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Duramorph

- Pregnancy Category C
- opioid analgesics
- severe pain, pulmonary edema and pain associated with MI
- crosses placenta, enters into breast milk in small amount

Fentanyl

- Pregnancy Category C
- opioid analgesics supplementary to general anesthesia => balanced anesthesia
- preoperative and postoperative analgesia

Phenergan (promethazine)

- Pregnancy Category C
- various allergic conditions and motion sickness
- preoperative sedation
- treat and prevent nausea and vomiting
- adjunct to anesthesia and analgesia
- given for nausea IV, PO, or rectal mostly early in pregnancy

Pitocin

- Pregnancy category X
- Induction of labor at term
- Facilitate threatened abortion
- Postpartum control of bleeding after expulsion of the placenta
- IV => emergency

Methergine (methylergonovine)

- Pregnancy category X
- uterine contraction => prevent and treat postpartum or postabortion hemorrhage caused by uterine atony or subinvolution
- contradicted in hypertensive/gestational hypertensive and cardiac patients
- IM or PO, not for emergency

Hemabate (carboprost tromethamine)

- uterine contraction: aborting pregnancy between the 13th and 20th weeks
- given for postpartum hemorrhage but not in asthmatics
- IM only, not for emergency

Demerol (meperidine)

- Pregnancy category X (Opioid analgesics)
- moderate or sever pain, anesthesia adjunct, analgesic during labor, preoperative sedation and rigors
- maybe given IV for pain relief in labor or postpartum for pain relief especially in C/S patients

Stadol (Butorphanol)

- Pregnancy category C (Opioid analgesics)
- moderate or sever pain, analgesic during labor, sedation before surgery, supplement in balanced analgesia

Nubain (nalbuphine)

- Pregnancy category C (Opioid analgesics)
- moderate or sever pain, analgesic during labor, sedation before surgery, supplement in balanced analgesia

Cervidil (dinoprostone)

- Pregnancy category C
- cervical ripening agent
- ripen the cervix at near term when labor induction is indicated
- inserted vaginally to ripen or prepare the cervix for labor
- management o missed abortion up to 28 wk
- management of nonmetastatic gestational trophoblastic disease (benign hydatidiform mole)

Marcaine / Bupivacane

- Pregnancy category C
- epidural local anesthetics
- local or regional anethesia or analgesia for surgical, obstetric, or diagnostic procedures

Terbutaline

- Pregnancy category B
- manage reversible airway disease due to asthma or COPD
- given SC or PO to treat preterm labor (off label use), woman's heart rate should be less than 100 bpm before giving
- not a drug of choice for PTL, but will be used in emergency IVP

Procardia (NIFEdipine)

- Pregnancy category C (antianginals, antihypertensives)
- Manage HTN, angina, prevent migraine, CHF or cardiomyopathy
- cardiac medication given for preterm labor or to lower BP

Magnesium Sulfate

- Pregnancy category D
- treat and prevent hypomagnesemia
- Treat HTN, anticonvulsant associated with severe eclampsia, pre-eclampsia or acute nephritis
- Unlabeled Use: preterm labor, adjunct treatment for bronchodilation in moderate to severe acute asthma
- most common medication used for preterm labor and preeclampsia

Depo provera

- Pregnancy category X
- antineoplastics, contraceptive hormones (progestins)
- to decrease endometrial hyperplasia in postmenopausal women receiving concurrent estrogen
- treat secondary amenorrhea and abnormal uterine bleeding caused by hormonal imbalance
- can be given to postpartum bottle-feeding mother postpartum immediately as contraceptives => an inj to prevent ovulation for 90 days or more

TDap

- Tetanus toxoid

Prophylaxis of endocarditis

- Gentamicin (Garamycin)
- Ampicillin (Polycillin)

Digoxin (Lanoxin)

- to increase maternal cardiac output during pregnancy
- may be prescribed for fetal tachycardia

Propranolol (Inderal)

