Prenatal Pharmacology Flashcards Preview

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Flashcards in Prenatal Pharmacology Deck (24):
1

Acyclovir use during pregnancy

Safety has not be established during pregnancy

2

Acyclovir is used to TX which STI's?

Virus infections? Check

3

Betamethasone (Celestone)
glucocorticoids
(London 444)

Given to promote lung maturity if deliver is anticipated e.g. 32 weeks gestation, marginal abrupt placenta

4

Methotrexate (MTX)

Inhibits cell division and embryo enlargement, dissolving the pregnancy

5

Methotrexate (MTX)
Instruct pt to avoid (2) to prevent a toxic response to medication

1) Alcohol consumption
2) Vitamins containing folic acid

6

Methotrexate (MTX)
Advise pt to protect herself against?

sun exposure (photosensitivity)

7

Methotrexate (MTX):
Route:
Dosage
Frequency

Route: Intramuscular injections
Dosage
Frequency

8

Betamethasone (Celestone Soluspan)
Purpose: (2)

1) Capable of inducing pulmonary maturation
2) Decreasing incidence of respiratory distress syndrome
(London 444)

9

Betamethasone (Celestone Soluspan)
1) Route
2) Dosage
3) Frequency
4) Birth should be delayed for at least?
5) Risk to mother?
6) If fetus is younger than 34 completed weeks, delivery route?

1) Route: IM, deep GM avoid deltoid
2) Dosage: 12 mg
3) Frequency: Once daily for 2 days
can be administered with Dexamethasone to enhance effect: 6 mg q 12hrs for 4 doses (2 days)
4) Birth should be delayed for at least 24 hrs after completing the first round of TX.
5) Increase risk for infection
6) Likely C-section due to strain of labor and immature lungs. Prepare parents for this possibility.

10

Betamethasone (Celestone Soluspan)
Contraindications: (5)

1) Inability to delay birth
2) adequate L/S ratio
3) Presence of a condition that necessitates immediate birth ( e.g. maternal bleeding)
4) Presence of maternal infection, DM (relative contradiction)
5) Gestational age greater that 34 completed weeks

11

Betamethasone (Celestone Soluspan)
1) Birth should be delayed for at least?

1) Birth should be delayed for at least 24 hrs after completing the first round of TX.

12

Betamethasone (Celestone Soluspan)
Effects of Fetus/Newborn: (3)

1) Lower cortisol levels at birth but with rebound by 2 hours
2) Hypoglycemia
3) Increase risk of neo sepsis

13

Glucose: 1 day old

40-60mg/dL

14

Neonate s/s of hypoglycemia:

Infants with low blood sugar may not have symptoms. If your baby has one of the risk factors for low blood sugar, nurses in the hospital will check your baby's blood sugar level, even if there are no symptoms.

Bluish-colored or pale skin
Breathing problems, such as pauses in breathing (apnea), rapid breathing, or a grunting sound
Irritability or listlessness
Loose or floppy muscles
Poor feeding or vomiting
Problems keeping the body warm
Tremors, shakiness, sweating, or seizures
(MedlinePlus)

15

Neonate at risk for hypoglycemia if?

Low blood sugar level is more likely in infants with one or more of these risk factors:

Born early, have a serious infection, or needed oxygen right after delivery
Mother has diabetes (these infants are often larger than normal)
Have slower than usual growth in the womb during pregnancy
Are smaller in size than normal for their gestational age
(MedlinePlus)

16

Neonate needs glucose for?

Babies need blood sugar (glucose) for energy. Most of that glucose is used by the brain.

17

Tocolytic Medications

Tocolytics are medicines that attempt to stop labor. They are used if labor begins before term. Tocolytics can stop labor or delay labor to give the baby's lungs time to mature. If started early in premature labor, they may be effective. They are not as successful later in labor, if the membranes have broken, or if your cervix is already dilated beyond 2 centimeters. When taking this medication, you may need hospitalization or home therapy.

Terbutaline, ritodrine, nifedipine and magnesium sulfate are all used as tocolytic drugs. Tocolytics are not used if the mother has chorioamnionitis (an infection in the membranes around the baby), abruptio placenta, severe preeclampsia or eclampsia, cardiac disease, or other severe medical illnesses. Tocolytics are also not used if the fetus has died in the uterus, or if the fetus is in acute distress. Some of these drugs are used in combination with other medications.

18

Terbutaline
Tocolytic Medications

Terbutaline: This medicine is used to stop preterm labor. It is also known as Brethine. It can be taken as a pill, through an IV (through a catheter directly into your vein), as an injection, or through a controlled infusion pump. A pump is used to give a continuous low dose of the terbutaline. Additional amounts of the medication can be administered if uterine activity increases. A subcutaneous (the medicine is injected under your skin but not directly into a vein) infusion pump may be used with home uterine monitoring. Some of the side effects can include nervousness, restlessness, insomnia, headache, rapid heart rate, nausea, hyperglycemia (high blood sugar) and hypokalemia (low blood potassium). A rare but serious side effect is pulmonary edema. The baby may also experience a fast heart rate and high or low blood sugar after birth. The mother and baby should be monitored while taking this drug. Your doctor should be informed if you have shortness of breath or chest pain while taking this medicine, or if the contractions begin again while you are on this medicine.

19

Nifedipine
Tocolytic Medications

Nifedipine: This medicine is used to stop contractions. It is also called Adalat or Procardia and is taken as a pill. It is used to stop contractions and delay labor, and may also be used for occasional uterine irritability. Some of the side effects that may occur include facial flushing, headache, nausea, palpitations, and lightheadedness. No serious newborn side effects have been noted.

20

Magnesium sulfate:
Tocolytic Medications

Magnesium sulfate: This medicine can be used to stop contractions as well as in the treatment and prevention of seizures in a patient with preeclampsia. It can be taken as a pill or through an IV. Side effects may include feelings of extreme warmth, perspiration, flushing, nausea, vomiting, blurred vision, lightheadedness, lethargy, nasal stuffiness and constipation. Magnesium sulfate can affect your reflexes and slow your breathing. Some women report chest pain, especially if they are taking this medicine with another of the tocolytics. Women who have myasthenia gravis, a history of renal impairment (kidney problems), heart block, or a history of a myocardial infarction (heart attack) should discuss this with your doctor before using magnesium sulfate. Side effects usually go away within a few days. The fetus may show a decreased baseline heart rate. A newborn who has been exposed to magnesium sulfate may seem drowsy, have a weak cry and a decreased sucking rate in the early postpartum period. The mother and fetus should be monitored while on this medication.

21

Indomethacin:
Tocolytic Medications

Indomethacin: This medicine is used to try to stop preterm labor, and is also called Indocin. It can be taken as a pill or as a suppository (in the rectum). Side effects include abdominal discomfort, nausea, vomiting, depression and dizzy spells for the mother. Indocin can also have serious effects on the fetus if used long term or if the gestational age is greater than 32-34 weeks. This drug may also be dangerous for the mother is she has a history of bleeding disorders, aspirin sensitivity, or kidney problems.

22

Dexamethasone

Often administered with Betamethasone to obtain max results of fetal lung maturity

23

Ceftriaxone IM: Used to Tx bacteria?
Pregnancy Class B

1) Gonorrhea safe during pregnancy

24

Doxycycline
Pregnancy Class D/ not safe during pregnancy

1) Used to treat Gonorrhea

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