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Perinatal Medications – Comprehensive Guide (A+)
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Perinatal Medications – Comprehensive Guide (A+)
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Perinatal Medications – Comprehensive Guide (A+)Lactated Ringers Right Ans - -this or D5W is commonly used to hydrate pts
in labor or postpartum
-rate: 125 mls/hr
-can be used to administer IV push medications
-piggybacked onto main line: antibiotics, insulin, oxytocin
Oxytocin Right Ans - -MOST FREQUENTLY USED MEDICATION IN
PERINATAL SETTING
-uterotonic medication (causes uterine contractions)
-in labor, it is added to an LR solution most often 30 milliunits per 500 mls in a
premixed solution yielding 1 milliunit/mL
-administered by pump
-minium= 1 mu/mL
-maximum= 40 mu/mL
-oxytocin is used to INDUCE (begin) or AUGMENT (enhance) labor & ctx
-> can also be used postpartum to contract uterus & prevent excessive
bleeding
-use cautiously in TOLAC (trial of labor after cesarean) pts
-most serious complication= HYPERSTIMULATION OF UTERUS causing fetal
distress
oxytocin dose range Right Ans - 1 mu/ml to 40 mu/ml
Fentanyl Right Ans - -short acting opioid analgesic given slow IVP in doses
of 50-100 mcgs for pain
-may be repeated PRN
-combined with bupivicaine for epidural admin
-> when given epidural, administer via pump at a dose and rate based on
patient's weight
-ADR: respiratory depression of newborn & mother, itching, nausea, dizziness
-> do not give within 2 hrs of expected birth
fentanyl dose range Right Ans - 50-100 mcgs
Stadol Right Ans - -opioid analgesic given by slow IVP in doses of 1-2 mgs
for labor pain
-may be repeated PRN
, stadol dose range Right Ans - 1-2 mgs
Terbutaline Right Ans - -smooth muscle relaxant used to relax the uterus
when there is hyper stimulation of uterus
-given 0.25 mg slow IVP over 2 minutes PRN
-rarely, it is used for premature labor often causing severe tachycardia
if hyper stimulation of the uterus occurs, give terbutaline at what dose/time?
Right Ans - 0.25 mg SLOW IVP over 2 minutes PRNi
Misoprostol (Cytotec) Right Ans - -synthetic prostaglandin analog used for
pre-induction of labor
-causes uterine contractions that soften and ripen the cervix BEFORE the use
of oxytocin
-> also used postpartum to contract the uterus and treat hemorrhage in doses
of 800 mcgs rectally
-administered most commonly per vagina; 25 mcgs- 50 mcgs q4hrs
-ADRs: HYPERSTIMULATION OF THE UTERUS CAUSING FETAL DISTRESS
in postpartum hemorrhage, give misoprostol in doses of: Right Ans - 800
mcgs rectally
Dinoprostone (Cervidil) Right Ans - -prostaglandin used as for misoprostol
for pre-induction of labor
-dose: 10 mgs per vagina
dinoprostone dose/route Right Ans - 10 mgs per vagina
Methergine Right Ans - -uterotonic that contracts the uterus post-delivery
when there is concern for hemorrhaging
-administered PO or IM in 0.2 mgs
-given as a one-time dose or repeated doses q4-6 hrs
-ADRs: HTN; BP must always be taken before giving methergine
-NEVER give IV as it can cause CVA (stoke)
methergine dose/route Right Ans - 0.2 mgs PO or IM
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