Medications used in OB - NE 106

What is the generic name for Pitocin?
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Terms in this set (132)
What is the generic name for Pitocin?
oxytocin injection
What drug class is Pitocin (oxytocin injection) in?
Oxytocic hormones (uterine stimulant)
What is the dosage range for Pitocin (oxytocin injection)?
Low-High and Average
Initially 0.5-1 mU/min, than at 30-60 minute intervals the dose should be gradually increased in increments of 1-2 mU/min until the desired contraction pattern has been established; 10 units IM
Physiology and mechanism of action: What is the effect Pitocin (oxytocin injection) has on that part of the body?
Causes the uterus smooth muscle to contract, producing uterine contractions
What are the reasons for taking Pitocin (oxytocin injection)?
Used to produce uterine contractions during the third stage of labor; control postpartum bleeding or hemorrhage
What are the side effects that Pitocin (oxytocin injection) causes?
Nausea, vomiting, cardiac dysrhythmias, fetal bradycardia, HTN episode, mother, ventricular premature beats, mother and fetus.
Water intoxication syndrome.
Drug interactions for Pitocin (oxytocin injection)?
Vasoconstrictors cause severe hypertension
What assessments are needed before and after administration of Pitocin (oxytocin injection) to validate the need for the medication and recognize side effects patient may be experiencing?
Start flow sheets to record maternal BP and other VS, I&O ratio, weight, strength, duration, and frequency of contractions, as well as fetal tone and rate before instituting treatment.
Monitor fetal heart rate and maternal BP and pulse at least q15m during infusion period. Report change in rate and rhythm immediately. Stop infusion to prevent fetal anoxia, turn pt on her side, and notify prescriber if contractions are prolonged. Be alert to the possibility of hypertensive crisis. Watch for symptoms of water intoxication.
Patient teaching for Pitocin (oxytocin injection)?
Advise patient to expect contractions similar to menstrual cramps after administration has started.
Report sudden, severe headache immediately to healthcare providers.
What drug class is Magnesium Sulfate in?
Tocolytic
Physiology and mechanism of action: *What is the effect Magnesium Sulfate has on that part of the body?*Central nervous system depressant and relaxes smooth muscles, thus inhibiting uterine activity by suppressing contractionsWhat are the reasons for taking Magnesium Sulfate?Used to slow contractions in preterm labor; labor that starts before 37 weeks of pregnancyWhat are the side effects that Magnesium Sulfate causes?Mother: flushing, feeling uncomfortably warm, headache, dry mouth, nausea, and blurred vision. Patients often state they feel wiped out, as though they have the flu Baby: listless or floppy at birthWhat is the dosage range for Magnesium Sulfate? Low-High and Average(IV) Initial infusion of 4 to 6 grams over 15 to 30 minutes, and then a maintenance dose of 2 to 3 grams per hour.What assessments are needed before and after administration of Magnesium Sulfate to validate the need for the medication and recognize side effects patient may be experiencing?*HIGH ALERT (IV)* Monitor blood magnesium, calcium, and phosphorus. Monitor blood pressure, heart rate, and respiratory rate when given intravenously. Assess for magnesium toxicity - thirst, confusion, decrease in reflexesPatient teaching for Magnesium Sulfate?IV magnesium is safe for the fetus. Educate the patient it is not uncommon to experience untoward side effects such as warmth, flushing, and nausea.What is the generic name for ILOTYCIN?ErythromycinWhat drug class is ILOTYCIN (Erythromycin) in?Macrolide antibioticsPhysiology and mechanism of action: *What is the effect ILOTYCIN (Erythromycin) has on that part of the body?