| Drug | Tradename | Class | Dosage | Indication for Use | Action | Contraindications | Nursing Implications | Patient Teaching |
| Antepartum/LD | ||||||||
| Betamethasone | betnelan, betnesol | corticosteroid | PO: 0.6 – 7.2 mg/day as single or divided doses. IM: 0.5 – 9mg. Prevent RDS: 12 mg daily 2-3 days prior to delivery. | Inflammation, hematologic, allergic reactions. Prevention of Respiratory Distress Syndrome in newborn. | supress inflammation and normal immune response | avoid chronic use with lactation, alcohol intolerance, caution with hypothyroidism | monitor electrolytes and glucose. Cause hyperglycemia, decrease WBCs, decrease K+, monitor edema | Notify provider if edema is noticed. Assess for adrenal insufficiency (hypotension, weight loss, lethargy) |
| Brethine | ||||||||
| Dinoprostone | cervidil | cervical ripening agent | Endocervical gel – 0.5 mg Vaginal insert – one 10 mg insert | used when induction for labor is indicated, management of missed abortion up to 28wk | produce contractions, dialate cervix, stimulates GI smooth muscle | hypersensitivity to prostaglandins, previous C-section, unexplained vaginla bleeding, traumatic delivery | auscultate breath sounds (wheezing and sensation of chest tightness indicate hypersensitivity), monitor temp, bp, pulse, assess for N/V, monitor vaginal discharge, monitor uterine activity, dilation, remove insert at beginning of active labor | explain purpose, may experience warm feeling, notify provider of contractions become prolonged |
| Misoprostol | cytotec | antiulcer, cytoprotective | 15mg/day | cervical ripening, labor induction, terminate pregnancy of less than 49 days | causes uterine contractions | should not be used to prevent NSAID induced gastric injury, Lactation: can cause diarrhea in nursing infant | assess mental status, assess suicidal tendencies, restrict amount of drug available to pt, monitor for seizure activity, assess CBC and hepatic function before and during treatment | notify provider for dry mouth, urinary retention. Increase fluid intake to prevent constipation, may cause drowsiness |
| methylergonovine | methergrine | oxytocic | PO: 200-400mcg q6-12hr for 2-7 days. IM: 200mcg q 2-4 hr up to 5 doses. | prevent and treat postpartum or postabortion hemorrhage caused by uterine atony or subinvolution | stimulates uterine and vascular smooth muscle | do not use to induce labor, caution in third stage labor | monitor BP, HR and uterine response, notify provider if uterine relaxation become prolonged or change in bleeding, assess for ergotism, decreases serum prolactin | take as directed do not skip or double dose, may cause menstrual like cramps, avoid smoking, notify provider of new infection |
| Hemabate | carboprost tromethamine | synthetic prostaglandin | postpartum hemorrhage | induces contractions | severs cardiovascular, renal, and hepatic disease, pelvic inflammatory disease | |||
| Magnesium Sulfate | mineral and electrolyte replacements | Eclampsia/Pre-eclampsia: 4-5g IV infusion with up to 5g IM in each buttock then 4-5g IM q4hr or 4g IV followed by 1-2g/hr continuous infusion. | preterm labor | essential for activity of many enzymes. Plays a role in neurotransmission and muscular excitability. Resolve eclampsia | unless used for preterm labor, avoid continuous use during active labor or within 2 hr of delivery | monitor newborn for hypotension, hyporeflexia, respiratory depression. Monitor I&O, monitor respirations | explain purpose of medication to family | |
| Oxytocin | pitocin | hormone | Labor induction: IV:0.5-2milliunits/min increased by 1-2 milliunits/min q 15-60 min until pattern established, then decrease dose. Post Partum Hemorrhage: IV: 10units at 20-40 milliunits.min IM: 10 units after delivery of placenta | induction of labor at term, postpartum control of bleeding after expulsion of placenta | stimulates uterine smooth muscle, producing uterine contractions | caution with first and second stage labor, hypersensitivity, caution over extended dosage (24hr) (coma, water intoxication) | assess fetal maturity, presentation, and pelvic adequacy, assess contraction, fetal HR, monitor BP, monitor electrolytes | Contractions similar to menstrual cramps |
