OB 316 clinical med list PDF

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Summary

this is half the medication list for OB clinical 316, it has the MOA, contraindications, the side effects more maternal and fetus....

Description

Medication Generic & Brand

Dose / Route

MOA Use/Indication

Contraindications

Adverse Effects

Nursing care/ Education

Oxytocin (Pitocin)

10 units are added to 1L of isotonic solution or 20-40 units in a liter IV infusion pump piggybacked into the main IV line at the port most proximal to the insertion site.

Artificial induction and augmentation of labor. It stimulates contractions of the uterus; acts on uterine myofibrils to contract/to initiate or reinforce labor.

Unfavorable fetal positions/ presentation (transverse lies) Fetal distress hyperactive/hypertonic uterus Invasive cervical carcinoma, active herpes genitalis, cord presentation or prolapse of cord.

Uterine hyperstimulation leading to fetal compromise and impaired oxygenation; dec urine flow leading to water intox; HA and vomiting; impaired uterine blood flow leading to fetal hypoxia

Assess baselin and FHR and infusion frequ Determine frequency, du and strength o contraction frequently. M I&O Monitor for a effects.

Metoclopramide (Reglan)

10-20 mg IM

Antiemetic, accelerates cervical dilation, and reduces first stage duration

Plans to breastfeed, should only be used if clearly needed and the benefit outweighs the risk to fetus.

Drowsiness, dizziness, tiredness, trouble sleeping, agitation, headache, diarrhea.

Assess for EP dyskinesia

Nifedipine (Procardia)

30 mg PO followed by 10-20 mg q4h – q6h

Used to stop labor before 37 weeks of pregnancy. (preterm delivery).

Allergy to nifedipine, sick sinus syndrome, secondary or tertiary heart block, hypotension, and hepatic dysfunction.

Dizziness, flushing, weakness, swelling ankles/feet, constipation, and headache.

Assess for an pain, monitor maternal and VS.

Nubain

0.3 mg/kg to 3 mg/kg IV

Used to treat pain during childbirth.

Flushing, nausea, vomiting, stomach cramps or pain, upset stomach.

May slow FHR, and breathing problems.

Newborns VS breathing, nee be monitored

Ondansetron (Zofran)

4 – 8 mg q8h PO

Used to reduce symptoms of N/V known as morning

None noted.

Headache, diarrhea, constipation, weakness,

Monitor fo adverse ef

sickness. Promethazine Phenergan

12.5 to 25 mg PO q4h-q6h

Allergies, nausea, and vomiting.

Plasmaderived VIII (Hemofil-M)

250 IU – 1500 IU

Used to treat hemorrhage due to hemophilia A.

Plasma derived IX (AlphaNine SD)

1 unit/kg x body wt (kg) x desired increase (% of normal) = Number of factor IX units required

Used to prevent and control bleeding in adults with hemophilia B.

Recombinant factor VIII (Advate)

IU/dL (or % of normal) = [Total Dose (IU)/body weight (kg)] x 2 [IU/dL]/ [IU/kg]

Recombinant factor IX (BeneFix)

IU/dL (or % of normal) = [Total Dose (IU)/body weight (kg)] x 2 [IU/dL]/ [IU/kg] SQ IM 0.25 mg 2nd dose within 15-30 min. Total dose within 4 hrs should not exceed 0.5 mg.

Terbutaline (Brethine)

Betamethasone

12 mg IM

tiredness, dizziness. Might increase the chance of slowed breathing in NB baby.

Hypersensitivity.

Drowsiness

Monit breathi

Headache, drowsiness, Admin at r lethargy, fever, than 10 mL blurred vision, chills.

Increases risk of thrombosis.

Headache, dizziness, rash, injection site pain, N/V

Plasma/albumin recombinant factor VIII replacement therapy for patients with hemophilia A.

Known anaphylaxis to mouse or hamster protein or other constituents of the product.

Hives, bradypnea, swelling of face, lips, tongue, throat, itching, rash, numbness.

