Maternity Drugs Flashcards
(20 cards)
Phytonadione (VitaminK)
Action: Needed for adequate blood clotting (factors II, VII, IX, X)
Route: IM
Side effects: Headache, hemolytic anemia, hyperbillirubinemia, bronchospasm, respiratory arrest
Considerations: Assess PT during treatment; monitor for bleeding, pulse and B/P
Classification: fat soluble vitamin
contraindications: hypersensitivity, severe hepatic disease, last few weeks of pregnancy
Cytotec (Misoprostol)
Indications: Prevention of postpartum hemorrhage, cervical ripening/ labor induction, pregnancy termination
Mechanism: Cervical ripening induction
Route: PO or intravaginally
Side Effects: diarrhea, n/v, constipation, abdominal pain, spotting cramps, hypermenorrhea, menstrual disorders
Nursing Responsibilities: Asess GI symptoms, administer with food for prolonged effect
Classification: Gastric mucosa protectant, antiulcer
Contraindications: hypersensitivity to this product or prostaglandins
Duramorph
Indications: moderate to severe pain control
Mechanism:depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors
Route:PO, IV
Side Effects: seizures, drowsiness, dizziness, bradycardia, respiratory depression
Nursing Responsibilities: Assess pain, respiratory function, do not break, crush or chew pills
Classification: opioid analgesic
Contraindications: hypersensitivity, addicts, hemorrhage, bronchial asthma, increased intracranial pressure
Fentanyl
Indications: relieve moderate to severe labor pain and postop pain after a c-section
Mechanism of Action: Opioid agonist analgesic that stimulate both mu and kappa opioid receptors to decrease the transmission of pain impulsesl, rapid action with short duration (0.5-1hr IV; 1-2h epidural) sufentanil citrate has a more potent analgesic action than fentanyl citrate with less passage across the placenta to the fetus
Route: 25-50 mg IV; 1-2 mg with 0.125% bupivacaine at rate of 8-10 ml/hr epidurally
Side Effects: dizziness ,drowsiness, allergic reactions, rash, pruritis, maternal and fetal or neonatal respiratory depression, N/V, urinary retention
Nursing Considerations: Assess for respirateory depression; naloxone should be available as an antidote.
Classification: opioid agonist
Contraindiations: hypersensitivity to opioids; myesthenia gravis
Magnesium Sulfate
Indications: anticonvulsant in eclampsia, electrolyte, persistent pulmonary hypertension of the newborn in mechanically ventilated neonates (unlabeled)
Mechanism: increase osmotic pressure, draws fluid into colon, neutralizes HCL
Route:IM/ IV
Side Effects: N/V, cramps, muscle weakness, sweating, flaccid paralysis, circulatory collapse
Nursing Responsibilities: seizure precautions, B/P, ECG magnesium toxicity; thirst , confusion, decrease in reflexes; I&O ratio
Classification: electrolyte, anticonfulsant
Contraindications: hypersensitivity, heart block, myocardial damage, obstruction
Penicillin G
Indications: antiinfective
Mechanism:interferes wit hcell wall replicaiton of susceptible organisms
Route:IM
Side Effects:lethargy, ologuria, bone marrow depression, anaphylaxis
Nursing Responsibilities: Assess I&O, monitor any patient with compromises renal system since product is excreted slowly in poor renal system function, toxicity may occur
Classification: antiinfective
Contraindications: hypersensitivity to penicillin or corn
Toradol (Ketoralac)
Indications:mild to moderate pain
Mechanism: inhibits prostaglandin synthesis by decreasing an enzyme needed for biosynthesis
Route: IM/ IV/PO
Side Effects:drowsiness, dizziness, flushing, CV thrombotic events, MI, stroke, black box warning for epidural/ intrathecal adminstration
Nursing Responsibilities: Assess patients with aspirin sensitivity, asthma, assess pain
Classification: NSAID
Contraindications: pregnancy 3rd trimester, hypersensitivity, asthma, hepatic dz
Betamethasone (Celestone)
Indications: Mechanism: Route: Side Effects: Nursing Responsibilities: Classification: Contraindications:
Cervidil (Dinoprostone)
Indications: To efface and dilate the cervix in pregnancy at term
Mechanism: stimulates uterine contractions
Route: vaginal suppository
Side Effects: dysrhythmias, DIC, bradycardia, N/V, uterine rupture, anaphylaxis
Nursing Responsibilities: Assess cervical dilation, V/S
Classification: Oxytocic
Contraindications: hypersensitivity, C-section, surgery
Ephedrine Sulfate
Indications: shock, increased perfusion, hypotension
Mechanism: causes increased contractility and heart rate by action on the beta receptors in the heart; also acts on alpha receptor causing vasocontriction in blood vessels
Route:IM/ SUBCUT/ IV
Side Effects: seizures, CNS depression, cerebral hemorrhage, dysuria, dyspnea
Nursing Responsibilities: Assess I&O, ECG, for paresthesis and coldness of extremities
Classification: bronchodilator, nonselective adrenergic
Contraindications: hypersensitivity to sympathomimetics, nonanaphylactic shock during general anesthesia, hypertension
Hemabate
Indications:postpartum hemorrhage caused by uterine atony not controlled by other methods
Mechanism: stimulates uterine contractions
Route:IM
Side Effects:fever, chills, N/V
Nursing Responsibilities: B/P, pulse, respiratory rate
Classification: oxytocic
Contraindications: hypersensitivity to product, severe CV/ respirator/renal/hepatic disease
Nubain (Nalbuphine)
Indications: Moderate to severe labor and postop pain after c-section
