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51 terms

OB Medications

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