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21 Cards in this Set
- Front
- Back
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Pitocin |
Oxytocin (Induction)
Uses: Causes uterine contractions. Induction of labor if cervix is ripe. Has vasopressor and antidiuretic effects. Dose: Milliunits/minute. 20U in 1000mL is: 3mL/hr = 1mu/min. Most pts require 4-8 mu/min to achieve adequate labor. Short half life - max effects occur 40 min after increase in dosage. Use port most proximal to IV site Comments: Very potent. Monitor pt and fetus carefully. If tachysystole or abnormal FHR pattern, discontinue |
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Cytotec |
Misoprostil (Induction) Uses: To ripen cervix in term induction. Treatment of peptic ulcers. To induce in 2nd trimester terminations or fetal demise Dose: 25mcg q 4 hrs. 1/4 of 100mcg tablet is placed in/near cervix by MD. 200-400 mcg for 2nd trimester inductions. Comments: Use with great caution. Follow policy. If contractions regular, consider holding next dose. Can cause hyperstimulation and precipitous delivery. Do not use to induce term labor if previous C-section. Do not handle tablets if pregnant or nursing. |
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Prostin E2 |
Dinoprostone (Induction) Uses: Causes cervical softening, dilation and contractions. To induce labor for 2nd trimester terminations at 12-20 wks or fetal demise up to 28 wks. Dose: 10-20 mg vaginally by MD Q 3-5 hrs. Comments: Can cause fever, N/V/D. Use with caution in pts with asthma, CV disease or renal disease. |
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Pitocin - PPH |
Oxytocin (PPH) Uses: Contracts uterus with intermittent contractions to help prevent postpartum hemorrhage. Doses: 20 U in 1000mL wide open. 10 U IM if no IV. Can give up to 40 U in IV solution. Comments: Routinely begun as soon as placenta delivers. Can give 2nd liter if bleeding is heavy. |
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Methergine |
Methylergononvine maleate (PPH) Uses: An ergot - contracts uterus. Stimulates uterus directly Dose: 0.2 mg IM (0.2mg/mL) Comments: Hold for increased BP. May cause HTN, N/V |
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Hemabate |
Corboprost Tromethamine (PPH) Uses: Stimulates uterine and vascular smooth muscle Dose: 250 mcg IM. Repeat every 15-90 minutes. May also be given by MD directly into uterine muscle through abdomen. Comments: Refrigerate. Avoid with cardiac, pulmonary, hepatic or renal problems. Can cause N/V, HA, fever. |
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Cytotec - PPH |
Misoprostil (PPH) Uses: Contacts uterus Dose: 200 - 1000 mcg into rectum by MD. 100mcg/tablet Comments: Used if other agents do not control bleeding. |
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Demerol |
Meperidine (Pain) Uses: Narcotic/Opioid Dose: 25 - 100 mg slow IVP q3h during labor. 50 - 100 mg IM or IV q3-4h post c-section. Use Z-track method. **If given before active labor, may slow or stop labor. **If given too close to time of delivery, may cause resp depression in newborn **Limit use to 2 - 3 days and 600-900 mg in 24hrs Comments: Fetus should be reassuring before giving. **review various side effects in notes. Other meds are preferable. |
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Stadol |
Butorphanol (pain) Uses: Synthethetic partial opiate agonist. 2mg Stadol = 75mg Demerol Dose: 1-2mg slow IVP Q2-4hrs during labor. Causes variability and sinusoidal pattern in fetus. If given before active labor, may slow or stop labor. If given too close to delivery, may cause resp depression of newborn. Comments: May cause drug withdrawal symptoms in pts addicted to opiates. May reverse effects of Demerol (avoid alternating with Demerol) |
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Nubain |
Nalbuphine (pain) 10mg Nubain = 75mg Demerol Dose: 5-10mg IV or 10-20mg IM q2-4 hrs during labor. Comments: May cause drug withdrawal symptoms for opiate user. May cause irritability or breastfeeding problems in newborn if given to mom during labor. |
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Phenergan |
Promethazine (N/V) Dose: 12.5 to 25 mg very slow IVP with analgesia Comment: No effect of APGAR |
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Fentanyl |
Sublimaze (pain) Uses: Quick onset, short duration. Used in epidural. More potent than Demerol or morphine. Dose: 50-100mcg Comments: May cause urinary retention, pruritus, N/V, resp distress. |
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Darvocet |
Acetaminophen + Propoxyphene (pain) 1-2 tabs PO q 3-4 hrs. 6/day total. |
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Tylenol #3 |
Acetaminophen + Codeine (pain) 1-2 tabs PO q 3-4hrs. 12/day total. |
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Motrin |
Ibuprofen (pain) 600-800mg PO q6-8 hrs Comments: Helpful for uterine involution pain / cramping. |
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Brethine |
Terbutaline (PTL) Uses: Sympathomimetic Beta Adrenergic Agonist. Bronchodilator. Smooth muscle relaxer. **Used to stop preterm labor. Dose: 0.25mg SQ (may repeat in 30min to 2hrs) or 5mg PO q6-8hrs. **Peaks 30-60min after SQ injection. Comments: May cause tachycardia, pulmonary edema, hypoglycemia, hypokalemia. Stop drug for: hypotension, vomiting, chest discomfort, SOB, pulse > 110. Contraindicated in: uncontrolled DM, HTN, arrhythmias. |
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Magnesium Sulfate |
(PTL) Use: Stop preterm labor. CNS depressant and calcium antagonist. Dose: 4-6 Gm bolus over 20 min followed by 1-3 Gm/hr. Solution: 40Gm in 1000mL H20. Use port proximal to IV site. Comments: Therapeutic levels are 4-7.5 mEq/L (4-9 mg/dL). Careful I&Os. Watch for s/sx toxicity: decreased DTR, decreased RR, decreased UOP, marked hypotonia. Antidote: Calcium Gluconate 1Gm over 3 min (have nearby!) |
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Procardia |
Nifedipine (PTL) Uses: Ca Channel Blocker for smooth muscles and myocardium. Used for preterm labor. Dose: 10-20 mg PO q2 x 3 then q4-6 hrs Comments: May contribute to CHF, MI. Watch for: dizziness, HA, nervousness, dyspnea, arrhythmias, tachycardia, nausea. **When used with terbutaline, severe hypotension may occur **Contraindicated in liver disease or possible DM |
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Indocin |
Indomethacin (PTL) Uses: NSAID. Inhibits prostaglandin synthesis. To be used before 32 weeks gestation. Dose: 25-50 mg PO q6hrs for 48 hrs maximum. 50-100 mg rectal suppository. Comments: Can cause oligohydramnios and premature closure of ductus arteriosus if given to mother for more than 72hrs. May cause HA, N/V. **Contraindicated in: Cardiac, Renal disease, GI bleed. |
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Celestone |
Betamethasone (PTL) Uses: Speeds up lung maturity in 24-34 wks gestation if premature delivery is anticipated. Optimal benefit requires at least 24hrs of therapy. Dose: 12mg IM q 24hrs x 2 doses (to mom) Comments: Reduces respiratory distress by 50% . Also reduces intraventricular hemorrhage in newborn. |
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Decadron |
Dexamethasone (PTL) Alternative to Betamethasone Dose: 6mg IM q12hrs x 4 doses. |