Mechanism: Mixed agonist-antagonist analgesic that stimulate kappa opioid receptos and block or weakly stimulate mu opioid receptors, rsulting in good analgesia but with less respiratory depression and nausea and vomiting when compared with opioid agonist analgesics
Route: IV or IM
Side effects: confusion, sedation, hallucinations, “floating” feeling, drowsiness, headache, dizziness, nervousness, sewating; maternal palpitations and tachycardia or bradycardia; transient nonpathologic sinusoidal-like fetal heart rate rhythm; respiratory depression; nausea and vomiting, urinary retention
Nursing Responsibilities: May precipitate withdrawal symptoms in opioid-dependent women and their newborns. Assess maternal v/s, degree of pain, FHR and uterine activity before and after administration; observe for maternal respiratory depression, encourage voiding ever 2h and palpate for bladder distention; if birth occurs within 1-4h assess newborn for respiratory depression
Classification: Opioid analgesic
Contraindications: hypersensitivity; addiction
Terbutaline (Brethine)
Indications: bronchospasm (preterm labor) ulabeled use
Mechanism:relaxes bronchial smooth muscle by direct action on beta 2 receptors throug haccumulation of cAMP at beata adrenergic receptor sites
Route: PO/ SUBCUT
Side Effects: cardiac arrest, tremors, anxiety
Nursing Responsibilities: Assess respiratory function, maternal heart rate, B/P, contraction, fetal heart rate
Classification: selective beta 2 agonist; bronchodilator
Contraindications: hypersensitivity to sympathomimetics, closed-angle glaucoma, tachydysrhythmias
Bendaryl (diphenhydramine)
Indications:nystagmus (eyes), infant colic
Mechanism:acts on blood vessels by competing with histamine for H1 receptor site
Route:PO/ IM/IV
Side Effects: dizziness, drowsiness, seizures, anxiet, thrombocytopenia
Nursing Responsibilities: assess for urinary retention, use deep IM in large muscle and rotate site, assess respiratory function
Classification: antihistamine 1st generation
Contraindications: hypersensitivity to H1 receptor antagonists; neonates
Bupivacaine (Marcaine)
Indications: production of local or regional anesthesia or analgesia for surgery
Mechanism:Sterile isotonic solutions containing sodium chloride.
Route: Epidural anesthesia
Side Effects: hypotension, respiratory paralysis
Nursing Responsibilities: assess respiratory function
Classification: analgesic
Contraindications: Marcaine is contraindicated in obstetrical paracervical block anesthesia. Its use in this technique has resulted in fetal bradycardia and death.
Marcaine is contraindicated in patients with a known hypersensitivity to it or to any local anesthetic agent of the amide-type or to other components of Marcaine solutions.
Oxytocin (Pitocin)
Indications: postpartum hemorrhage
Mechanism:acts directly on myofibrils, producing uterine contraction, stimulates milk ejection by the breast, stimulation of labor
Route: IV/ IM
Side Effects: seizures, tetanic contractions, abruptio placentae, decreased uterine blood flow
Nursing Responsibilities: assess I&O, vitals, length& intensity of contractions, fetal distress
Classification:hormone
Contraindications: hypersensitivity, hypertonic uterus, active genital herpes, prolapsed umbilical cord
Hepatitis B Vaccine
Indications: prevention of Hep B virusin exposed patients, including passive immunity in neonates born to HBsAG positive mother
Mechanism: provides passive immunity to hepatitis B
Route:neonate IM
Side Effects: anaphylaxis, angioedema, n/v, h/a
Nursing Responsibilities: assess for skin reaction or anaphalyxis
Classification: immune globulin
Contraindications: hypersensitivity to immune globulins, coagulation disorders
Lidocaine
Indications: ventricular tachycardia, ventricular dysrhythmias
Mechanism: increases electrical stimulation threshold of ventricle, His- Perkinje system, which stabilizes cardiac membrane, decreases automaticity
Route:IV/IM
Side Effects:headache, dizziness, seizures, heart block, CV collapse/ arrest, resp depression
Nursing Responsibilities: monitor v/s &ECG, assess I&O, give IM inj in deltoid, check with patient about herbal medications (could interact)
Classification: antidysrhythmic
Contraindications: hypersensitivity to amides, severe heart block, supraventricular dysrhythmias
Morphine Sulfate
Indications: moderate to severe pain control
Mechanism:depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors
Route:PO, IV
Side Effects: seizures, drowsiness, dizziness, bradycardia, respiratory depression
Nursing Responsibilities: Assess pain, respiratory function, do not break, crush or chew pills
Classification: opioid analgesic
Contraindications: hypersensitivity, addicts, hemorrhage, bronchial asthma,
increased intracranial pressure
Procardia (Nifedipine)
Indications: Chronic stable angina pectoris, vasospastic angina, hypertension
Mechanism:inhibits calcium ion influx across cell membrane during cardiac depolarization; relaxes coronary vascular smooth muscle; dilates coronary arteries
Route: PO
Side Effects:H/A, fatigue, drowsiness, dizziness, flushing, dysrhythmias
Nursing Responsibilities: assess cardiac status, V/S, potassium/renal,hepatic studies during treatment
Classification: calcium channel blocker, antihypertensive
Contraindications: hypersensitivity to the product or dihydropyridine, cardiogenic shock