*Slows the growth of micro-organisms by inhibiting protein synthesis (bacteriostatic), but is bactericidal at high dosesWhat are the reasons for taking ILOTYCIN (Erythromycin)?Used after birth to prevent certain eye infections, such as neonatal conjunctivitis and ophthalmia neonatorum (neonatal blindness)What are the side effects that ILOTYCIN (Erythromycin) causes?Edema and inflammation and inability to focus. Usually disappear in 24-48 hrs.What is the dosage range for ILOTYCIN (Erythromycin)? Low-High and AverageUse a 1 cm ribbon of ointment in the eyes once at birthILOTYCIN (Erythromycin) precautions?Hypersensitivity of erythromycins.Patient teaching for ILOTYCIN (Erythromycin)?Instruct parents to not wipe off of baby's eyes. It will be removed with first bathWhat is the generic name for Stadol?butorphanolWhat drug class is Stadol (butorphanol) in?opioid analgesics/opioid agonists/antagonistsPhysiology and mechanism of action: *What is the effect Stadol (butorphanol) has on that part of the body?*Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.What are the reasons for taking Stadol (butorphanol)?Analgesia during labor (if childbirth is expected to be more than 4 hours away)What are the side effects that Stadol (butorphanol) causes?Mother: Pain at the injection site, Nausea and vomiting, Drowsiness or sedation, Dizziness, Muscle weakness, Itching, Urinary retention Baby: Slow breathing in the baby, Sleepiness, Poor feeding or breastfeeding, ApneaWhat is the dosage range for Stadol (butorphanol)? Low-High and Average(IV) 0.5 mg - 2 mg (IM) 1mg - 4 mg q 3-4 hr as neededWhat assessments are needed before and after administration of Stadol (butorphanol) to validate the need for the medication and recognize side effects patient may be experiencing?While side effects in a healthy baby are rare, they are more likely to appear in these situations: Pt receives the medication within two hours of delivery. Pt gets multiple doses. Pt takes it along with other pain medication or sedatives. The delivery is premature.Patient teaching for Stadol (butorphanol)?Instruct patient on when and how to ask for pain medication. Explain to the client that the medication will cause drowsiness. Instruct the client to request assistance with ambulation.What is the generic name for AquaMEPHYTON injection?phytonadione injectionWhat drug class is AquaMEPHYTON (phytonadione) injection in?VitaminsWhat is the dosage range for AquaMEPHYTON (phytonadione) injection? Low-High and Average(subQ) or (IM) 0.5 mg to 1 mg within one hour of birth for a single doseWhat are the reasons for taking AquaMEPHYTON (phytonadione) injection?to prevent hemorrhagic disease of the newborn (Newborn has a sterile bowel at birth and thus lacks bacteria necessary to make Vitamin K.)What are the side effects that AquaMEPHYTON (phytonadione) injection causes?Pain, tenderness, edema at injection site. Allergic reactions, such as rash and urticaria, may also occur.What assessments are needed before and after administration of AquaMEPHYTON (phytonadione) injection to validate the need for the medication and recognize side effects patient may be experiencing?Observe for generalized ecchymoses or bleeding from umbilical cord, circumcision site, GI track. Observe for jaundice and kernicterus, especially in preterm infants. Observe for local inflammation. Give before circumcision procedure.AquaMEPHYTON (phytonadione) injection nursing administration consideration during drug prep?Protect the drug from light until just before adminPatient teaching for AquaMEPHYTON (phytonadione) injection?Comfort parents in educating need and importance of vitamin K (allow parents to comfort neonate). Low levels of vitamin K can lead to dangerous bleeding in newborns and infants.What is the generic name for Procardia?nifedipineWhat drug class is Procardia (nifedipine) in?Calcium Channel BlockerWhat is the dosage range for Procardia (nifedipine)? Low-High and AveragePO; 10-20mg for three doses, then every 4-8 hr.Physiology and mechanism of action: *What is the effect Procardia (nifedipine) has on that part of the body?