Human blood coagulation indicated in adult and pediatric patients with hemophilia B. Prevent and slow contractions of the uterus; used to stop or delay preterm labor; may delay birth for several hours or days. Indicated for the

Known anaphylaxis to mouse or hamster protein or other constituents of the product.

Fever, pain at injection site, chills, headache, flushing, N/V.

Hypersensitive to sympathomimetic amine.

Anxiety, apprehension, bronchospasm, cough, pulmonary edema, palpitation, arrhythmias.

Active/inactive TB,

Increased BS,

Monitor la anaphylax hypersens

Beta blo hand arrhythm distr Report ch SOB, and H

Monitor an

signs of pe HSV, fungus, intestinal trembling, every 24 hrs for reduction of ulcer, hear dizziness, infection caused by 2 doses. neonatal N/V, vomi weakness, roundworm mortality blood, tarr fatigue, fast stronglyoides. (RDS), HR. intraventricular hemorrhage in women at risk for preterm delivery at less than 34 weeks. Assess BP & VS, Relieves pain Hypersensitive to Somnolence, Nasal 1mg (1 implement dizziness, N/V, butorphanol or spray in 1 nostril) during the first nasal congestion, therapeutic stage of labor preservative repeat 60-90 exercises to insomnia, benzethonium mins. reduce pain and lethargy, chloride. help pt wean off anorexia, dry opioids. mouth, Fall risk. confusion, hypotension. Swelling, repaid Should not In patients with 500 mg – 2g Used during exceed 2 mL per weight gain, a ventricular IV second stage of minute, monitor light-head labor can reduce fibrillation, and HR & ECG. feeling, like you hypercalcemia. the amount of might pass out; intrapartum & slow & irregular postpartum heartbeats. hemorrhage in single-birth primipara. Monitor for any 250 mcg/mL IM, prostaglandin Hypersensitivity N/V, adverse effects. repeat PRN q15- used to treat Acute pelvic nervousness, 90 min postpartum inflammatory epistaxis, sleep uterine disease disorder, hemorrhage due Active cardiac, hyperthermia, to atony when pulmonary, renal flushing other methods of or hepatic management disease have not been effective.

(celestone)

Butorphanol (Stadol)

Calcium Gluconate

Carboprost (Hemabate)

Dinoprostone (Cervidil)

Vaginal insert 10 mg, endocervical gel 0.5mg/3g

Used to prepare the cervix for the induction of labor in pregnant women who are at or near term.

Hypersensitivity to prostaglandins, cases of fetal distress where delivery not imminent,

Hypertonic Monitor for any uterine adverse effects. dysfunction with fetal distress, fever/temperature elevations, GI upset.

Diphenhydramine (Benadryl)

No more than 1-2 Used as a tablets every 4-6 sedative, antihistamine, hrs. and nausea drug.

Duramorph (morphine)

IV, epidural

Used for pain during labor

Fentanyl

IV/IM  adults 50-100 mcg IM/IV slow over 1-2 mins

Pain relief during childbirth has fewer side effects on both mother and fetus.

Folic Acid (folate)

400 mcg daily PO

folic acid helps form the neural tube. It can help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).

Lidocaine

100 mg/100 mL – 800mg/mL

unexplained vaginal bleeding during pregnancy. Overactive thyroid gland, increased pressure in the eye, closed angle glaucoma, HTN.

Dry mouth, nose, throat, drowsiness, dizziness, nausea, vomiting.

Exposure during the third trimester may result in adverse reactions in premature infants and neonates.

Drug abuse, cor cuplmonale.

Nausea, vomiting, constipation, lightheadness, dizziness, drowsiness.

Surgery, GI obstruction, alcoholism, depression, ETOH abuse, COPD, asthma MAOI therapy. None noted.

Apnea, cardiac arrest, clamminess, confusion, constipation, floating feeling, HA, lethargy. Unlikely to get side effects but some people feel sick, lose their appetite, get wind or feel bloated.

