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Flashcards by Kate Parvey, updated more than 1 year ago
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Created by Kate Parvey
almost 8 years ago
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| Question | Answer |
| Ampicillin Route & Dose Range | IV 2 gm initial dose then 1-2 gm Q4 until birth Goal: infuse minimum of 2 doses prior to birth |
| Ampicillin Class & Action | Antibiotic, bactericidal Treatment for positive GBS ( Group B Strep) inhibits cell wall mucopeptide synthesis * For Pregnancy & Labor |
| Ampicillin Side Effects & LR/PR | GI disturbance, allergy, rash, anaphlaxis L1/ B |
| Betamethasone (Dexamethasone {discontinued in US}) Route & Dose Range | IM Fetal Lung Maturation: 12 mg IM Q 24hrs x 2 doses |
| Betamethasone (Dexamethasone {discontinued in US}) Class & Action | Long-Acting Corticosteroid To induce fetal lung maturation in expectant mothers between 24-24 weeks gestation at high risk of premature delivery Notes: given to mother inflammatory action unknown; inhibits multiple inflammatory cytokines; produces multiple glucocorticoid and mineralocorticoid effects * For Pregnancy & Labor |
| Betamethasone (Dexamethasone {discontinued in US}) Side Effects & LR/ PR | Sodium and fluid retention , hypokalemia, BP elevated, edema, diaphoresis, rash, dyspepsia, H/A L3/ C |
| Calcium Gluconate Route & Dose Range | IV Push 1-2 g Hyper magnesium status/ magnesium toxicity |
| Calcium Gluconate Class & Action | Mineral Given as the "antidote" to magnesium |
| Calcium Gluconate Side Effects & LR/PR | Nausea or vomiting; decreased appetite; constipation; dry mouth or increased thirst; increased urination L3/C may use during pregnancy; no known risk of fetal harm based on human data |
| Cytotec Route & Dose Range | Oral, vaginal, rectal 1/4 of 25mg tablet intra-vaginally for labor 800-1000mcg rectally for PP hemorrhage |
| Cytotec Class & Action | Prostaglandin Cytokine ***Induction of labor, PP hemorrhage, Gastric protectant * Inhibits gastric acid secretion and protects GI Mucosa; produces uterine contractions (prostaglandin E1) * for Pregnancy & Labor |
| Cytotec Side Effects & LR/PR | Cramping: keep woman in bed for one hour after administration Uterine Hyper stimulation L3/ X |
| Cytotec Black Box Warnings | *** Pregnancy Black Box Warning use in pregnancy women can cause abortion, premature birth, or birth defects; uterine rupture reported w/ use to induce labor or abortion past 8 weeks of pregnancy do not use to decrease NSAID ulcer risk in pregnant pts of abortifacient property and warn not to give to others *** Women of Childbearing Potential do not use to decrease risk of NSAID- induced ulcers in women of childbearing potential unless high risk of gastric ulcer; in such pts only use if 1)negative serum pregnancy test <2wk prior to start of treatment; 2) pt capable of complying w/ effective contraception; 3) patient given oral and written warnings of hazards. risks of contraception failure, and danger of taken by other women of childbearing potential; 4) start med on 2nd or 3rd day of next normal menstrual period. Postpartum: take the med immediately after a feed and wait 4 hrs until next feed. |
| Hemabate Route & Dose | IM Postpartum Hemorrhage 250 mcg IM x1 Max: 2 mcg total dose May repeat Q15-90 min for refractory bleeding |
| Hemabate Class and Action | Oxytocic Prostaglandin Prostaglandin to control bleeding after birth stimulates smooth muscle and uterine contractions (synthetic prostaglandin) |
| Hemabate Side Effects & LR/PR | H/A, N &V and diarrhea L3/C *** do not give if patient has history of asthma Appropriate Use ( Black Box Warning) strictly follow recommended dose; use only by medically trained personnel in hospital w/ ICU and surgical facilities |
