Pitocin (Oxytocin) produces:
Intermittent uterine contractions
Pitocin (Oxytocin) comes pre-mixed for intrapartum use.
Solution strengthe is 30 units in 500cc D5LR
Pitocin (Oxytocin) Usual low dosage to induce labor: (in milli-units)
2 mu per hour rate increase rate of dosage by 2 mu every 30 min.
Pitocin (Oxytocin) Usual regular dosage to induce labor: (in milli-units)
3 - 4mu per hour, increase infusion rate by 2mu q 30 min.
Pitocin (Oxytocin) to augment labor process
Initiate when contractions are less than 250 MVU's for more than 1 hour. Generally use low dose protocol.
Protaglandins (Cervadil) used to:
"Ripen" a cervix as preparation for labor induction.
Protaglandins (Cervadil) Administration:
Vaginally - placed in the posterior fornix. Remains in place for up to 12 hours.
Protaglandins (Cervadil) Important points to remember:
Requires continuous fetal monitoring. One hour must lapse after removal prior to starting pitocin infusion.
Cytotec (Misoprostol) is used to:
Cytotec (Misoprostol) Administration:
Vaginally 25 - 50 mcg. Q 6 hrs. Orally 25 - 50 mcg Q 6hrs may give up to four doses.
Pitocin used to control heavy bleeding Following delivery Administration:
IM - 10 Units or IV solution 20 - 40 Units in 1000 CC IV fluid. Run maintence at 200 cc/hour.
Cytotec (Misoprostol) to control heavy bleeding Post delivery:
600 - 800 mcg PO or PR, may repeat as needed to control bleeding.
Methergine to control heavy bleeding following delivery, what does it do?
Produces a continuous uterine contraction
Methergine to control heavy bleeding following delivery administration:
0.2 mg IM q 2 - 5 hrs. Do not exceed 5 doses. Do not give if mom has hypertension.
Hemabate (Prostin) to control heavy bleeding following delivery. Administration:
250 mcg IM q 1 1/2 - 2 1/2 hrs.
Demerol (Meperidine HCL) forl pain in labor. Dosages
25, 50, 75, 100 mg.
Demerol (Meperidine HCL) for pain in labor. IM Administration
50 - 100 mg for labor. Peak effect in 30 - 50 min, duration 2 - 4 hours
Demerol (Meperidine HCL) for pain in labor.IV Administration
12.5 - 25 mg SLOWLY. Onset 5 min, peak 20 min, duration 1 - 2 hrs (FETAL CNS DEPRESSION)
Morphine for pain in Labor
Admin IM or IV, 6 - 10 Mg IM, 3 - 6 mg IV. Rapid onset - 2 hour duration.
Fentanyl (Sublimaze) for pain in labor
100 mcg/2 cc, 1 -2 cc (50 -100 mcg( q 1 - 2 hrs IV rqapid onset, pak 7 min - 30 - 60 min duration. (RESP. DEPRESSANT)
Narcan (Naloxolone) is used as
Opiod reversal (antagonist) for overdose.
0.4 - 2mg. IM or sub Q 2 - 3 min. until response up to 10 mg.
Sedative - Seconal dose
Admin 200 mg PO. Half live of 30 hours
Tranquilizer - Phenergan (promethazine) is also..
Anti-emetic, adjunct to analgesic.
Dosage for Phenergan
12.5 - 50 mg IM early labor, (max 100 mg/24 hrs)
Tranquilizer - Vistaril (hydroxyzine) is also...
Dosage for Vistaril
50 mg IM - 50 - 100 mg PO (never give IV)
Betamethasone (Celestone) is a
Betamethasone (Celestone) is given to
women 24 hrs prior to birth of infant less than 34 weeks gestation to hasten maturity of lungs and decrease RDS
Dosage of Betamethasone (Celestone)
12.5 mg IM inital dose, second dose repeated in 24 hours.
Magnesium Sulfate (MgSo4) is a..
Magnesium Sulfate (MgSo4) is given to
diminish muscle contractibility
Magnesium Sulfate (MgSo4) dosage:
3 - 6 gm in 250cc LR over 30 min.
Magnesium Sulfate (MgSo4) dose for Pre-eclamptic pt/seizures.
Loading dose 4gm in 250 CC LR IV over 30 min then 2 - 3 gm/hr IV
IMORTANT TO REMEMBER W/Magnesium Sulfate (MgSo4)
Monitor MGSo4 levels every 6 hours, if mag level less than 9 do not repeat dose. Always check patellar reflexes hourly, STOP if reflexes are diminished.
Antidote for Magnesium Sulfate (MgSo4)
Calcium Gluconate - Administer IV VERY SLOWLY
Preterm Labor Medicine Magnesium Sulfate (MgSo4)
CNS depressant, will diminish uterine muscle contraction activity
Preterm Labor Medicine Terbutlaline
Effective in relaxing the uterine muscle.
How is Terbutlaline aministered and what are dosages?
Sub Q 2.5 mg or PO .25mg
What are the side effect of Terbutlaline?
Rapid heartrate and some SOB
Post Partum Medications
PPM Methergine is used when...
Increased bleeding after initial recovery period.
Dosage of Methergine
0.2 mg PO q 4 - 6 hrs.
PPM Pitocin is used to
contract the uterus, continue from L & D recovery
Dosage for Pitocin
20 - 40 Units in 1000 cc IV solution and rate of 100 - 125 cc/hr.
Prostaglandin inhibitor/Anti inflammatory agent
Dosage of Ibuprofen
800 mg q 8 hr PO
Percocet (oxycodone/acetaminophen) dosage
5/325 or 7.5/325 PO
Tylenol #3 (codine/acetaminophen) dosage
1 - 2 q 4 - 6 hrs PRN/pain PO (not to exceed 12 tabs in 24 hrs.
Lortab (hydorcodone/acetaminophen) dosage
5/500 - 7.5/500 1 or 2 tabs q 4 - 6 hrs (not to exceed 8 tabs in 24 hrs)
Sleep medicine Seconol dosage
100 Mg. @ H.S. PO (not used as much as in the past - 30 hr half life)
Sleep medicine Ambien (Zolpidem) dosage
5 - 10 mg PO @ H.S. short half life
Colace (docusate) dose
50 - 100 mg PO Must be taken with a full glass of water.
Erythomycin Opthalmic antibiotic ointment dosage
1 mg. unit dose for administration to both eyes of newborn
Injection 1 mg - 0.5 cc (unit dose)
Hepatitis B first injection of series
1 mcg - 0.5 cc (unit dose)
Prophylaxis for Group B Strep - Penicillin dose
1,200.00 Units IV pigyback initially then q 4 hrs until delivery. Administered to mom for baby's benefit.