Delivery Room Drug Study 2330t
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Generic Name (Brand Name)
Indication
Methylergonovine maleate (Methergine, Methylergobasine Methylergobrevin Methylergonovine)
Indication: Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution
Dosage, Mechanism of Route, Action Frequency 2 Ampules Methergine immediately ↓ after the Stimulates uterine delivery of smooth muscles the Placenta ↓ producing sustained contractions ↓ thereby shortens the third stage of labor
Adverse Reaction Cardiovascular: hypertension, temporary chest pain, palpitation
> contraindicated in patients hypersensitive to methylergonovine or any component of the CNS:Hallucinations, formulation. dizziness, seizure, >ergot alkaloids are headache contraindicated with potent inhibitors of Gastrointestinal: CYP3A4 (includes Nausea, vomiting, protease inhibitors, diarrhea, foul taste azole antifungals, and some macrolide Local: antibiotics); Thrombophlebitis Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Diaphoresis
Maniulit, Joeanne Mae A. N-304 Group 3
Contraindication
>hypertension; toxemia of pregnancy (PIH)
Nursing Responsibility >Be alert for adverse reactions and drug interactions. >This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely. >Monitor Uterine Contractions
Generic Name (Brand Name)
Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Oxytocin (Pictopin, Syntocinon)
Indication: Induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion
For stimulation of labor: 10 units (1ml) of drug infused in 1L D5LRS before deliver
Oxytocin ↓ Causes potent and selective stimulation of uterine and mammary gland smooth muscles ↓ producing sustained contractions ↓ Induces labor and milk ejection and reduces post partum bleeding
Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias
> Contraindicated in patients hypersensitive to the drug or any of its component.
> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15.
For Reduction of Postpartum bleeding: 1 amp after delivery of placenta
CNS: seizures, coma from water intoxication Gastrointestinal: Nausea, vomiting, GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma Hematologic: afibrinogenemia Respiratory: anoxia, asphyxia
Maniulit, Joeanne Mae A. N-304 Group 3
> Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isn’t imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa.
>Be alert for adverse reaction >Monitor I/O. Antidiuretic effect may lead to fluid overload, seizures, and coma >never give oxytocin simultaneously by more than one route. >have 20% solution magnesium sulfate available for relaxation of the myometrium.
> Also contraindicated >If contractions are less in fetal distress. than 2 minutes apart, if they’re above 50mm Hg ,or if they last 90seconds or longer, stop infusion, and turn patient on her side, and notify physician or midwife.
Generic Name (Brand Name)
Indication
Hyoscine Butylbromide (Buscopan)
Indication: To reduce secretions perioperatively.
Dosage, Route, Frequency Given via IV, 1mg/ml to promote cervical effacement.
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Hyoscine Butylbromide ↓ Inhibits muscarinic actions of acetylcholine in the ANS ↓ Affecting neural pathway ↓ Relieves spasticity, nausea and vomitting; reduces secretions; and blocks cardiac vagal reflexes.
CNS: dizziness, headache, restlessness, disorientation, irritability, fever
Contraindicated in patients with angleclosure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.
>Be alert for adverse reactions and drug interactions.
↓ Promotes cervical effacement
GI: constipation, dry mouth, nausea, vomiting CV: palpitations, tachycardia, flushing EENT: dilated pupils, blurred vision, photophobia, dysphagia GU: urinary hesitancy, urinary retention Skin: rash, dryness
Maniulit, Joeanne Mae A. N-304 Group 3
>Encourage pt. to void >Monitor BP for possible hypotension. >Monitor cervical effacement and dilatation.
Generic Name (Brand Name)
Indication
Hydralazine (Apresoline)
Indication: Pre-eclampsia / eclampsia
Dosage, Route, Frequency 5 mg/dose then 5-10 mg every 20-30 minutes as needed.
Mechanism of Action Hydralazine ↓ Directly relaxes arteriolar smooth muscle ↓ Vasodilaion ↓ Lowers Blood Pressure
Adverse Reaction
Contraindication
Nursing Responsibility
CNS: peripheral neuritis, headache, dizziness
Contraindicated to pt.s hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.
