioids
- resp depression
- sedation
- N/V
- dizziness
- altered mental status
- euphoria
- decreased GI motility
- delayed gastric emptying
- urinary retention
If a women is under general anesthesia and has a prolonged gastric emptying time, what is she at risk for
Aspiration
Effects of opioids on the fetus
- absent or minimal FHR variability during labor
- resp depression
Opioids that stimulate mu and kappa
Agonist
Opioids have an amnesic effect. T or F
F
What can opioids do to contractions
Inhibit them
When to give opioids
When labor is well established
Synthetic opioid that causes less resp depression than morphine
Meperidine hydrochloride (Demerol)
Adverse effects of Demerol
- tachycardia
- sedation
- N/V
- dizziness
- altered mental status
- euphoria
- decreased GI motility
- delayed GI emptying
- urinary retention
When to not give Demerol
If birth is expected w/in 1-4 hrs
Potent short-acting opioid agonist analgesic
Fentanyl citrate (Sublimaze)
Sublimaze readily crosses the placenta. T or F
T
Compared w/ meperidine, fentanyl provides what
Equivalent analgesia w/ fewer neonatal effects and less maternal sedation and nausea
What is a disadvantage of fentanyl
More frequent dosing
Adverse effects of fentanyl citrate (Sublimaze)
- sedation
- resp depression
- N/V
What should be available of fentanyl citrate (Sublimaze) causes resp depression
Naloxone
Agent that activates or stimulates a receptor to act
Agonist I
Agent that blocks a receptor or a medication that is designed to activate a receptor
Antagonist
Which receptors do agonist-antagonist work as agonist for
Kappa
Agonist-antagonist opioids provide what
Adequate analgesia w/out causing significant resp depression
What is the major advantage of opioid agonist-antagonist
Ceiling effect
Opioid agonist-antagonist are less likely to cause N/V but greatly cause what
Sedation
When to withhold an opioid agonist-antagonist
Opioid dependent mother
Relieve anxiety and induce sleep
Sedatives
