OB Medications

Created by Leandra7112 

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Postpartum, Neonatal, and high risk antepartum medications for the OB rotation

Colace: Indication

Constipation

Colace: Onset/Peak/Duration

Duration- QD

Dulcolax suppository: Indication

Constipation

Dulcolax contraindication

DO NOT GIVE if patients has a 4th degree tear or 4th degree extension of Episiotomy

Darvocet N: Indication

Mild to moderate pain relief

Darvocet: Onset/Peak/Duration

Onset- 15-60 minutes
Peak- 2-3 hours
Duration- 4-6 hours

RhoGAM Indication:

Prevention of antibody response and hemolytic disease of the newborn in future pregnancies of women who have conceived an Rh (+) baby when the mother is Rh (-)

RhoGAM Nursing Judgement

If Coombs (+), it's too late. Will have problems with future pregnancies if future fetus is Rh (+)

Must give before/within 72 hours after delivery

RhoGAM: Onset/Peak/Duration

Prophylaxis at 28 weeks gestation and any time there is invasive procedures/trauma/abortion.

Provides coverage for approximately 12 weeks

Colace Dosage

1 po qd

Darvocet Dosage

N-100 po q4h

RhoGAM Dosage

300 mcg (one vial) IM <72 hrs

Tylenol Dosage

1-2 po q3-4

Tylenol Indication

Mild to moderate pain relief

Rubella (Meruvax) Dosage

vaccine 0.5 ml SQ (MMR)

Rubella Indication

To prevent risk of measles infection if is exposed during subsequent pregnancy—very damaging to fetus
Need vaccine when Titer < 1:8

Rubella Nursing Judgement

Stress that mother should NOT get pregnant after vaccine (for 3 months)

DO NOT GIVE if allergic to Eggs

Erythromycin ointment Dosage

(Ilotycin) 0.5% ribbon O.U.

Erythromycin ointment Indication

Prophylaxis ophthalmia neonatorum- blindness in baby d/t gonorrhoeae or chlamydia infection @ birth.

Erythromycin ointment Nursing Judgement

MUST give med within 1 hour of birth—if microbes are present, don't want an infection to start if you are slow about giving it. May wait a few minutes to allow bonding to occur.

Aqua Mephyton (Vit K) Dosage

1 mg IM in thigh

Aqua Mephyton (Vit K) Indication

Prevention of bleeding- inadequate normal flora in gut to synthesize vitamin K at birth

Aqua Mephyton (Vit K) Nursing Judgement

Wash leg first then use alcohol.

Magnesium Sulfate Dosage

drip (MgSO4) 1-4 gm/hr

Magnesium Sulfate Indication

Pre-term labor (used less often for this purpose)-- decreases the intensity and frequency of uterine contractions

Preeclampsia (PIH)- to prevent seizures

Magnesium Sulfate category

Anticonvulsant

Magnesium Sulfate Nursing Judgment

STOP OR TURN DOWN if DTR= 0 or 1; or RR<12/min. Watch closely with impaired renal function (which you have with PIH) because it is excreted in the kidneys and can have toxic level build ups.
DO NOT GIVE with Ca channel blocker (has additive effect) nor with diagnosed myasthenia

Magnesium Sulfate Onset/Peak/Duration

Onset- immediately
Peak- unknown
Duration- 3-4 hours after drug is withdrawn

Magnesium Sulfate Antidote

Calcium Gluconate
1 GM over 3 - 5 min IVP

Terbutaline (Brethine) Dosage

0.25 mg SQ q1-3 hr units/1000 cc IV drip

Terbutaline (Brethine) Category

Tocolytic/Bronchodilator

Terbutaline (Brethine) Indication

Pre-term labor

Terbutaline (Brethine) Nursing Judgement

DO NOT GIVE if HR > 110 - 120.
Take heart rate before administering.
USE WITH CAUTION in cardiac disease (affects heart rate) and with diabetics (increases blood sugar)

Terbutaline (Brethine) Onset/Peak/Duration

Onset- <15 min
Peak- ½-1 hr
Duration- 1.5-4 hr

Nicardipine (Cardene) Category

**CA channel blocker antihypertensive
(smooth muscle relaxant and also antihypertensive)

Nicardipine (Cardene) Indication

Preterm labor contractions

PIH

Nicardipine (Cardene) Nursing Judgement

DO NOT GIVE in combination with Magnesium sulfate (Will cause severe hypotension and subsequent pulmonary edema)
Check BP before giving-if too low (i.e., 90/50) DO NOT GIVE.

Nicardipine (Cardene) Onset/Peak/Duration

Onset- <1min
Peak-45 min
Duration- 50 hrs

Nifedipine (Adalat, Procardia) Dosage

10 mg SL (MR q 20 min X3)

Nifedipine (Adalat, Procardia) Category

**CA channel blocker (see Cardene above)

Nifedipine (Adalat, Procardia) Indication

Preterm labor contractions

PIH

Nifedipine (Adalat, Procardia) Nursing Judgement

DO NOT GIVE in combination with Magnesium sulfate (Will cause severe hypotension and subsequent pulmonary edema)
Check BP before giving-if too low (i.e., 90/50) DO NOT GIVE.

Nifedipine (Adalat, Procardia) Onset/Peak/Duration

Onset- 20 min
Peak- unknown
Duration- 6-8 hrs

Betamethasone (Celestone) Dosage

12 mg IM q 12 X2, or
12 mg now and in 24 hours.

Betamethasone (Celestone) Indication

To prevent respiratory distress syndrome in the newborn when delivered prematurely

Betamethasone (Celestone) Nursing Judgement

DO NOT GIVE in combination with Magnesium sulfate (Will cause severe hypotension and subsequent pulmonary edema)
Check BP before giving-if too low (i.e., 90/50) DO NOT GIVE.

Betamethasone (Celestone) Onset/Peak/Duration

Onset- 20 min
Peak- unknown
Duration- 6-8 hrs

Hydralazine (Apresoline) Dosage

5-10 mg IV q 20 min

Hydralazine (Apresoline) Category

Antihypertensives

Hydralazine (Apresoline) Indication

Moderate to severe hypertension from PIH

Hydralazine (Apresoline) Onset/Peak/Duration

Onset- 10-20 minutes
Peak- 15-30 minutes
Duration- 3-8 hrs

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