Induce labor or prevent PPH

Question 1

6 drugs

Answer 1

1 dinoprostone 
2 oxytocin
3 misoprostol
4 carboprost tromethamine
5 methylergonovine
6 tranexamic acid

Question 2

dinoprostone

brand name

Answer 2

Cervidil

Question 3

oxytocin

brand name

Answer 3

Pitocin

Question 4

misoprostol

brand name

Answer 4

Cytotec

Question 5

carboprost tromethamine

brand name

Answer 5

Hemabate

Question 6

methylergonovine

brand name

Answer 6

Methergine

Question 7

tranexamic acid

brand name

Answer 7

TXA

Question 8

dinoprostone [Cervidil]

indication

Answer 8

cervical ripening

• induce abortn (12-20 wk)
• induce labor
• remove remaining placental material fr miscarriage

Question 9

dinoprostone [Cervidil]

MOA

Answer 9

naturally occurring prostaglandin

-stim myometrium to produce contractions

Question 10

dinoprostone [Cervidil]

CI

Answer 10

• uterine scarrine
• spont delivery or vaginal delivery
• oxytocin
• amniotic fluid embolism

Question 11

dinoprostone [Cervidil]

teaching

Answer 11

• stay supine/lateral for 2 hours
• remove after 12 hr
• oxytocin should be delayed 30-60min after removal

Question 12

dinoprostone [Cervidil]

S/E

Answer 12

• NVD

- report severe dizzy + ab pain

Question 13

oxytocin [Pitocin]

indication

Answer 13

standard: given to all moms after delivery of placenta
- induce labor
- strengthen UC
- decr bleeding
- let-down of milk

Question 14

oxytocin [Pitocin]

MOA

Answer 14

stim smooth muscle> uterine contraction

Question 15

oxytocin [Pitocin]

CI

Answer 15

• hypertonic or hyperactive uterus

- non-vaginal delivery

Question 16

oxytocin [Pitocin]

education

Answer 16

• has antidiuretic effect so monitor fluid/electrolyte balance
• cramping is similar to mentrual cramping
• bolus 350 after delivery

Question 17

misoprostol [Cytotec]

indication

Answer 17

• induce labor or abortion
• incr UC to prevent PPH

other use: prevents stomach ulcers r/t NSAIDs

Question 18

misoprostol [Cytotec]

moa

Answer 18

prostaglandin analogue> stim uterine to contract

Question 19

misoprostol [Cytotec]

CI

Answer 19

• hx of C section
• uterine scarring
• dont give to others for abortion
• hypersensitivity to oxytocin

Question 20

misoprostol [Cytotec]

teaching

Answer 20

in combo w oxytocin, notify HCP if rash, chest pain, diarrhea
-oxytocin should be delayed for 4 hrs

Question 21

carboprost tromethamine
[Hemabate]
indication

Answer 21

• PPH

- induce UC for abortion

Question 22

carboprost tromethamine [Hemabate]

MOA

Answer 22

prostaglandin> UC> reduce bleeding

Question 23

carboprost tromethamine
[Hemabate]
CI

Answer 23

• ASTHMA*
• pulmo disease
• renal disease
• hepatic disease

Question 24

carboprost tromethamine
[Hemabate]
teaching/side effects

Answer 24

• explosive diarrhea (medicate w antidiarrheal/antiemetic)

- monitor for s/s of hemorrhage (tachycard, hypotnsn)

Question 25

methylergonovine [Methergine]

indication

Answer 25

• PPH

- subinvolution

Question 26

methylergonovine [Methergine]

moa

Answer 26

ergot alkaloid acts on smooth muscle to incr contraction

-shortens labor, reduce blood loss

Question 27

methylergonovine [Methergine]

CI

Answer 27

• HTN
• hrt problems
• no breastfeeding

Question 28

tranexamic acid [TXA]

indication

Answer 28

• PPH

- heavy menstruation

Question 29

tranexamic acid [TXA]

moa

Answer 29

inhibit activation of plasminogen to plasmin

Question 30

tranexamic acid [TXA]

CI

Answer 30

• embolism/thrombo
• acquired defective color vision
• hormonal contraceptives

Question 31

tranexamic acid [TXA]

teaching

Answer 31

• stop med w any vision changes

- report flushing, one side weaknss, seizure, clot like chest pain