Flashcards in PPH meds Deck (23):
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
What is the onset and when does the peak action of Methergine take place?
Onset: 2-5 min.
Peak: 20-30 min.
Contraindications to Methergine?
Side effects of Methergine?
HTN, cramping, N/V, seizure, HA
*tip: take pt's BP prior to administration
What is the dose/route of Oxytocin (Pitocin)?
10-80u in 250-500 mL of NS or LR (IV)
10u IM injection
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
Contraindications to Pitocin?
Side effects of Pitocin?
Cramping; large doses can cause hyponatremia
Rapid infusion of undiluted bolus can cause cardiac collapse
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
How long does it take for Hemabate to be at its peak action?
P.S. it's less effective than Methergine
Contraindications to Hemabate?
asthma, CAD, pulmonary/ renal/ and hepatic disease
Side effects of Hemabate?
N/V, diarrhea, bronchospasm, HTN
- pyrexia is common
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
What is the onset of action of Cervidil/ Prepidil?
Contraindications to Cervidil/ Prepidil?
Hypotension or CAD
Side effects of Cervidil/ Prepidil?
- pyrexia is common
What is the dose/route of misoprostol (Cytotec)?
When can you give it again?
600-800 mcg sublingual
800-1000 mcg per rectum
- Can't! Just 1 dose.
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.
Contraindications to misoprostol (Cytotec)?
Side effects of misoprostol (Cytotec)?
N/V/D, abdominal pain
- pyrexia can occur w/ higher doses
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
Contraindications to TXA?
-Acquired defective color vision
-Hypersensitivity to TXA