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Treatment for fetal pulmonary maturity in PTL
Corticosteroids
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Dosage of Betamethasone in PTL
Betamethasone valerate 12 mg IM q24h x 2
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Dosage of Dexamethasone in PTL
Dexamethasone 6mg IM q 12h x 4 doses
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Treatment of nausea in pregnancy
Diclectin
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Dosage of Diclectin
Doxylamine succinate w vitamin B6 2 tabs qHS, 1 tab qAm, 1 tab qPM,
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Drug to treat medical abortion or ectopic
Methotrexate
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Dosage of MTX for Ectopic or medical abortion
Methotrexate 50mg/m2 IM OR 50mg PO x 1
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Drugs to treat uterine atony
Oxytocin, Ergotamine, Carboprost
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Dose of Oxytocin for uterine atony
- 10U IM at delivery of ant shoulder (prevention)
- 20Units/Litre NS IV continuous infusion (treatment)
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Dose of Hematbate/Carbaprost for uterine atony
0.25mg IM q15min, max 2mg
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Dose of Ergotamine for uterine atony
- Methylergonavine maleate(Ergotamine) 0.25mg IM q5min, max 1.25mg
- OR 0.125mg IV bolus
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Uses of Cytotec (Misoprostol)
Treat PPH, for medical abortion, *outside of pregnancy only - prevent NSAID induced ulcers
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Dose of Cytotec/Misoprostol for PPH/medical abortion
800-1000 mcg PR x 1, 400mcg PO x 1, 800 mcg PV x 1
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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
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Dose of Rhogam
Rhogam 300mcg IM x 1 dose Exception - Miscarriage or TA - 50mcg IM
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Folic acid dosage - normal and increased risk
0.4 to 1.0 mg PO OD x 1-3 mo preconception and T1
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Dose of FOlic acid if increased risk of NTD
5mg PO OD if high risk/past NTD
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Cervidil/dinoprostone usage and dose
Induction of labour 10mg PV x 12 hours (then remove), max 3 doses
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Common discharge meds for obs
Empracet 30 (tylenol w codeine 30mg) Colase (docusate sodium) Iron (FeSO4)
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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
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Drug & dose for GBS prophylaxis in labour
Pen G 5 millin U IV then 2.5 million IV q4h until delivery
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If GBS+ and Pen allergic but no anaphylaxis
Cefazolin (Ancef) 2g IV q8h
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If GBS+ and Pen allergic w anaphylaxis
Clindamycin 900mg IV q8h or Erythromycin 500mg IV q6h
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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.
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1st line Treatment of UTI in Pregnancy
Amoxicillin 250-500mg PO q8h x 7d
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Alternative treatments of UTI in Pregnancy
Septra(TMP-SMX) or nitrofurantoin
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Mgmt of pyelonephritis in peg
Hospitalize and IV Abx
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Mgmt of missed abortion (cervix closed)
a) watch and wait, b) misoprostol 400-800mcg Po/PV, c) D&C +/- oxytocin
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3 things to always check in abortion and bleeding in pregnancy
1) R/O ectopic pregnancy, 2) check Rh status 3) hemodynamic stability
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