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delivery room drug study

delivery room drug study

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Published by macel sibayan
drug study of different drugs used in the delivery room
drug study of different drugs used in the delivery room

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Published by: macel sibayan on Mar 05, 2010
Copyright:Attribution Non-commercial

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07/30/2013

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DRUG STUDY 1. Generic Name
:Methylergonovine maleate
Brand Name:
Methergine
Classification:
Oxytocic
Therapeutic Actions:
A partial agonist or antagonist at alpha receptors; as a result, it increases thestrength, duration, and frequency of uterine contractions.
Indications:
Routine management after delivery of the placenta.
 Treatment of postpartum atony and hemorrhage; subinvolution of the uterus.
Uterine stimulation during the second stage of labor following the delivery of the anterior shoulder, under strict medical supervision.
Contraindications
Contraindicated with allergy to methylergonovine, hypertension, toxemia,lactation, pregnancy.
Adverse Effects:
CNS: Dizziness, headache, tinnitus, diaphoresisCV: Transient hypertension, palpitations, chest pains, dyspneaGI: Nausea and vomiting
Nursing Considerations:
Assess history of allergy to the drug.
Administer by IM injection or orally unless emergency requires IV use.Complications are more frequent with IV use.
Monitor postpartum women for BP changes and amount and character of vaginal bleeding.
Avoid prolonged use of the drug.
 Teach client to report difficulty breathing, headache, numb or coldextremities, severe abdominal cramping.
2. Generic Name:
Dinoprostone (prostaglandin E2)
Brand Name:
Cervidil
Classification:
Prostaglandin; abortifacient
Therapeutic Actions:
Stimulates the myometrium of the pregnant uterus to contract; similar to thecontractions of the uterus during labor, thus evacuating the contents of theuterus.
Indications:
 Termination of pregnancy 12-20 wks from the first day of the LMP.
Evacuation of the uterus in the management of missed abortion orintrauterine fetal death up to 28 wk gestational stage
Initiation of cervical ripening before induction of labor
Contraindications:
Contraindicated with allergy to prostaglandins; acute PID; active cardiachepatic; pulmonary, renal disease; women in whom prolonged uterinecontractions are inappropriate.
Adverse Effects:
CNS: Headache, paresthesias, anxiety, weakness, syncope, dizzinessCV: Hypotension, arrthymias, chest painFetal: Abnormal heart ratesGI: vomiting, diarrhea, nauseaRespiratory: Coughing, dyspnea
Nursing Considerations:
Monitor uterine tone and vaginal discharge throughout the procedureand several days after the procedure.
Ensure adequate hydration throughout the procedure.
 
Be prepared to support patient through labor. Give oxytocin infusion 6-12 hr after dinoprostone.
 Teach client to report severe pain, difficulty breathing, palpitations,eye pain, rash.
3. Generic Name:
Oxytocin
Brand Name:
Pitocin
Classification:
Oxytocic; hormone
Therapeutic Actions:
Synthetic form of an endogenous hormone produced in the hypothalamusand stored in the posterior pituitary; stimulates the uterus, especially thegravid uterus just before parturition, and causes myoepithelium of the lactealglands to contract, which results in milk ejection in lactating women.
Indications:
Antepartum: to initiate or improve uterine contractions to achieve earlyvaginal delivery; stimulation or reinforcement of labor in selected cases of uterine inertia; management of inevitable or incomplete abortion; 2
nd
trimester abortion
Postpartum: to produce uterine contractions during the third stage of labor tocontrol postpartum bleeding or hemorrhage
Lactation defieciency
Contraindications:
Significant cephalopelvic disproportion, unfavorable fetal positions orpresentations, obstetric emergencies that favor surgical intervention,prolonged use in severe toxemia, uterine inertia, hypertonic uterine patterns,induction or augmentation of labor when vaginal delivery is contraindicated,previous cesarian section.
Adverse Effects:
CV: cardiac arrhythmias, PVCs, hypertension, subarachnoid hemorrhageFetal effects: fetal bradycardia, neonatal jaundice, low Apgar scoresGI: nauseas, vomitingGU: postpartum hemorrhage, uterine rupture, pelvic hematoma, uterinehypertonicity, spasm
Nursing Considerations:
Ensure fetal position and size and absence of complications that arecontraindicated with oxytocin therapy
Ensure continuous observation for induction of labor; fetal monitoring ispreferred.
Regulate rate of oxytocin delivery; monitor rate and strength of contractions
Monitor BP during administration
4. Generic Name:
Lidocaine hydrochloride
Brand Name:
Dilocaine
Classification:
Local anesthetic
Therapeutic Actions:
Blocks the generation and conduction of action potentials in sensory nervesby reducing sodium permeability, reducing height and rate of rise of theaction potential, increasing excitation threshold, and slowing conductionvelocity
Indications:
Infiltration anesthesia, peripheral and sympathetic nerve blocks, centralnerve blocks, spinal and caudal anesthesia
Contraindications:
Contraindicated with allergy to lidocaine or amide-type local anesthetics, CHFcardiogenic shock, 2
nd
or 3
rd
degree AV blocks
Adverse Effects:
 
