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postpartem med
meds for obstetric procedures and pharm calc
| Question | Answer |
|---|---|
| Prostaglandins. Oxytocin. | Induction and augmentation of labor: |
| Cervical ripening: | Prostaglandins. misoprostol (Cytotec). Magnesium sulfate. |
| Use of prostaglandins as a cervical gel are for: | Endocervical Gel, Vaginal Insert: used to "ripen" the cervix in pregnancy at or near term when induction of labor is indicated. |
| prostaglandins as a vaginal insert are for: | Induction of midtrimester abortion. Management of missed abortion up to 28 wk. Management of nonmetastatic gestational trophoblastic disease (benign hydatidiform mole). |
| prostaglandin Action: | Produces contractions similar to those occurring during labor at term by stimulating the myometrium (oxytocic effect). Initiates softening, effacement, and dilation of the cervix ("ripening"). Also stimulates GI smooth muscle. |
| Therapeutic effects are what: | Initiation of labor. Expulsion of fetus. |
| classification of prostaglandins in postpartum tx: | Therapeutic: cervical ripening agent. Pharmacologic: oxytocics , prostaglandins. Example: dinoprostone (Prepidil): prostaglandin gel. dinoprostone (Cervidil): vaginal insert. |
| absorbed and distributed how? | Absorption: rapidly absorbed. Distribution: unknown. Action is mostly local. Metabolism and Excretion: metabolized by enzymes in lung, kidneys, spleen, and liver tissue. |
| Prostaglandin dosage and route in post partum period is vaginal and cervical how? | Endocervical gel: 0.5 mg; if response is unfavorable, may repeat in 6 hr (not to exceed 1.5 mg/24 hr). Vaginal insert: one 10-mg insert. Vaginal suppository: One 20-mg suppository, repeat q 3-5 hr (not to exceed 240 mg total or longer than 48 hr). |
| The gel/insert should be avoided in situations in which prolonged uterine contractions should be avoided, including: | Previous cesarean section or uterine surgery. Cephalopelvic disproportion. Traumatic delivery or difficult labor. Multiparity (>6 term pregnancies). Hyperactive or hypertonic uterus. Fetal distress (delivery not imminent) |
| The gel/insert should be avoided in situations in which prolonged uterine contractions should be avoided, including (part two): | Unexplained vaginal bleeding. Placenta previa. Vasa previa. Active herpes genitalis. Obstetric emergency requiring surgical intervention. Situations in which vaginal delivery is contraindicated. |
| Prostaglandin contraindications | Presence of acute pelvic inflammatory disease or ruptured membranes. Concurrent oxytocic therapy (wait for 30 min after removing insert before using oxytocin. |
Created by:
redhawk101
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