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NUR 106 drugs

Terms in this set (17)

magnesium sulfate
anticonvulsant, tocolytic
decreases acetylcholine releases and depresses the CNS to act as anticonbulsant, also decreased uterine contractions
used to prevent and contro seizures in preeclampsia and prevention of uterine contractins in preterm labor
counteract Pitocin
Dosage: Iv bolus loading dose(piggyback) of 4 grams over 20 min followed by continuous infusion of 1-2 gr/hr with infusion pump
excreted by kidneys
adverse reactions: flushing, sweating, hypotension, depressed DTR, CNS depression, respiratory depression
Nursing Care: monitor P,R,BP, UO,LOC,DTR'S AND HEART AND BREATH SOUNDS Q1HR
stop if R<12, UP<30ml/hr, absent DTR
antidote: calcium gluconate
oxytocin(pitocin, syntocin)
oxytocic
Indications: labor induction or augmentation, facillitation of threatened abortion, postpartum control of bleeding after expulsion of placenta, nasal spary to facilliate milk let down reflex
Actions: stimulates uterine smooth muscles to contract, let down reflex by breast, has ADH and vasopressor effects
rapidly metabolized by liver and kidneys, half life only 3-9 min
contraindications and precautions: hypersenitivity, CPD(celfo-pelvic disportion)
Adverse effects: seizures, coma with IV use, water intoxication, increased BP, tetanic uterine contractions in labor with decreased blood flow to placenta, abruptio
antidote: magnesium sulfate(relaxes the uterus)
route and dosage oxytocin
for labor induction/agmentation
1-2 milliunits/min until contractions 2-3 min apart(no more than 5 in 10 min)
goal: contractions q2-3 min lasting 45-60 sec with at least 30 sec intervals between each contractions
stop if contractions exceed 5 in 10 min or last longer than 90 sec or if fetal distress occurs
infusion pump always used
piggyback so can be stopped PRN
monitor contractions and FHT
terbutaline (Brethine)
adrenergic, tocolytic (unlabeled)
Indication: supress uterine activity, management of preterm labor
Action: beta 2 adrenergic effects to surpress uterine activity, can delay delivery up to 3 days
contraindications and precautions: women with cardiac disease, diabetes, pregnancy near term and hyperthyroidism
adverse effects: maternal- paradoxical bronchospasm, tachycardia, cardiac arrhythmia, myocardial ischemia, pulmoary edema, elevation in blood glucose and hypokaemia
fetal-mild tachycardia is possible
route and dosage terbutaline
can be given IV, SQ, and PO
IV maximum dose 0.08 mg/min
SQ-0.25 mg q3-4hr
PO-2.5-5.0 mg q4-6 hour (must be taken round clock)
nursing care terbutaline
monitor FHR and UCs( want less than 6/hr)
monitor IO for fluid overload
auscultate lungs for pulmonary edema, monitor maternal HR, hold dose if HR greater than 120, monitor blood glucose
methergine(methylergonovine maleate)
oxytocic (ergot alkaloid derivative)
stimulate uterine contractinand decrease postpartum bleeding
used for postpartum or post abortion bleeding
dosage:0.2 mg q2-4 hr. IV maximum 5 doses may follow with PO prn 0.2 q6hrs x2-7 days
NEVER USE FOR INDUCTIO OR AUGMENTION OF LABOR(NEVER USED WITH VIABLE BABY INSIDE)
contraindications: hypersensitivity, heart disease, threatened AB, hypertension
S/E: uterine cramping, hypertension, leg cramps, water intoxication
calcium gluconate
given to reverse Magnesium Sulfate toxicity
1mg(10ml) of 10% solution IV over 2 min
demerol( meperidine hydrochloride)
opioid agonist analgesic
acts at specific opioid receptors in CNS to produce analgesia, euphoria, and sedation
used for preoperative mediction, support of anesthesia and pain during labor
dosage: 25-100mg IM or IVP slowly q1-4hr PRN
contraindication: respiratory depression
s/e: respiratory depression, N/V
Stadol(butorphanol tartrate)
narcotic analgesic
centerally acting analgesic with ixed narcotic agonsit and antagonsit action, can precipitate withdrawl in addict
used for pain during labor,
dosage:0.5-2 mg IV q3-4 hr PRN
contraindication: narcotic addiction
s/e: respiratory depression
narcan
narcotic (opiate) antagonist
reverses side effects if narcotics by displacing them from opiate receptor sites
dose/adm: adult IM/SQ 0.4-2 mg may repeat in 2-3 min prn x2
side effects may cause withdrawl in addicts
monitor respiratory status carefully, may wear off before opiate does, last 1-4 hr
bupivacaine HCI (marcaine, sensorcaine)
anesthetic
produces local anesthesia by inhibiting Na flux across nerve cell membrane
high potency and slow onset, long lasting
used as anesthetic agent for epidural anesthesia
epidural
500-1000 ml IV bolus prior
test dose done
marcaine gives excelent sensory and little motor block
can be done at 3-4 cm
s/e: maternal decreased BP most frequent, can decrease blood flow to baby
s/s of toxic level: metallic taste, peri-oral numbness, tinnitus
ephedrine
s/e: hypersensitivity, dizziness, wheezing, palpitations
nursing: docment lung sounds, VS, before and q 1hr, BP and P q15 min
prostaglandin E2(dinoprostone, cervidil insert, prepidil gel)
cervical ripening agent,
used for preinduction cervical ripening before oxytocin induction of labor,can also initiate contractions, usually left in 12 hr, oxytocin started at least 30 min after removal,
adverse reactions: headache,nausea, diarrhea, fever, hypotension, tachysystole with fetal distress
prostaglandin E1 (pge1)
used like cervidil, tablet placed in posterior fornix,
adverse reaction: headache, nausea, diarrhea, fever, hypotension, tachysystole with fetal distress
rubella vaccine (meruvax II)
dosage: 0.5 ml SQ
contraindication: pregnancy- should be avoided for at least 1 month allergy to neomycin, febrile illness, allergy to eggs
defer at least 3 months after RhoGam or other gamma globulin
adverse reactions s/e: stinging at infection site, rash, fever 7-10 days later, encephalitis
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