- to treat tachyarrhythmias
- to lower maternal blood pressure

Drugs prescribed for pre-term labor

- Terbutaline (Brethine): stimulate beta-2 receptors in the smooth muscle fibers to inhibit uterine activity
- Magnesium sulfate: relaxes the smooth muscle of the uterus and thus inhibits uterine activity by suppressing
contractions
- Indomethacin (Indocin): NSAID => inhibits prostaglandins thus suppresses uterine contractions
- Betamethasone (Celestone): enhance fetal lung maturity and surfactant production

Drugs prescribed for PROM

- Ampicillin (Omnipen): to treat infection
- Betamethasone (Celestone): enhance fetal lung maturity
and surfactant production

Prostoglandin Gel

- inserted vaginally to ripen or prepare the cervix for labor

Ibuprofen

- given postpartum for cramping and pain PO

Penicillin

- given most often to treat GBBS every 4 hours IV

Cytotec

- induction agent pill given PO or vaginally, may also be used for postpartum hemorrhage

Laminaria

- substance that swells the cervix, dilating it slightly

prenatal vitamin

- should be taken from preconception through breastfeeding and postpartum

vitamin K

- necessary to assist the infant in ability to clot, normally made in the intestines

Labetalol and Hydralazine

- meds given IVP to lower the blood pressure in women with hypertensive disorders of pregnancy

Calcium Gluconate

- reversal agent for magnesium sulfate

Simethicone

- used to relieve gas pains in patients postpartum

Colace

- stool softener given to postpartum patients

Toradol

- IV version of ibuprofen
- often given to C/S patients for cramping and pain relief for 1st 24 hrs

Hepatitis B

- recommended by most pediatricians
- for the prevention of a common liver disease, series of 3 injections

Erythromycin Eye Ointment

- prophylaxis of ophthalmia neonatorum due to N. gonorrhoeae or C. trachomatis

Zidovudine syrup

- oral medication for infant with HIV+ mother

Drugs prescribed post-circumcision

- Tylenol 40mg po

Drugs for afterbirth pain

- NSAIDS 600mg to 800mg
- or something stronger for severe cases

Antibiotics for conjunctivitis

- Erythromycin
- Gentamycin
- Ceftriaxone

Antiviral for conjunctivitis

- Acyclovir

Combination (Estrogen/Progesterone) birth control pills

- Not given to breast-feeding mother at all => will dry up the breastmilk
- Not given to bottle-feeding mother with no risk of DVT and VTE until until 25 days
- Not given to bottle-feeding mother with risk and or history of DVT and VTE until 42 days

Birth Control for breast-feeding mothers

- should have nothing til at least 3 wks until milk supply thoroughly established
- then Micronor, a Progestin only pill, is available

Loading dose of oxytocin for hypotonic labor

- 0.5-1.0 milliunits/minute (mU/min)

Maintenance dose of oxytocin for hypotonic labor

- up to 20 milliunits/minute (mU/min) by increasing 1-2/mU/min q30-60min

Adequate uterine contractions in labor

- 40-90 seconds duration
- 40-90 mm uterine pressure
- 2-3 minutes apart
- progressive cervical dilation

Loading dose of Magnesium Sulfate for PIH

- 4 gm bolus in 250 cc fluid over 20 mins

Maintenance dose of Magnesium Sulfate for PIH

- 2 - 4 mg / 1 hr
- if the dose is not effective, may increase the drug in cc but lower the amount of plain fluid
- typically not exceed 100 cc per hour in order not to overload her with fluid and end up with pulmonary edema

Signs of Magnesium Sulfate toxicity

- depressed respirations
- decreased deep tendon reflexes

Measures for monitoring patients with magnesium sulfate

- strict bed rest and seizure precaution
- monitor for Magnesium sulfate toxicity
- output q30mins, VS q30mins, fetal monitoring, check reflexes and breathing, etc.
- lab Magnesium Sulfate level q6h => to watch for toxicity

17 alpha-hydroxyprogesterone caproate injections

- Indicated for clients who lack sufficient progesterone to maintain pregnancy
- IM weekly

Drug indication for Ephedrine (E)

- IV push to correct the hypotensive situations caused by administering epidural

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