Obstetric Medications

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Obstetric Medications
2011-10-12 21:03:12

Commonly used Obs meds
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  1. Treatment for fetal pulmonary maturity in PTL
  2. Dosage of Betamethasone in PTL
    Betamethasone valerate 12 mg IM q24h x 2
  3. Dosage of Dexamethasone in PTL
    Dexamethasone 6mg IM q 12h x 4 doses
  4. Treatment of nausea in pregnancy
  5. Dosage of Diclectin
    Doxylamine succinate w vitamin B6 2 tabs qHS, 1 tab qAm, 1 tab qPM,
  6. Drug to treat medical abortion or ectopic
  7. Dosage of MTX for Ectopic or medical abortion
    Methotrexate 50mg/m2 IM OR 50mg PO x 1
  8. Drugs to treat uterine atony
    Oxytocin, Ergotamine, Carboprost
  9. Dose of Oxytocin for uterine atony
    • 10U IM at delivery of ant shoulder (prevention)
    • 20Units/Litre NS IV continuous infusion (treatment)
  10. Dose of Hematbate/Carbaprost for uterine atony
    0.25mg IM q15min, max 2mg
  11. Dose of Ergotamine for uterine atony
    • Methylergonavine maleate(Ergotamine) 0.25mg IM q5min, max 1.25mg
    • OR 0.125mg IV bolus
  12. Uses of Cytotec (Misoprostol)
    Treat PPH, for medical abortion, *outside of pregnancy only - prevent NSAID induced ulcers
  13. Dose of Cytotec/Misoprostol for PPH/medical abortion
    800-1000 mcg PR x 1, 400mcg PO x 1, 800 mcg PV x 1
  14. Use of Rhogam (anti-Rh IgG)
    Rh negative women: routinely @ 28wks GA, w/i 72h after birth of +ive baby, +ive Kleihauer Betke test, invasive procedures in peg, etcopic pregnancy, antepartum hemorrhage, miscarriage or TA
  15. Dose of Rhogam
    Rhogam 300mcg IM x 1 dose Exception - Miscarriage or TA - 50mcg IM
  16. Folic acid dosage - normal and increased risk
    0.4 to 1.0 mg PO OD x 1-3 mo preconception and T1
  17. Dose of FOlic acid if increased risk of NTD
    5mg PO OD if high risk/past NTD
  18. Cervidil/dinoprostone usage and dose
    Induction of labour 10mg PV x 12 hours (then remove), max 3 doses
  19. Common discharge meds for obs
    Empracet 30 (tylenol w codeine 30mg) Colase (docusate sodium) Iron (FeSO4)
  20. Dose of Iron
    • FeSo4 300mg PO OD if Hb 80-99
    • FeSO4 300mg PO BID if Hb <79
    • x 3mos or duration of breast feeding
  21. Drug & dose for GBS prophylaxis in labour
    Pen G 5 millin U IV then 2.5 million IV q4h until delivery
  22. If GBS+ and Pen allergic but no anaphylaxis
    Cefazolin (Ancef) 2g IV q8h
  23. If GBS+ and Pen allergic w anaphylaxis
    Clindamycin 900mg IV q8h or Erythromycin 500mg IV q6h
  24. Treatment of Therapeutic/Elective Abortions if <9 weeks GA
    • Methotrexate + misoprostol
    • MTX 50mg/m2 IM, then 3-7 days after Misoprostol/Cytotec 400mcg Po x 1 or 800mcg PV x 1.
  25. 1st line Treatment of UTI in Pregnancy
    Amoxicillin 250-500mg PO q8h x 7d
  26. Alternative treatments of UTI in Pregnancy
    Septra(TMP-SMX) or nitrofurantoin
  27. Mgmt of pyelonephritis in peg
    Hospitalize and IV Abx
  28. Mgmt of missed abortion (cervix closed)
    a) watch and wait, b) misoprostol 400-800mcg Po/PV, c) D&C +/- oxytocin
  29. 3 things to always check in abortion and bleeding in pregnancy
    1) R/O ectopic pregnancy, 2) check Rh status 3) hemodynamic stability