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Medications in OB
Common meds
| Question | Answer |
|---|---|
| Electrolyte replacement- Antidote for hypermagnesium Usual dose: 1 g IV over 3-5 mins. | Ca Gluconate Antepartum |
| Steroid increases fetal lung maturity 12.5 mg IM q 24 hrs x 2 doses Given to mom when in PTL (24 – 34 wks) | Celestone Antepartum Betamethasone |
| Prostaglandin Termination of pregnancy n/v/d, fever May be premedicated with Tylenol, antidiarrheal and antiemetic. | Dinoprostone Antepartum Prostin E2 |
| antihypertensive - BP control- Given slow IVP for acute hypertension | Hydralazine Apresoline Antepartum |
| CNS agent Anticonvulsant tx Used during seizure. Must be kept refrigerated. | Lorazepam Ativan Antepartum |
| Anticonvulsant tx;Tx of PTL During loading dose: Facial flushing, warmth During tx: hypermagnesium (loss of reflexes, resp arrest, cardiac arrest) | Magnesium Sulfate Antepartum |
| First choice during seizure and anti-seizure; Also used for PTL.DTRs 1st sign of hypermagnesia; Therapeutic level 4-8 mg/dL. Given thru infusion pump. | Magnesium Sulfate Antepartum |
| antihypertensive BP control DOC for antihypertension maintenance. | Methyldopa Aldomet Antepartum |
| Calcium-channel blocker Tocolysis; BP control Hypotension, tachycardia, facial flushing, h/a. Off-label use for tocolysis. Co-administration with Ritodrine or Terbutaline OK. Do not give with MgSO4. Check BP prior to administering. | Nifedipine Procardia Antepartum |
| Tocolytic Tocolysis Hypotension, tachycardia, palpitations, pulmonary edema, facial flushing. Fetal tachycardia Given IV thru infusion pump titration first. Then moved to PO. Not used much anymore. | Ritodrine Yutopar Antepartum |
| Tocolytic Tocolysis Hypotension, tachycardia, palpitations, pulmonary edema, facial flushing. Fetal tachycardia. Given IV thru infusion pump titration. Then moved to PO. May use SQ doses for acute, short-term use. | Terbutaline Brethine Antepartum |
| Local anesthetic Epidural anesthesia Complications r/t hypotensive episode with epidural. Most have BP monitored frequently (q 15 min) with epidural anesthesia. | Bupivicaine Marcaine Intrapartum |
| Narcotic analgesic Pain relief Sedation. Can cause transient loss of FHR variability. Neonatal respiratory depression, if given close to delivery. | Butorphanol Stadol intrapartum |
| Narcotic analgesic Synergistic effect with epidural anesthesia Not absorbed systemically. Adverse effects r/t hypotension w/ epidural. Small amts added to epidural anesthesia. | Fentanyl citrate Sublimaze intrapartum |
| Narcotic Analgesic Pain relief Sedation. Can cause transient loss of FHR variability. Neonatal respiratory depression, if given close to delivery. | Meperidine Demerol Intrapartum |
| Prostaglandin Cervical ripening Can cause uterine hyperstimulation Approved as antiulcer. Off-label use in OB. Also used as abortifacient in 2nd trimester. | Misoprostol Cytotec Intrapartum |
| Narcotic Analgesic Pain relief Sedation. Can cause transient loss of FHR variability. Neonatal respiratory depression, if given close to delivery. | Nalbupine Nubain Intrapartum |
| Oxytoxic Labor induction;Prevention of PPH. R/T hyperstimulation Given IV thru infusion pump titration. 1st line of drug for prevention/tx of PPH. | Oxytocin Pitocin Intrapartum |
| Antiemetic Prevention/tx of n/v.Synergistic with narcotics. Can cause extrapyramidal effects. Use lowest dose. | Promethazine Phenergan Intrapartum |
| Local anesthetic Episiotomy w/o epinephrine | Xylocaine Intrapartum |
| Prostaglandin Severe PPH 3rd line drug for PPH | Carboprost tromethamine Hemabate Postpartum |
| Stool softener Prevention of constipation | Docusate Sodium Colace Postpartum |
| Iron replacement Prevention/tx of anemia May turn stools dark. Take with Vit C to Increase absorption | Ferrous sulfate Feosol Postpartum |
| NSAID Pain relief | Ibuprofen Motrin Postpartum |
| Progestin Birth control Given q 3 months IM; If breastfeeding wait 6 weeks before administering. | Medroxyprogesterone acetate Depoprovera postpartum |
| Vaccine Prevention of rubella Given PP only. | Meruvax II Rubella vaccine Postpartum |
| Oxytocic PPH May increase BP 2nd line drug for PPH (IV). Can be continued PO. | Methylergonovine maleate Methergine Postpartum |
| Narcotic analgesic Pain relief (surgical) Sedation Duramorph placed in epidural line for continued pain relief up to 24 hrs. Morphine usual drug in PCA. Also given in RR for pain relief. | Morphine Sulfate DuramorphMorphine Postpartum |
| NSAID Pain relief | Naproxen Sodium Anaprox Postpartum |
| Combination Analgesic Pain relief Sedation | Oxycodone/Acetaminophen Percocet Postpartum |
| Immunoglobulin Prevention of development of antibodies to fetus’s Rh-positive blood Given antepartum to mom who is Rh negative: at 28 wks and after amnio or abortion; and to Rh negative mom at delivery who’s baby is Rh positive. | Rho(D) Immune Globulin Rhogam Postpartum |
| Lung surfactant Improve lung surfactant to incidence of RDS Given intratracheal only w/i 15 mins of birth; rescue given w/I 8 hrs of age. Indicated for infants 600-1750 g. | Beractant Survanta Newborn |
| Antibiotic Prevention of neonatorum ophthalmia Prevents blindness from gonorrhea, Chlamydia. Should be given w/i first hr of life. State law. | Erythromycin 1% oint Newborn |
| Vaccine Prevention of HepB Recommended w/i 1st 12 hrs after birth. Series of vaccines. | Hep B vaccine Recombivax HB newborn |
| Narcotic antagonist Reversal of resp depression r/t narcotics Given IM. Must assure neonatal dosage. | Naloxone Narcan newborn |
| Vitamin K Prevention of hemorrhagic dx of the newborn Given IM w/i 1st hr of life. | Phytonadione Aqua Mephyton Newborn |
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