335 Med Cards Week 4 PDF

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Medication: (Generic and trade name): Cervidil (generic name is Dinoprostone) Drug Classification: Prostaglandin E2 FDA pregnancy category: C, adverse effects such as bone anomalies have be noted in lab research on rats and rabbits but in humans. Use (Why is this drug usually prescribed?): Aids in starting and continuing cervical ripening for women who require labor to be induced whether they are at or near term. Action (How the drug works): Cervidil is a prostaglandin hormone- like subs;.tance naturally made by the body. It is used in labor to soften the muscles of the cervix to allow the fetus to pass through the birth canal during labor. Dinoprostone is naturally secreted by the fetal membrane and placenta and helps initiate labor. It allows the smooth muscle of the uterine to change from rigid to dilated and movable without compromising contractions. It works by activating the enzyme collagenase that will digest structural collagen networks in the cervix. Contraindications: Effects of IV oxytocic agent may be altered if used with Cervidil. Remove at least 30 minutes prior to administering oxytocic. Use caution if mother is a high risk of postpartum disseminated intravascular coagulation (DIC). Patients with known hypersensitivity to prostaglandins and unexplained vaginal bleeding during pregnancy. Patients with clear signs of fetal distress and have no signs of imminent delivery. Patients who have had recent C-sections are at an increased risk of uterine rupture. Side Effects (at least 5): 1. 2. 3. 4. 5. 6.

Fever Nausea and vomiting Abdominal pain Warm sensation in the vaginal area Strong contractions very close together (notify doctor or midwife) Abnormal heart rate in newborn

Dosage: 10mg vaginal insert used up to 12 hours. The insert will release 0.3mg of Cervidil per hour. The gel form is 0.5mg (2.5mL) and can be repeated every 6 hours, the maximum dose is 1.5mg over the course of 24 hours. Cervidil can be repeated after the 12-24 hours has passed and the cervix is not dilated if the OB decides it is safe and the mother responds well to treatment. However, alternative methods may be used if the mother or fetus are at an increased risk of adverse effects. Nursing Administration Considerations (List monitoring parameters, patient teaching needs, administration considerations, IV guidelines, etc.) Cervidil is the only FDA approved vaginal insert for cervical ripening. Keep frozen prior to use at temperatures from –4 degrees Fahrenheit to 14 degrees Fahrenheit. Resembles a tampon, has a retrieval system that will be used to remove insert when finished with use. Avoid tension on retrieval system to avoid early removal and ambulation is allowed after 2 hours of insertion. In

the case of uterus hyperstimulation immediate removal of Cervidil with reverse side effects within 3 minutes. Monitor fetal heart rate as dilation of the cervix progresses for adverse effects of hyperstimulation of the uterine. References: “Cervidil (Dinoprostone): Uses, Dosage, Side Effects, Interactions, Warning.” RxList, RxList, 16 July 2020, www.rxlist.com/cervidil-drug.htm. Commissioner, Office of the. U.S. Food and Drug Administration, FDA, www.fda.gov/....