>Assess blood pressure before starting therapy and regularly thereafter.
CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations. GI: n/v, diarrhea, anorexia Hematologic: neutropenia, leukopenia, agranulocytopenia Metabolic: weight gain, sodium retention Skin: rash
Maniulit, Joeanne Mae A. N-304 Group 3
Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.
>Instruct client to take oral form with meals. >Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly. >Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs. >Tell client to limit sodium intake.
Generic Name (Brand Name)
Indication
Hydralazine (Apresoline)
Indication: Pre-eclampsia / eclampsia
Dosage, Route, Frequency 5 mg/dose then 5-10 mg every 20-30 minutes as needed.
Mechanism of Action Hydralazine ↓ Directly relaxes arteriolar smooth muscle ↓ Vasodilaion ↓ Lowers Blood Pressure
Adverse Reaction
Contraindication
Nursing Responsibility
CNS: peripheral neuritis, headache, dizziness
Contraindicated to patients who are hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.
>Assess blood pressure before starting therapy and regularly thereafter.
CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations. GI: n/v, diarrhea, anorexia Hematologic: neutropenia, leukopenia, agranulocytopenia Metabolic: weight gain, sodium retention Skin: rash
Maniulit, Joeanne Mae A. N-304 Group 3
Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.
>Instruct client to take oral form with meals. >Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.
Generic Name (Brand Name)
Indication
Phytomenadione (Vitamin K, Phylloquinone, menaquinone)
>To stimulate the clotting factors of the newborn >To prevent hemorrhagic disease of the Newborn.
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency 0.1 cc via IM to the Vastus Lateralis of the newborn
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Sterility of GI tract ↓ istration of Vitamin K ↓ Increased Synthesis of precursor proteins in the GIT mainly factors II, VII, IX, and X are produced and increased. ↓ From 30-60% compared to adult clotting factor values, blood clotting factors increase.
>The synthetic form of Vitamin K and Vitamin K3 (Menadione) can cause allergic reaction, Hemolytic Anemia, and Cytotoxicity in liver cells.
>Contraindicated to those who are hypersensitive to any component of Vitamin K containing products.
>Ensure that the adequate dose is given while following the proper IM Drug istration. >Apply pressure to the injection site to prevent further bleeding. >Document the giving of the medication to newborn to prevent an accidental doubling of the dose.
Generic Name (Brand Name)
Indication
Oxytetracycline (Terramycin Opthalmic Ointment, Terak, Terramycin with Polymyxin B)
To prevent infection of the eye which may derive from flora or present infections of the vagina during normal spontaneous delivery To prevent Opthalmia neonatorum in infants.
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency 1 cm strip applied from the inner canthus of the eye to the outer canthus
Mechanism of Action
Adverse Reaction >Irritation >Redness >Tearing >Iching sensation
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Nubaine
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Lidocaine (Xylocaine)
>Injected prior to normal spontaneous delivery to anesthetize the area of the perineum to be used for episiotomy. >Used as a local anesthesia for Cesarean section.
Dosage, Route, Frequency For normal vaginal delivery: 50mg/ml of a 5% hyperbaric solution or 9mg-15mg (0.6ml-1ml) of a 1.5% solution. For Cesarean Section: Up to 75 mg (1.5ml) of a 5% hyperbaric solution.
Maniulit, Joeanne Mae A. N-304 Group 3
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Lidocaine ↓ Stabilizes the neuronal membrane ↓ Inhibits sodium ion movemnts ↓ Conduction of impulses are inhibited ↓ Local loss of pain sensation
> Dizziness >Paresthesia >Drowsiness >Confusion >Respiratory Depression >Convulsions
>Hypovolemia >Heartblock >Other Conduction Disturbances
> Observe for untoward reactions such as drowsiness, depressed respiration, or seizures.