CNS: headache, backache, septic meningitis, persistent sensoryCV: hypotensionDermatologic: urticaria, pruritus, erythema, edemaGU: urinary retention, urinary or fecal incontinence
Nursing Considerations:
Check drug concentrations carefully
Establish safety precautions if CNS changes occur
 Teach client to report difficulty speaking, thick tongue, numbness, tingling,difficulty breathing, pain or numbness at site, swelling or pain at site
5. Generic Name:
 Terbutaline Sulfate
Brand Name
:Brethine
Classification:
 Tocolytic
Therapeutic Actions:
-In low doses, acts relatively selectively at beta 2-adrenergic receptors tocause bronchodilation and relax the pregnant uterus; at higher doses, beta 1selectivity is lost and the drug acts at beta 2 receptors to cause typicalsympathomimetic cardiac effects
Indications:
-Tocolytic to prevent preterm labor
Contraindications:
-Contraindicated with hypersensitivity to terbutaline, tachyarrythmias,tachycardia, hypertension, lactation.
Adverse Effects:
CNS: restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesias,insomnia, tremorsCV: cardiac arrhythmias, palpitations, angina pain, changes in BP and ECGGI: Nausea, vomiting, heartburn, unusual or bad tasteRespiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasmNursing Considerations:-Use minimal doses for minimal periods of time; drug tolerance can occur-Maintain a beta-adrenergic blocker on standby in case cardiac arrhythmiasoccur-Teach client to report chest pain, dizziness, insomnia, weakness, tremor
6. Generic Name:
Carboprost tromethamine
Brand Name
:Hemabate
Classification:
Prostaglandin; Abortifacient
Therapeutic Actions:
Stimulates the myometrium of the pregnant uterus to contract; similar to thecontractions of the uterus during labor, thus evacuating the contents of theuterus.
Indications:
-Termination of pregnancy 13-20 wk from the first day of the LMP-Evacuation of the uterus in instance of missed abortion or intrauterine fetaldeath in the 2nd trimester-Postpartum hemorrhage due to uterine atony unresponsive to conventionalmethods
Contraindications:
-Contraindicated with allergy to prostaglandin preparations, acute PID; activecardiac,hepatic, pulmonary, renal disease
Adverse Effects:
CNS: headache, paersthesias, flushing, anxiety, weakness, syncope, dizzinessCV: hypotension, arrhythmias, chest painGI: vomiting, diarrhes, nausea
Nursing Considerations:
-Assess allergy to the drug-Monitor uterine tone and vaginal discharge during procedure and severaldays after to assess drug effects and recovery-Ensure adequate hydration

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Rhymer Balbuena added this note|
tanx to all people who did this...its a big help to me! ;D
Furat Faisal added this note|
thank you very mach . the subject is very good

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