| Magnesium Sulfate Route & Dose | IV 4-6 gm bolus x1 then 1-3 gm per hour x 12-24 hours IV MAX: 40 g/24h; x5-7 days Monitoring may include: Check your facility's P&P VS (BP, Pulse, Respiration) [For Respirations< 14/min : STOP MAG and notify OB provider • Before initiation and after completion of loading dose • Then q 15 mins x 4 • Every 30 mins x 2 • Then every hour Comes packaged as 40 grams in 1000 ml of Normal Saline. You will have to calculate at what rate to set the pump for the Alaris pump for both the loading dose and the maintaince dose Breath sounds: before administration and every 2 hours Reflexes: patellar (and clonus for PIH pts) every hour. If absent STOP MAG and notify OB provider I&O: strict - obtain urine output q hour. For output <25-30 ml/hour: STOP MAG and notify OB provider • For pts with PIH, check urine protein as ordered |
| Magnesium Sulfate Class & Action | Alkaline earth metal sulfate saline laxative and anticonvulsant Preterm as a neuro protectant for the fetus decreases CNS irritability and prevention of seizures in hypertensive disorders of pregnancy ( most common being preeclampsia conditions: relaxes the uterus to stop uterine contractions in preterm labors. |
| Magnesium Sulfate Side Effects & LR/PR | Serious Reactions • cardiovascular collapse; respiratory depression or paralysis; hypothermia; depressed cardiac function; pulmonary edema; fetal harm (prolonged in utero exposure) Common Reactions • depressed reflexes; hypotension; flushing; drowsiness; impaired cardiac function; diaphoresis; hypocalcemia; hypophosphatemia; hyperkalemia: vision changes, metallic taste in the mouth. L1/B |
| Methergine Route & Dose | PO/IM 0.25 mg IM 0.2 mg PO tid-qid up to 1wk |
| Methergine Class & Action | Ergot derivative with vasoconstrictive properties Stimulates uterine contractions to control bleeding after birth |
| Methergine Side Effects & LR/PR | Will increase blood pressure *** Do not give if patient is hypertensive. Avoid breast feeding during treatment and x12h after D/C; safety unknown; inadequate literature available to assess risk L2/ C |
| Pitocin (synthetic Oxytocin) Route & dose | IV 20-60 units diluted in 500 ml to 1000 ml IM Dose: 10 units IM x1 after placenta delivery; labor induction or augmentation [individualize dose IV] Start: 0.5-2 milliunits/min IV, incr. 1-2 milliunits/min q15-40min until contraction pattern established.; Max: 20 milliunits/min (augmentation), 40 milliunits/min (induction); Alt: 6 milliunits/min IV, incr. 3-6 milliunits q15-40min, reduce increment if hyperstimulation occurs; Info: rates >9-10 milliunits/min rarely required at term, higher rates may be needed before term; mix 10 units/L IV fluid Alt: 20 milliunits/min IV after placenta delivery until uterus firmly contracted; titrate rate to sustain contraction and control uterine atony; Info: mix 10-40 units/L IV fluid |
| Pitocin (synthetic Oxytocin) Class & Action | Binds to oxytocin receptors in myometrium, increasing intracellular Ca and stimulating uterine contractions Stimulates uterine contractions; used to "firm" the uterus when hemorrhaging or prevent hemorrhaging; Titrated dosages during induction/augmentation of labor; continuous doses after birth of placenta. ***Students may not administer Pitocin in this rotation. |
| Pitocin ( synthetic Oxytocin) Side Effects & LR/ PR | Hyperstimulation, uterine rupture, abruptio placenta L2/X ***Black Box Warning: Not for Elective Labor Induction not indicated for elective labor induction since inadequate data to evaluate benefit vs risk; elective induction defined as labor initiation w/o medical indications |
| Terbutaline, Brethine Route & Dose | SQ/IV 0.25 mg SQ 2.5 mg - 5 mg q 4-6 hours PO |
| Terbutaline, Brethine Class & Action | Beta-2 adrenergic Relaxes uterus in pre-term labor or with a tetanic uterine contraction during an induction or for fetal distress |
| Terbutaline, Brethine Side Effects & LR/PR | Tachycardia in both mother and fetus, uncomfortable for women HIGH ALERT MEDICATION: not used for long-term use to stop premature labor. May still be used as a one-time use to relax a uterus with systole. If given more than one dose requires an EKG be done on the woman to rule out cardiac issues. |
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