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Flashcards in PPH meds Deck (23):
1

What is the dose/route of Methylergonovine maleate (Methergine)?

After giving the 1st dose, how often can you repeat it?

0.2 mg IM

- May repeat in 5 min.
- thereafter, q2-4 hours

P.S. Do NOT give IV --> risk of sudden vasospasm, HTN, and CVA

2

What is the onset and when does the peak action of Methergine take place?

Onset: 2-5 min.
Peak: 20-30 min.

3

Contraindications to Methergine?

HTN, PEC

4

Side effects of Methergine?

HTN, cramping, N/V, seizure, HA

*tip: take pt's BP prior to administration

5

What is the dose/route of Oxytocin (Pitocin)?

10-80u in 250-500 mL of NS or LR (IV)
OR
10u IM injection

6

What is the onset of Pitocin?
How long does it take to become effective?
What is the duration of IM Pitocin's effectiveness?

Onset: 2-3 min.
Effective in 15-30 min.
Duration: 2-3 hrs if given IM

7

Contraindications to Pitocin?

Hypersensitivity

(?!?!)

8

Side effects of Pitocin?

Cramping; large doses can cause hyponatremia

Rapid infusion of undiluted bolus can cause cardiac collapse

9

What is the dose/route of carboprost tromethamine (Hemabate)?

How many doses can you give, and how often?

250 mcg IM

q15-90 min.; up to 8 doses

10

How long does it take for Hemabate to be at its peak action?

30 min.

P.S. it's less effective than Methergine

11

Contraindications to Hemabate?

asthma, CAD, pulmonary/ renal/ and hepatic disease

12

Side effects of Hemabate?

N/V, diarrhea, bronchospasm, HTN
- pyrexia is common

13

What is the dose/route of dinoprostone (Cervidil, Prepidil, or Prostin E2)?

How often can you give it?

20 mg vaginal or rectal suppository

May repeat q2hrs

14

What is the onset of action of Cervidil/ Prepidil?

10 min.

15

Contraindications to Cervidil/ Prepidil?

Hypotension or CAD

16

Side effects of Cervidil/ Prepidil?

N/V/D
- pyrexia is common

17

What is the dose/route of misoprostol (Cytotec)?

When can you give it again?

600-800 mcg sublingual
OR
800-1000 mcg per rectum

- Can't! Just 1 dose.

18

What is the onset of action of misoprostol (Cytotec)?
What is the peak action (sublingual and rectal)?

Onset: 3-5 min.
Peak sublingual peak: 30 min.
Peak rectally: 40-60 min.

19

Contraindications to misoprostol (Cytotec)?

None known!

20

Side effects of misoprostol (Cytotec)?

N/V/D, abdominal pain
- pyrexia can occur w/ higher doses

21

What is the dose/route of tranexamic acid (Cyklokapron)?

TXA (standard concentration 1000mg/100ml NS)
- use within first 3 hrs of hemorrhage

Loading dose: 1000mg IV over 10 minutes
- may repeat in 30 min. if bleeding persists

22

Contraindications to TXA?

-Thromboembolic disorders
-Acquired defective color vision
-Subarachnoid hemorrhage
-Hypersensitivity to TXA

23

Side effects of TXA?

- Seizures, HA, dizziness
- Visual abnormalities
- Hypotension, thromboembolism, thrombus
- N/V/D
- Pain at IV site