*Suppresses contractions by inhibiting calcium from entering smooth musclesWhat are the reasons for taking Procardia (nifedipine)?Used to reduce high blood pressure, stoppage of preterm labor.What are the side effects that Procardia (nifedipine) causes?Hypotension, flushing, palpitations, nausea, dizziness, headache, peripheral edema, angina, diarrhea, nasal congestion, cough.What assessments are needed before and after administration of Procardia (nifedipine) to validate the need for the medication and recognize side effects patient may be experiencing?Monitor for headache, flushing, dizziness, and nausea. These are usually related to orthostatic hypotension that occurs with administration. Should not be administered with magnesium sulfate, or with or immediately following a beta adrenergic agonistsPatient teaching for Procardia (nifedipine)?Slowly change positions from spine to upright, and sit until dizziness disappears. Maintain adequate hydration to counter hypotension.What drug class is Terbutaline Sulfate in?beta-adrenergic agonistWhat is the dosage range for Terbutaline Sulfate? Low-High and Average(PO) 5mg TID at 6h intervals (max 15mg/day), (SubQ) 0.25mg q15-30min up to0.5mg in 4 hours.Physiology and mechanism of action: *What is the effect Terbutaline Sulfate has on that part of the body?*Used as a tocolytic that relaxes smooth muscles and inhibits uterine activityWhat are the reasons for taking Terbutaline Sulfate?indicated to delay pre-term laborWhat are the side effects that Terbutaline Sulfate causes?nervousness, tremor, lightheadedness, tachycardia, palpitationsWhat assessments are needed before and after administration of Terbutaline Sulfate to validate the need for the medication and recognize side effects patient may be experiencing?assess vitals and obtain a baseline BP and pulse before each dose, monitor patient treated for preterm labor for cardiovascular signs and symptoms for 12h after discontinuation and report tachycardia promptly, monitor I&O.Patient teaching for Terbutaline Sulfate?Change positions slowly to avoid injury from light-headedness, report palpitations or feeling of racing heartWhat is the generic name for Trandate?LabetalolWhat drug class is Trandate (Labetalol) in?Alpha and beta adrenergic antagonist; antihypertensiveWhat is the dosage range for Trandate (Labetalol)? Low-High and Average(PO) 100mg BID, may increase to 200-400mg BID (max 1,200-2,400mg/day), (IV) 20-40mg every 15 min as needed, and then administer 2mg/min continuous infusion until desired BP is reached(max 300mg total dose).Physiology and mechanism of action: *What is the effect Trandate (Labetalol) has on that part of the body?*Lower BP by decreasing cardiac output and causing vasodilationWhat are the reasons for taking Trandate (Labetalol)?BP reductionWhat are the side effects that Trandate (Labetalol) causes?Congestive heart failure, bradycardia, heart block, bronchospasm, postural hypotensionWhat assessments are needed before and after administration of Trandate (Labetalol) to validate the need for the medication and recognize side effects patient may be experiencing?closely monitor BP and pulse, monitor BP at 5 min intervals for 30 min after IV administration; then at 30 min intervals for 2 hr; then hourly for about 6h and as indicated thereafter; monitor diabetic patients closely because drug may mask cardiovascular repsonse to acute hypoglycemia (e.g. tachycardia)Patient teaching for Trandate (Labetalol)?postural hypotension is most likely to occur during peak plasma levels (2-4 hr after administration), make all position changes slowly (especially from lying down to an upright position), do not drive until effects are known, diabetics must monitor glucose closely, do not stop drug abruptly.What is the generic name for Apresoline?HydralazineWhat drug class is Apresoline (Hydralazine) in?Non-nitrate vasodilator, antihypertensiveWhat is the dosage range for Apresoline (Hydralazine)? Low-High and Average(PO) 10-50mg QID, (IM) 10-50mg q 4-6h, (IV) 10-20mg q 4-6h, maybe increase to 40mg.Physiology and mechanism of action: *What is the effect Apresoline (Hydralazine) has on that part of the body?