week 12

Question 1

Trebutaline

Answer 1

Trebutaline Beta Agonist-Bronchodilator
Brand: Breathine

MOA: Relaxes uterus to prevent contractions (tocolytic)

IND: pre term contractions, bronchospasm, uterine hyperstimulation

CON: use past 72 hours, hypersensitivity, HTN, Hypokalemia

Adverse: Adult: heart problems, tachycardia, tremors, pulmonary edema, headache, hyperglycemia, anxiety, paradoxical bronchospasm
Fetus: tachycardia, hypoglycemia

Dose/Route: 0.25mg/ 20min max 3 doses SQ
5-80 mcg/min titrated infusion

Special Notes: Preggo Class B, DON’T use for more than 48-72hr

Question 2

Oxytocin

Answer 2

Oxytocin Horomone

Brand: Pitocin

MOA: Uterine stimulant that causes uterine contractions, lactation and control post-partum hemorrhage

IND: post-partum hemorrhage

CON: 2nd placenta needs to be delivered, don’t use for anything other than what its intended for!

Adverse: angina, anxiety, uterine rupture, nausea, vomiting, hyper/hypotension

Dose/Route: 3-10units IM
10-40units IV/IO Drip in 500-1000ml NS

Special Notes: Preggo Class X, use w/ caution in pregnant PTs, renal impairment & elderly PTs

Question 3

Methyergonovine Maleate

Answer 3

Methyergonovine Maleate Ergot Alkaloid

Brand: Methergine

MOA: increases force & frequency of contractions to control post-partum hemorrhage

IND: post-partum hemorrhage

CON: hypertension, toxemia, hypersensitivity,pre eclampsia, breast feeding

Adverse: seizure, hypertension, vasospasm, Diff breathing, CP

Dose/Route: 0.2mg IM/IV/IO
every 2-4 hours
Special Notes: Preggo C, use caution in sepsis, liver/kidney disease

Question 4

Mag sulfate

Answer 4

magnesium sulfate Electrolyte-Antidysrhythmic-Anticonvulsant

MOA: CNS depressant, smooth muscle relaxant, dilation of bronchial

IND: Polymorphic V-tach (torsades de pointes) (often caused by malnutrition). Bronchospasm, Pre eclamptic seizures
CON: Shock, heart block, GI obstruction hypotension, hypothermia, bradycardia, dialysis, renal insufficiency.
Adverse: potentiates digoxin/digitalis, flushing respiratory depression, hypotension, hypothermia, bradycardia.
Dose/Route: VF or VT—1-2g in 1-2 min. (3rd/4th line treatment)
Torsade de Pointes—5-10g @ 1g/min
Pedi—25-50mg/kg over 2-5 min.
Infusion—max 2g/30-60min.
Resp.—1-2g @ 1g/min
Pedi 25-50mg/kg over 2-5min.
OBGYN/Eclamptic Seizures—4-6g over 20 min IV Drip
Special: Prego Class A. Do not exceed 1g a minute, burns injection site. Ca++ is antidote. Renal failure = electrolyte dysfunction.