Given IV through infusion pump titration moved PO Rarely now choice to stop labor after
Given IV through infusion pump titration moved PO Rarely now choice to stop labor after
| Category | Drug Names | Special Considerations |
| Anticonvulsants | Magnesium Sulfate lorazepam (Ativan) |
Drug of Choice, used in antepartum
Also electrolyte replacement, Used for PTL, Smooth muscle relaxant Dose: Loading 4-6g/1000 mL over 20 min Maintenance 2 g/hour Therapeutic level 4-8 mg/dL Always given through infusion pump Watch for loss of DTR in hypermagnesium ANTIDOTE: Ca GLUCONATE Benzodiazepine, used in antepartum MUST BE KEPT REFRIGERATED Must be given slowly Dose for Anticonvulsant: IV 50 mcg/kg up to 4 mg. May repeat in 10/15 minutes, but not to exceed 8 mg / 12 hrs |
| Antihypertensives | hydralazine
(Apresoline) methyldopa (Aldomet) nifedipine (Procardia) |
Vasodilator, used in antepartum
Dose: IVP 5 mg q 15-20 min up to 20 mg FOR ACUTE USE ONLY Antiadrenergic, used in antepartum Drug of choice of HTN maintenance Dose: 250-500 mg bid/tid Calcium channel blocker, used in antepartum BP control + tocolytic effect DO NOT GIVE WITH MAG SULFATE Ok to give with ritodrine (Yutopar) and terbutaline (Brethine) |
| Narcotics | butorphanol (Stadol)
meperidine(Demerol) nalbupine (Nubain) fentanyl citrate (Sublimaze) morphine sulfate (Morphine, Duramorph) |
Sedation and pain relief, intrapartum
FHR loss/variability Neonatal resp if given too close to delivery Synergistic effect with epidural, intrapartum Small amounts added to epidural Not absorbed systemically Possible hypotension Morphine placed in PCA, intrapartum, PP Duramorph placed in epidural line Surgical pain relief May use in recovery room Antidote for category: naloxone (Narcan) |
| Category | Drug Names | Special Considerations |
| NSAID | ibuprofen (Motrin) naproxen sodium (Anaprox) |
Uterine cramping relief, post partum Anti-inflammatory |
| Combined Analgesic | oxycodone/
acetaminophen (Percocet) |
Pain relief, post partum
May cause constipation |
| Local Anesthetics | bupivicaine (Marcaine) xylocaine |
Epidural anesthesia, intrapartum
Monitor BP q 15 min because may cause maternal hypotension May cause fetal compromise Load with 1000-1500 mL fluid to prevent hypotention Local anesthesia to repair episiotomy, PP |
| Oxytoxics (Green means go!) |
oxytocin (Pitocin) methylergonovine maleate (Methergine) |
Labor induction, intrapartum
1st choice drug for prevention of PP hemorr Can cause H20 intoxication Given IV through infusion pump titration ALWAYS ON PUMP AND MONITOR 2nd choice drug for tx of PPH (IV), postpartum May increase BP |
| Prostaglandins | misoprostol (Cytotec) carboprost tromethamine (Hemabate) dinoprostone (Prostin E2) |
Induces cervical ripening, intrapartum
May cause uterine hyperstimulation and longterm contractions Abortifacient in 2nd trimester Primarily approved as ulcer tx 3rd line choice for PPH, post partum Early term abortion, antepartum May have N/V/D, OK to pretreat with acetaminophen |
| Tocolytics (Red means stop!) |
ritodrine (Yutopar) terbutaline (Brethine) |
Stop labor, antepartum
Causes facial flushing, hypotension, tachycardia, strong palpitations Given IV through infusion pump titration then moved to PO Rarely used now 2nd choice to stop labor after MgS04, antepartum Hold if HR >120 or BP <90/60 |
| Miscellaneous | Drug Names | Special Considerations |
| For lung maturity Antibiotic Vaccines Stool softener Iron Replacement Contraceptive hormone Antiemetic Immunoglobin Vitamin |
celestone (Betamethasone) beractant (Survanta) Erythromycin 1% ophthalmic ointment hep B vaccines (Recombivax HB) rubella vaccine (Meruvax II) docusate sodium (Colace) ferrous sulfate (Feosol) medroxyprogestrone acetate(Depoprovera) promethazine (Phenergan) Rho(D)immune globin (Rhogam) phytonadione (Vit K) (Aqua Mephyton) |
Steroid, antepartum
Given to mom in Ptl @ 24-34 wks 12.5 mg q 24˚ X 2 Lung surfactant, postpartum Decreases incidence of RDS Given to infants 600-1750 g (1 lb = 480 g) Given intratracheally with 15 minutes of birth; rescue given within 8 hrs of birth. Prevention of neonatorum ophthalmia State mandated requirement of all infants within 1st hour of life Prevents blindness from gonorrhea, Chlamydia Prevention of hepatitis B begin series within 12 hours of birth Prevention of rubella in mom DO NOT GIVE WHILE PREGNANT GIVE PP ONLY Prevention of constipation, postpartum Prevention/tx of anemia, postpartum May turn stools dark Take with Vit C to improve absorption Birth control, given post partum Given IM q3 months Prevention/tx of N/V, post partum Synergistic with narcotics Use lowest dose 2ndary to possible extra pyramidal effects Prevention of development of antibodies to fetus’ Rh+ blood Given IM with each pregnancy (antepartum) to Rh – mom @ 28 wks and after amnio, abortion and to Rh – mom at delivery if Rh + baby Prevention of hemorrhagic dz in newborn Given IM in 1st hour of life |
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