*reduces BP mainly by direct effect on vascular smooth muscles of arterial-resistance vessels, resulting in vasodilation.What are the reasons for taking Apresoline (Hydralazine)?reduction of BPWhat are the side effects that Apresoline (Hydralazine) causes?headache, palpitation, tachycardia, anorexia, N/V, diarrheaWhat assessments are needed before and after administration of Apresoline (Hydralazine) to validate the need for the medication and recognize side effects patient may be experiencing?monitor BP and HR very closely, monitor I&O, use parenteral form immediately after opening, withdraw drug slowly to prevent rebound hypertension.Patient teaching for Apresoline (Hydralazine)?monitor weight and report gains to MD, monitor for edema, make position changes slowly, avoid strenuous exercise and hot baths/showers, headache and palpitations may occur within 2-4h of first PO dose and usually resolve on their ownWhat is the generic name for Motrin?ibuprofenWhat drug class is Motrin (ibuprofen) in?Nonsteroidal anti-inflammatory drugs (NSAIDs), antipyreticWhat is the dosage range for Motrin (ibuprofen)? Low-High and Average(PO) or (IV) 400-800 mg 2-4 times daily (don't exceed 3200 mg/day) Common dosage for OB: 800mg QIDPhysiology and mechanism of action: *What is the effect Motrin (ibuprofen) has on that part of the body?*Block the production of prostaglandins (substances causing pain and swelling, or inflammation) which the body releases in response to injury.What are the reasons for taking Motrin (ibuprofen)?Mild to moderate pain, inflammationWhat are the side effects that Motrin (ibuprofen) causes?short term: severe fatigue, GI distress, and dizziness; long term: heartburn, GI ulcers, renal toxicity, and platelet inhibitionWhat assessments are needed before and after administration of Motrin (ibuprofen) to validate the need for the medication and recognize side effects patient may be experiencing?assess platelet level and s/s of excessive bleeding, modified fall precaution, assess ability to care for neonate, take with meals to decrease GI irritationPatient teaching for Motrin (ibuprofen)?teach patient to avoid after 30-week gestation (may cause premature closure of fetal ductus arteriosus). Take it with a full glass of water and remain in an upright position for 15- 30 min after administration.What drug class is Ferrous sulfate in?Iron products, antianemicsWhat is the dosage range for Ferrous sulfate? Low-High and Average(PO) 30 -60mg/day after 1st trimester & 8-13 mg/dayPhysiology and mechanism of action: *What is the effect Ferrous sulfate has on that part of the body?*Replaces iron stores found in hemoglobin, myoglobin, and enzymes; allows transportation of oxygen via hemoglobinWhat are the reasons for taking Ferrous sulfate?Treatment and prevention of iron deficiency anemiaWhat are the side effects that Ferrous sulfate causes?hypotension, nausea, constipation, black/red tarry stool, diarrhea, epigastric pain.What assessments are needed before and after administration of Ferrous sulfate to validate the need for the medication and recognize side effects patient may be experiencing?VS, CBC, monitor stool, monitor iron rich dietary food intake.Patient teaching for Ferrous sulfate?Give 1 HR before or 2 HR after meals for best absorption. May notice dark or green stools. Instruct patient to follow a diet high in iron and increase fluids. Vitamin C aids with absorption. Liquid forms may stain teeth.What is the generic name for Tylenol?acetaminophenWhat drug class is Tylenol (acetaminophen) in?Analgesics (pain relievers)What is the dosage range for Tylenol (acetaminophen)? Low-High and Average(PO) 10-15 mg/kg/dose (160 mg/5 mL using package dispenser)Physiology and mechanism of action: *What is the effect Tylenol (acetaminophen) has on that part of the body?