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Flashcards in Obstetrics Deck (25):
1

spontaneous abortion drugs

misprostol (cytotec)
this drug is used to prevent ulcers so make sure don't give to woman of child bearing age to prevent ulcers

2

3 ways can evacuate spontaneous abortion

surgical
medical
expectant

3

preterm labor meds

tocolytics
steroids

4

Drug of choice for preterm labor between 24-32 weeks

Indomethacin
maternal side effects- nausea, gastric esophageal reflux, gastritis, emesis, platelet dysfunc
fetal side effects- closure of PDA, oligohydraminos

5

contraindications to indomethacin

Platelet dysfunction
Bleeding disorders
Hepatic dysfunction
GI ulcers
Renal dysfunction
Asthma if also sensitive to ASA (samters triad)
If give >48 hrs then need to monitor fetus w/ US to make sure PDA is open and oligohydraminos

6

Drug of choice for preterm labor between 32-34 weeks

Nifedipine
side effects- nausea, flushing, hypotension, HA, dizziness, palpitations
2nd line-terbutaline (beta agonist)
side effects-Tachycardia, palpitations, hypotension, tremor, shortness of breath, chest discomfort, hypokalemia, hyperglycemia

7

contraindications to nifedipine

hypotension, LV dysfunction or CHF, preload dependent cardiac lesion (right side of heart)
DO NOT use in conduction w/ magnesium sulfate cause work synergistically and can depress respiratory

8

what to monitor w/ nifedipine and terbutaline

I/O’s
Maternal symptoms of shortness of breath, CP, tachycardia
Stop drug if maternal HR > 120
Check blood glucose and K+ every 4-6 hours
`

9

antenatal steroids

bethamethasone (preferred)
dexamethasone (2nd line non sulfite containing one)

10

indications for abx prophylaxis of Group B strep

positive culture
had previous child w/ group b strep
group b strep bacteriuria during current pregnancy
or: maternal fever >100.4
preterm labor 18 hrs

11

do you need to give group b strep prophylaxis to woman who is having c section

no unless membranes rupture

12

abx prophylaxis for premature rupture of membranes

1 g Azithromycin at admission
followed by ampicillin
followed by amoxicillin
OR if pcn allergy
clindamyacin + gentamycin followed again by clindamycin

13

post partum hemorrhage

oxytocin- DOC
add misoprostol (stimulates uterine contractions)
add carboprost tromethamine (hemabate)
add methylergonovine maleate

14

contraindications for methylergonovine

HTN, raynauds, scleroderma (this drug is a vasoconstrictor)

15

contraindications of hemabate

asthma, HTN, renal failure, reduce cardiac output

16

severe HTN during labor

IV labetelol
or IV hydralazine
or PO nifedipine

17

seizure prophylaxis

magnesium sulfate
all cases of preeclampsia should be treated w/ this to prevent seizures

18

reversal of magnesium sulfate

calcium gluconate

19

how to check magnesium sulfate levels

plasma level 4- DTR decreased
level 8-10- DTR absent
10-15 respiratory paralysis
20-25 cardiac arrest

therapeutic level 4.8-8.4

20

contraindications to magnesium sulfate

heart block, myasthenia gravis, myocardial damage

21

induction of labor

pitocin (oxytocin)- stimulate uterine contractions
contraindications are things that you wouldn't want to induce labor yet

22

tx of diarrhea

oral rehydration and diet changes is first line
can use loperamide ONLY if symptoms are disabling

23

constipation

1st line is increase dietary fiber and fluids
2nd line bulk forming agents- psyllium (metamucil), methyl cellulose (citrucel), fibercon, benefiber
refractory cases-lactulose or dulcolax; can use milk of magnesia too

24

gerd

lifestyle modifications (elevate bed, don't eat late, antacids)
next line- sulcrafate
3rd line- h2 blockers- cimetidine (tagamet) or rantadine (zantac)
then ppi- omeprazole (prilosec), pantoprazole (protonix), lansoprazole (prevacid)

25

cold sxs

tylenol
saline spray
rhinorhea- ipratropium bromide (atrovent)
nasal congestion- pseudoephidrine (avoid in 1st trimester)
cough- robitussin or inhaled air, mucinex