| NIFEdipine | procardia | calcium channel blocker | PO: | preterm labor | slow uterine contractions | hypersensitivity, sick sinus syndrome, 2nd or 3rd degree AV block | monitor BP, and pulse before therpay, monitor ECG periodically, monitor I&O | take as directed, change position slowly, avoid grapefuit juice |
| Indomethacin | indocin | tocolytic | preterm labor | slow uterine contractions | hypersensitivity, GI bleeding, thrombocytopenia | patients with asthma, aspirin-induced allergy, and nasal polyps at increased risk for hypersensitive reaction. Evaluate BUN and liver function may be elevated | take with water, remain in upright position for 15-30 min, notify provider for chills, fever, rash | |
| oxymorphone | numorphan/numorphone | semi-synthetic opiod analgesic | relieve moderate to severe pain, obstetric analgesic | binds to opiat receptors in CNS, produces generalized CNS depression | ||||
| Penicillin | anti-infective | treat infections, prevent rheumatic fever | bind to bacterial wal causing cell death | previous hypersensitivity to penicillin | assess for infection, determine previous use of penicillins, cephalosporins, beta-lactam, observe for anaphlyxis | take around the clock, finish as directed, do not share, notify provider for diahhrea, fever, notify if symptoms do not improve | ||
| Newborn | ||||||||
| Erythromycin Opthalmic Ointment | ||||||||
| Vitamin K | ||||||||
| Hepatitis B | ||||||||
| Postpartum/Gyne | ||||||||
| Clomiphene | clomid | induce ovulation in women who do not produce ova | ||||||
| Depo-provera | contraceptive hormone | 150mg within 5 days of menses or within 5 days post partum | prevention of pregnancy | may alter cervical mucus and endometrial environment preventing penetration by sperm and implantation of egg and supress ovulation | pregnancy, vavular disease, diabetes with vascular involvement, uncontrolled HTN, cancer, genital bleeding, avoid use in lactation | assess BP, assess for acne, may alter thyroid function tests | take as directed, take single dose as soon as remembered, explain dose schedule, eat solid food to fight nasuea, report fluid retention, stop taking if pregnancy is suspected, take adequate calcium and vitamin D | |
| Oxycodone/acetaminophen | percocet | opiod analgesic | 10-40mg 3-4 times daily | moderate to severe pain | binds to opiat receptors in CNS, produces generalized CNS depression | hypersensitivity, avoid aspirin and ibuprofen, avoid chronic use | assess pain, assess BP, pulse, respirations, assess for dependence, assess bowel function | instruct on use, instruct not to increase dose, may cause drowsiness or dizziness, change position slowly |
| Rhogam | vaccine/immunizing agent | pregnancy or delivery of a Rh (D) positive infant | prevent production of anti-RH (D) antibodies in Rh (D) negative patients, prevent antibody response and hemolytic disease of the newborn in future pregnancies of women who have conceived a Rh positive fetus | prior hypersenstitivity reaction to human immune globulin Rh (D) or Du positive patients | assess vitals periodically, montiro for signs of intravascular hemolysis, anemia, renal insufficiency | explain purpose of medication | ||
| bisacodyl | dulcolax | laxative | 5-15mg/day as single dose PO, rect 10 mg/day single dose | treatment of constipation | stimulates peristalsis, produces fluid accumulation in colon | N/V, anal fissures | assess bowel sounds, usual bowel pattern, assess color, consistency, and amount of stool | only for short term use, increase fluid intake to 1500-2000 ml day, bowel patterns can vary, don’t strain |
| Rubella Vaccine |