*inhibits prostaglandin synthesis in the central nervous system (CNS) and blocks pain impulse generation in the peripheryWhat are the reasons for taking Tylenol (acetaminophen)?Use for mild or moderate pain - circumcision, teething, etc. Fever.What are the side effects that Tylenol (acetaminophen) causes?Adverse effects occur rarely, but may include skin rash, fever, thrombocytopenia, leucopenia, neutropenia, pancytopenia, agranulocytosis. Overdosage may lead to severe liver damage and occasionally acute renal tubular necrosis. Hypersensitivity reactions have been reported. These include urticaria, dyspnoea, hypotension, angioedema.What assessments are needed before and after administration of Tylenol (acetaminophen) to validate the need for the medication and recognize side effects patient may be experiencing?Liver/renal/blood functionality (pre-screen labs/tests) VS (including temperature), allergic reactions of parentsPatient teaching for Tylenol (acetaminophen)?Alert parents that many over-the-counter medications also contain acetaminophen or ibuprofen; they should not be used at the same time as the anti-pyretic for fever to prevent an overdose. Ensure that families avoid liver toxicity by using appropriate dosing.What drug class is Fentanyl in?analgesic, narcotic (opiate agonist)What is the dosage range for Fentanyl? Low-High and Average(IV or epidural) 50-100 mcg IVPhysiology and mechanism of action: *What is the effect Fentanyl has on that part of the body?*Acts at specific opioid receptors , causing analgesia, respiratory depression, physical depression, euphoria.What are the reasons for taking Fentanyl?short acting opiate that is used during labor to relieve moderate to severe pain and induce sedation.What are the side effects that Fentanyl causes?drowsiness/sedation, lightheadedness, nausea, CIRCULATORY DEPRESSION, CARDIAC ARREST, RESPIRATORY DEPRESSION OR ARREST.What assessments are needed before and after administration of Fentanyl to validate the need for the medication and recognize side effects patient may be experiencing?monitor vital signs and observe for signs of skeletal and thoracic muscle rigidity and weakness, watch for respiratory depression, have oxygen available, resuscitative and intubation equipment, and an opioid antagonist available.Patient teaching for Fentanyl?May experience dizziness, sedation, drowsiness, impaired vision, so ask for assistance if the pt needs to move. Show pt breathing exercises to help with breathing. Have head of bed in fowlers position to decrease breathing difficulties.What drug class is Morphine in?Analgesic; narcotic (opiate agonist)What is the dosage range for Morphine? Low-High and Average(IV) 25-75 mgPhysiology and mechanism of action: *What is the effect Morphine has on that part of the body?*opiate agonistWhat are the reasons for taking Morphine?Systemic analgesiaWhat are the side effects that Morphine causes?SERIOUS: cardiac arrest, disorder of cardiovascular system, circulatory depression, orthostatic hypotension, shock, syncope, anaphylaxis, myoclonus, coma, raised intracranial pressure, seizure, dyspnea, respiratory depression. COMMON: pruritus, constipation, nausea, vomiting, dizziness, headache, lightheadedness, somnolence, miosis, urinary retention.What assessments are needed before and after administration of Morphine to validate the need for the medication and recognize side effects patient may be experiencing?Obtain baseline RR, depth, and rhythm, and size of pupils before administration. Observe pt to ensure pain relief is achieved, encourage pt to TCDB, be alert for nausea and orthostatic hypotension, monitor I&OPatient teaching for Morphine?Do not ambulate without assistance, use caution with tasks requiring alertness.What is the generic name for Cytotec?misoprostolWhat drug class is Cytotec (misoprostol) in?Prostaglandin, Gastric Mucosa protectant, antiulcerWhat is the dosage range for Cytotec (misoprostol)? Low-High and Average(PO) or vaginal into cervical os, (per rectal) one dose. Range: 400-1,000 mcgPhysiology and mechanism of action: *What is the effect Cytotec (misoprostol) has on that part of the body?