Pregnancy medications

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Pregnancy medications
2009-11-24 20:45:21
pregnancy drugs

Pregnancy medications
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  1. oxytocin (Pitocin)
    • Action: uterine contraction, decreases bleeding
    • SE: Infrequent- water toxication, nausea/vomiting
    • Contraindication: none
    • Route: IV
  2. methylervonovine (Methergine)
    • Action: uterine contraction, decreases bleeding
    • SE: Hypertension, nausea/vomiting
    • Contraindications: hypertension, cardiac disease. Do not give if BP > 140/90
    • Route: IM
  3. prostaglandin F (Hemabate)
    • Action: uterine contraction, decreases bleeding
    • SE: Headache, nausea/vomiting, fever, tachycardia, hypertension, diarrhea
    • Contraindications: severe asthma
    • Route: IM
  4. misoprostol (Cytotec)
    • Action: uterine contraction, decreases bleeding
    • SE: Headache, nausea/vomiting, diarrhea
    • Contraindications: allergy to prostaglandins
    • Route: Oral
  5. terbutaline (Brethine)
    • beta2-adrenergic agonist- relaxes uterine smooth muscle
    • Oral or subcut
    • Adverse effects: tachycardia (should decrease over time), shortness of breath
    • Assess vital signs, respiratory effort
    • The other beta-adrenergic agonist is ritrodine (Yutopar) and is actually the only one approved as a tocalytic but is used less often.
  6. magnesium sulfate
    • tocolytic- relaxes uterine smooth muscle, CNS depressant
    • IV
    • Adverse effects: lethargy and weakness, visual blurring, headache, nausea/vomiting, depression of deep tendon reflexes, decrease in respiratory rate, decrease in urinary output, cardiac arrest
    • Assess for: mgso4 toxicity- loss of deep tendon reflexes, urinary output < 25-30 ml, respiratory depression less than 12/min, pulmonary edema, chest pain.
    • Antidote: calcium gluconate
  7. nifedipine (Procardia)
    • calcium channel blocker- blocks ca and reduces uterine contractions.
    • Oral
    • Adverse effects: maternal transient tachycardia, hypotension, headache, dizziness, peripheral edema, fetal uteroplacental insufficiency related to maternal hypotension.
    • Do Not combine with magnesium sulfate-->severe hypotension.
  8. indomethacin (Indocin)
    • prostaglandin synthetase inhibitors (nsaids)- relaxes uterine smooth muscle by inhibiting prostaglandins.
    • Adverse effects: nausea/vomiting, dizziness, oligohydramnios, reduced platelet aggregation (increased risk for hemorrhage). Fetal AE: constriction of ductus arteriosus-->premature closure, decrease in renal fxn due to oligohydramnios. Neonate AE: RDS, intraventricular hemorrhage (IVH)
    • Used only when other methods fail and only if < 32 gwks