Generic Name (Brand Name)
Indication
Duvadilan
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Epinephrine
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Maniulit, Joeanne Mae A. N-304 Group 3
Indication
Methylergonovine maleate (Methergine, Methylergobasine Methylergobrevin Methylergonovine)
Indication: Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution
Dosage, Mechanism of Route, Action Frequency 2 Ampules Methergine immediately ↓ after the Stimulates uterine delivery of smooth muscles the Placenta ↓ producing sustained contractions ↓ thereby shortens the third stage of labor
Adverse Reaction Cardiovascular: hypertension, temporary chest pain, palpitation
> contraindicated in patients hypersensitive to methylergonovine or any component of the CNS:Hallucinations, formulation. dizziness, seizure, >ergot alkaloids are headache contraindicated with potent inhibitors of Gastrointestinal: CYP3A4 (includes Nausea, vomiting, protease inhibitors, diarrhea, foul taste azole antifungals, and some macrolide Local: antibiotics); Thrombophlebitis Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Diaphoresis
Maniulit, Joeanne Mae A. N-304 Group 3
Contraindication
>hypertension; toxemia of pregnancy (PIH)
Nursing Responsibility >Be alert for adverse reactions and drug interactions. >This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely. >Monitor Uterine Contractions
Generic Name (Brand Name)
Indication
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Oxytocin (Pictopin, Syntocinon)
Indication: Induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion
For stimulation of labor: 10 units (1ml) of drug infused in 1L D5LRS before deliver
Oxytocin ↓ Causes potent and selective stimulation of uterine and mammary gland smooth muscles ↓ producing sustained contractions ↓ Induces labor and milk ejection and reduces post partum bleeding
Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias
> Contraindicated in patients hypersensitive to the drug or any of its component.
> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15.
For Reduction of Postpartum bleeding: 1 amp after delivery of placenta
CNS: seizures, coma from water intoxication Gastrointestinal: Nausea, vomiting, GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma Hematologic: afibrinogenemia Respiratory: anoxia, asphyxia
Maniulit, Joeanne Mae A. N-304 Group 3
> Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isn’t imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa.
>Be alert for adverse reaction >Monitor I/O. Antidiuretic effect may lead to fluid overload, seizures, and coma >never give oxytocin simultaneously by more than one route. >have 20% solution magnesium sulfate available for relaxation of the myometrium.
> Also contraindicated >If contractions are less in fetal distress. than 2 minutes apart, if they’re above 50mm Hg ,or if they last 90seconds or longer, stop infusion, and turn patient on her side, and notify physician or midwife.
Generic Name (Brand Name)
Indication
Hyoscine Butylbromide (Buscopan)
Indication: To reduce secretions perioperatively.
Dosage, Route, Frequency Given via IV, 1mg/ml to promote cervical effacement.
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Hyoscine Butylbromide ↓ Inhibits muscarinic actions of acetylcholine in the ANS ↓ Affecting neural pathway ↓ Relieves spasticity, nausea and vomitting; reduces secretions; and blocks cardiac vagal reflexes.
CNS: dizziness, headache, restlessness, disorientation, irritability, fever
Contraindicated in patients with angleclosure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.
>Be alert for adverse reactions and drug interactions.
↓ Promotes cervical effacement
GI: constipation, dry mouth, nausea, vomiting CV: palpitations, tachycardia, flushing EENT: dilated pupils, blurred vision, photophobia, dysphagia GU: urinary hesitancy, urinary retention Skin: rash, dryness
Maniulit, Joeanne Mae A. N-304 Group 3
>Encourage pt. to void >Monitor BP for possible hypotension. >Monitor cervical effacement and dilatation.
Generic Name (Brand Name)
Indication
Hydralazine (Apresoline)
Indication: Pre-eclampsia / eclampsia
Dosage, Route, Frequency 5 mg/dose then 5-10 mg every 20-30 minutes as needed.
Mechanism of Action Hydralazine ↓ Directly relaxes arteriolar smooth muscle ↓ Vasodilaion ↓ Lowers Blood Pressure
Adverse Reaction
Contraindication
Nursing Responsibility
CNS: peripheral neuritis, headache, dizziness
Contraindicated to pt.s hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.
>Assess blood pressure before starting therapy and regularly thereafter.
CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations. GI: n/v, diarrhea, anorexia Hematologic: neutropenia, leukopenia, agranulocytopenia Metabolic: weight gain, sodium retention Skin: rash
Maniulit, Joeanne Mae A. N-304 Group 3
Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.
>Instruct client to take oral form with meals. >Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly. >Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs. >Tell client to limit sodium intake.
Generic Name (Brand Name)
Indication
Hydralazine (Apresoline)
Indication: Pre-eclampsia / eclampsia
Dosage, Route, Frequency 5 mg/dose then 5-10 mg every 20-30 minutes as needed.
Mechanism of Action Hydralazine ↓ Directly relaxes arteriolar smooth muscle ↓ Vasodilaion ↓ Lowers Blood Pressure
Adverse Reaction
Contraindication
Nursing Responsibility
CNS: peripheral neuritis, headache, dizziness
Contraindicated to patients who are hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.
>Assess blood pressure before starting therapy and regularly thereafter.
CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations. GI: n/v, diarrhea, anorexia Hematologic: neutropenia, leukopenia, agranulocytopenia Metabolic: weight gain, sodium retention Skin: rash
Maniulit, Joeanne Mae A. N-304 Group 3
Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.
>Instruct client to take oral form with meals. >Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.
Generic Name (Brand Name)
Indication
Phytomenadione (Vitamin K, Phylloquinone, menaquinone)
>To stimulate the clotting factors of the newborn >To prevent hemorrhagic disease of the Newborn.
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency 0.1 cc via IM to the Vastus Lateralis of the newborn
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Sterility of GI tract ↓ istration of Vitamin K ↓ Increased Synthesis of precursor proteins in the GIT mainly factors II, VII, IX, and X are produced and increased. ↓ From 30-60% compared to adult clotting factor values, blood clotting factors increase.
>The synthetic form of Vitamin K and Vitamin K3 (Menadione) can cause allergic reaction, Hemolytic Anemia, and Cytotoxicity in liver cells.
>Contraindicated to those who are hypersensitive to any component of Vitamin K containing products.
>Ensure that the adequate dose is given while following the proper IM Drug istration. >Apply pressure to the injection site to prevent further bleeding. >Document the giving of the medication to newborn to prevent an accidental doubling of the dose.
Generic Name (Brand Name)
Indication
Oxytetracycline (Terramycin Opthalmic Ointment, Terak, Terramycin with Polymyxin B)
To prevent infection of the eye which may derive from flora or present infections of the vagina during normal spontaneous delivery To prevent Opthalmia neonatorum in infants.
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency 1 cm strip applied from the inner canthus of the eye to the outer canthus
Mechanism of Action
Adverse Reaction >Irritation >Redness >Tearing >Iching sensation
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Nubaine
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Lidocaine (Xylocaine)
>Injected prior to normal spontaneous delivery to anesthetize the area of the perineum to be used for episiotomy. >Used as a local anesthesia for Cesarean section.
Dosage, Route, Frequency For normal vaginal delivery: 50mg/ml of a 5% hyperbaric solution or 9mg-15mg (0.6ml-1ml) of a 1.5% solution. For Cesarean Section: Up to 75 mg (1.5ml) of a 5% hyperbaric solution.
Maniulit, Joeanne Mae A. N-304 Group 3
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Lidocaine ↓ Stabilizes the neuronal membrane ↓ Inhibits sodium ion movemnts ↓ Conduction of impulses are inhibited ↓ Local loss of pain sensation
> Dizziness >Paresthesia >Drowsiness >Confusion >Respiratory Depression >Convulsions
>Hypovolemia >Heartblock >Other Conduction Disturbances
> Observe for untoward reactions such as drowsiness, depressed respiration, or seizures.
Generic Name (Brand Name)
Indication
Duvadilan
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Generic Name (Brand Name)
Indication
Epinephrine
Maniulit, Joeanne Mae A. N-304 Group 3
Dosage, Route, Frequency
Mechanism of Action
Adverse Reaction
Contraindication
Nursing Responsibility
Maniulit, Joeanne Mae A. N-304 Group 3
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