*Used to prevent the formation of ulcers in the stomach during treatment with aspirin or NSAIDs by increasing gastric mucus production and mucosal bicarbonate secretion.What are the reasons for taking Cytotec (misoprostol)?medication abortion, medical management of miscarriage, induction of labor, cervical ripening before surgical procedures, and the treatment of postpartum hemorrhage.What are the side effects that Cytotec (misoprostol) causes?Diarrhea, nausea, abdominal pain, vomiting, uterine contraction.What assessments are needed before and after administration of Cytotec (misoprostol) to validate the need for the medication and recognize side effects patient may be experiencing?WARNING Ask female patient if she is or may be pregnant. If so, notify prescriber because misoprostol may cause uterine bleeding, contractions, and spontaneous abortion as well as teratogenic effects in the fetus. If diarrhea causes severe dehydration, misoprostol may be discontinued.Patient teaching for Cytotec (misoprostol)?Caution female patient about the risk of taking misoprostol during pregnancy, and urge her to use reliable contraception during therapy. Urge her to notify prescriber immediately if she is or might be pregnant. Instruct patient to take misoprostol with meals and at bedtime. Urge female patient to notify prescriber immediately about postmenopausal bleeding; she may need diagnostic tests.What is the generic name for Cervidil?dinoprostoneWhat drug class is Cervidil (dinoprostone) in?oxytocic, prostaglandin (uterine stimulant)What is the dosage range for Cervidil (dinoprostone)? Low-High and Average10 mg in a time-release vaginal insert left in place for up to 12 hr. Remove with onset of active labor, membrane rupture, or uterine hyperstimulation.Physiology and mechanism of action: *What is the effect Cervidil (dinoprostone) has on that part of the body?*stimulates uterine contractions, causing expulsion of uterine contentsWhat are the reasons for taking Cervidil (dinoprostone)?to expel uterine contents in fetal death or missed abortion during second trimester, or to efface and dilate the cervix in pregnancy at term.What are the side effects that Cervidil (dinoprostone) causes?diarrhea, nausea, vomiting, fever, UTERINE RUPTUREWhat assessments are needed before and after administration of Cervidil (dinoprostone) to validate the need for the medication and recognize side effects patient may be experiencing?bring gel to room temp before administering, avoid contact with skin, use sterile technique to administer, keep pt supine for 30 min after administering, document time of insertion and dosing intervals, remove insert with retrieval system after 12h or onset of labor, explain purpose and expected response to pt.Patient teaching for Cervidil (dinoprostone)?continue taking your temp a few days after discharge, contact prescriber with onset of fever, bleeding, and cramps, abnormal foul smelling discharge. Avoid douches, tampons, intercourse, and tub baths for at least two weeks.What is the generic name for Hemabate?carboprost tromethamineWhat drug class is Hemabate (carboprost tromethamine) in?Prostaglandin, oxytocic. (uterine stimulant)What is the dosage range for Hemabate (carboprost tromethamine)? Low-High and AveragePostpartum hemorrhage: 250 micrograms intramuscularly. May repeat at 15- to 90-minute intervals. Maximum total dose 2 mg.Physiology and mechanism of action: *What is the effect Hemabate (carboprost tromethamine) has on that part of the body?*Stimulates contraction of the uterus.What are the reasons for taking Hemabate (carboprost tromethamine)?Used for the treatment of postpartum hemorrhage caused by uterine atony. Also used for abortion.What are the side effects that Hemabate (carboprost tromethamine) causes?Excessive dose may cause tetanic contraction and laceration or uterine rupture. Nausea, vomiting, diarrhea (frequent), fever, chills, facial flushing, headache, hypertension or hypotension, tachycardia, pulmonary edema.What assessments are needed before and after administration of Hemabate (carboprost tromethamine) to validate the need for the medication and recognize side effects patient may be experiencing?Should be refrigerated. Give via deep intramuscular injection and aspirate carefully to avoid intravenous injection. Rotate sites if repeated. Monitor vital signs.Patient teaching for Hemabate (carboprost tromethamine)? -Advise patient of expected adverse reactions.