Monitor for adverse effects, suppression of CNS. Monitor for placental vasoconstriction. Avoid grapefruit, have naloxone, monitor RR, observe FHR for depression.

Given in an epidural (spinal block) to reduce discomfort of contractions during labor.

Hypersensitivity to anesthetics of the amide type

Only take until you’re about 12 weeks pregnant.

Cyanosis lips, fingertips, double vision, chest pain or discomfort, cold, clammy, pale

Monitor cardiac

Magnesium Sulfate

Loading dose: IV 4-6g over 15-30 min Maintain dose: 1-4g/hr

Treatment of preeclampsia or eclampsia

Heart block or myocardial damage

Misoprostol (Cytotec)

800 mcg per rectum, one dose. (range 400-1000 mcg)

Stimulates uterus to contract and reduce bleeding; used for acute postpartum hemorrhage; ripens cervix/ to induce labor

Amphotericin B (Fungizone)

1.5 mg/kg MAX

Used to treat infections caused by fungus.

Never give undiluted as a bolus injection/IV Allergy, active CVD, /pulmonary/hepatic disease, use with caution in women with asthma This product is contraindicated in those patients who have shown hypersensitivity to amphotericin B

Cefazolin (Ancef)

500 mg – 300 g IV

Cefazolin injection is also sometimes used to treat certain penicillin allergic women who are in labor in order to prevent the newborn from developing an infection.

Clindamycin

Alternative ABX for patients allergic to ampicillin/penicillin. Treats infection/ GBS during labor.

No known adverse effects use only if necessary

skin. N/V, HA, weakness, hypotension, cardiopulmonary arrest, blurred vision, dizziness, altered LOC N/V and D Uterine hyper stimulation category 2 FHR patterns

Assess variabil monitor RR effo deep ten reflexes Assess V FHR pa frequen Initiate inductio 4 hours dose wa

Pale skin, easy bruising, blood in stool, lightheadedness, seizures, jaundice.

Ampho should b adminis intraven under cl clinical observa medical trained personn

Genital itching, white patches in mouth, loss of appetite, heartburn, gas, nausea, vomiting.

Monitor of infec bleeding injection

Fatigue, headache, hypotension, abd pain, jaundice, elevated liver enzymes.

Monitor enzyme HR, BP injection

Clotrimazole (Lotrimin)

Antifungal (topical vaginal)

Gentamycin

Treatment of gramnegative bacterial infections and infections caused by staphylococci when penicillin or other less toxic drugs are contraindicated.

Ketoconazole (Nizoral)

Antifungal (vaginal topical cream)

No known contraindications only use if necessary.

No known adverse effects, only use if necessary. Local redness, stinging, blistering, peeling, swelling Not expected to harm unborn fetus.

MSE: N/V, diarrhea, decreased appetite. Fetal: evidence of (probably reversible) damage to immature nephrons of the fetal kidney associated with use, and eight cranial nerve damage associated with aminoglycoside exposure in utero.

MSE: N/V, abd pain, constipation, diarrhea, flatulence,

Hyperse to active ingredie additive preserva bases. A report a increase sensitiv Low am calcium blood, dehydra type of movem disorder parkinso

Avoid contact w cutaneous lesion when treating patient.

Methenamine (Hiprex)

No opioid analgesic, UTI

Miconazole (Monistat)

Used to treat vaginal yeast infections.

Nitrofurantoin (Macrodantin)

Used to treat or prevent uncomplicated UTI’s

Nystatin (Mycostatin)

Used to treat or prevent infections caused by fungus or yeast. (oral thrush)

Penicillin – Amoxicillin (Amoxil)

Used to treat a wide variety of bacterial infections

Fetal: No effects have been noted. MSE: Monitor liver hepatotoxicity, enzyme labs nausea, headache, Fetal: none noted in human fetuses.

Contraindicated in patients with renal insufficiency, severe hepatic insufficiency, or severe dehydration. No known MSE: burning, contraindications itching, local hypersensitivity, redness, stinging. Fetal: low doses of...