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RNC-OB medications

preparation for the RNC-OB exam

ACE inhibitors (-prils) not recommended to use when treating CHTN due to risk of IUGR, Oligohydramnios, and neonatal death
Propranolol and Thiazide Used for treatment of CHTN. Side effects include decreased CO, decreased renal blood flow, fetal respiratory depression, and fetal thrombocytopenia.
Hydralazine and Clonidine Used for treatment of CHTN. Side effects include increased CO and increased renal blood flow.
Labetalol Used for treatment of CHTN. Side effects include fetal respiratory depression, hypoglycemia, and bradycardia.
Indomethacin Used for treatment of PTL and polyhydramnios by decreasing fetal urine output. Dosage 50mg, then 25mg PO q4h. Adverse reactions include decreased fetal urine output and premature closure of PDA, resulting in pulmonary HTN and death
Procardia Used to treat HTN and PTL. Dosage = 10 mg PO TID. Adverse reactions include those associated with hypotension. Drug interactions: antihypertensives and MgSO4 (additive effects).
Terbutaline Used for treatment of uterine activity and irritability. Dosage = 0.25mg IM. Adverse reactions include tachycardia, pulmonary edema, cardiac effects, hypotension, hyperglycemia. Contraindicated for diabetics and pt's with cardiac conditions.
Magnesium Sulfate Indicated for seizure prevention and PTL. 4-6gm loading dose, then 1-3gm maintenance dose. Therapeutic range 5-7 (Seizure) 6-8 (PTL). Adverse reactions r/t CNS depression. Toxicity indicated by RR <16, loss of DTRs. Antidote = calcium gluconate
Methergine Used for treatment of postpartum hemorrhage. Dosage 0.2mg IM. Contraindicated with pt's with elevated BP or HTN disorders. Adverse effect = elevated BP.
Hemabate Used for treatment of postpartum hemorrhage. May be administered q15 minutes. Contraindicated for pt's with cardiac, pulmonary, or hepatic disorders. Adverse effects = elevated BP and diarrhea
Betamethasone corticosteriod used to accelerate lung development and increase surfactant production. 12mg IM q24 hours x2 doses. Most effective 48 hours after administration. Can cause transient decreased variability of FHTs.
Dexamethasone Corticosteroid used to accelerate fetal lung development and increased surfactant production. 6mg q12 hours x4 doses.
Oxytocin Used in induce contractility of uterine muscle for induction of labor or management of postpartum hemorrhage. onset = 3-5 mins IV; half life = 15 minutes adverse effects: intrinsic antidiuretic, water intoxication
Cervidil Directly softens and dilates cervix. Medication effective for 12 hours. Remove 30 minutes prior to oxytocin administration.
Prepidil Gel Direclty softens and dilates cervix. Allow 6-12 hours to pass prior to oxytocin administration
Cytotec Ripens cervix. 25 mcg q4h x max 4 doses. Allow 4 hours to pass prior to oxytocin administration.
Created by: kanani8806