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MEDICATION SHEETS

Student name: Allie Jones
Date: 09/03/09 REDONE 9/24/2009

Drug name: Oxytocin
Drug Classification: Hormone, oxytocics
Pregnancy Risk Category: X (intranasal), unknown (IV/IM)
Indication for use in this area: induction of labor, or augmentation of labor progressing slowly due to
inadequate contractions; enhancement of uterine contractions; postpartum control of
bleeding After expulsion of the placenta; evaluation of fetal competence; promote milk
letdown in lactating women
Route and usual range of dose: IV initial dose 0.5 - 1 milli units/min with increments of 1 to 2
milli units/min, recommended dose increments are Q30 - 60 min as it takes 30-40 min for
a steady state of Oxytocin to be reached and full effect of dosage increment to
be reflected in more intense, frequent, longer contractions; IM (for postpartum hemorrhage)
give 10 units after delivery of placenta; intranasal, 1 spray in 1 or both nostrils 2-3 min
prior to breastfeeding or pumping breasts
Specific dosing for your patient: prior to delivery: 14 milliunits/hr, titrated 1-2 milliunits/min Q30
min to induce in 0.9% 500 mL NaCl. Postpartum: 30 units IV in 0.9% NaCl 500 mL titrating to
keep fundus firm.
Potential side effects/adverse reactions/ nursing considerations: High doses given rapidly
may cause water intoxication and tumultuous labor with tetanic contractions which could
cause premature separation of the placenta, rupture of the uterus, lacerations to the
cervix, or post birth hemorrhage. Also the hyperstimulation of the uterus reduces blood
flow through the placenta resulting in FHR decelerations, fetal asphyxia, and neonatal
hypoxia.
Evaluation of Medication: Intensity of contractions results in intrauterine pressures of 40 -
90 mmHg, contraction durations are 60-90 sec., frequency of contractions is 2 - 3
min intervals. Resting tone of 10 - 15 mmHg, and cervical dilation of 1 cm/hr in active
phase; onset of effective contractions, increase in uterine tone, effective letdown reflex

Drug name: Terbutaline
Drug Classification: adrenergic
Pregnancy Risk Category: B
Indication for use in this area: management of preterm labor by relaxing the smooth muscles
and inhibiting activity of premature contractions.
Route and usual range of dose: SQ injection 0.25 mg Q20-30/min for 2 hr then maintenance
dose of 0.25 mg Q3-4 hr or SQ pump maintenance dose of 0.03-0.1 mg/hr; PO 2.5 mg Q 4-6 hrs
until delivery; IV 10 mcg/min infusion; increase by 5 mcg/min q 10 min until contractions
stop then decrease infusion rate after contractions have stopped for 30 min to lowest
effective amount and maintain for 4-8 hr.
Specific dosing for your patient: not used for my patient.
Potential side effects/adverse reactions/ nursing considerations: Maternal side effects
include tachycardia, palpitations, tremor, anxiety, and headache, hypoglycemia and
hypokalemia; the neonate side effects include hypoglycemia
Evaluation of Medication: control of preterm labor in a fetus of 20 - 36 weeks gestational age maternal
HR <120.

Drug name: Magnesium Sulfate
Drug Classification: anti-convulsant, magnesium salt
Pregnancy Risk Category: D
Indication for use in this area: treatment of preterm labor by slowing contractions until cervix
has stopped thinning or effacing; control seizures in preeclampsia and eclampsia
Route and usual range of dose: IV: initial dose of 4 to 6 grams over 15 to 30 minutes, then 2 to
3 grams/hr as a maintenance dose; IM: 1 – 4 grams Q4hrs
Specific dosing for your patient: not used for my patient.
Potential side effects/adverse reactions/ nursing considerations: For the mother, the
potential side effects include hypotension, tachycardia, cardiac arrhythmias, drowsiness,
hypoglycemia, respiratory paralysis, feeling uncomfortably warm, headache, dry mouth,
nausea, and blurred vision. For the baby, initial listless or floppiness at birth may be seen due to
relaxation of the muscles from the medication, but it should go away once the drug clears from
the baby's system.
Evaluation of Medication: contractions slowed, prolonging gestation for 2 - 7 days; control of seizures
in PIH pt

Drug name: Hemabate
Drug Classification: oxytocics, prostaglandins
Pregnancy Risk Category: C
Indication for use in this area: Treatment of postpartum hemorrhage by contraction of the
uterus by directly stimulating the myometrium
Route and usual range of dose: IM 250 mcg; may be repeated every 15–90 min (total
dose not to exceed 2 mg).
Specific dosing for your patient: not used for my patient.
Potential side effects/adverse reactions/ nursing considerations: uterine rupture,
nausea, vomiting, fever, diarrhea
Evaluation of Medication: control of postpartum bleeding

Drug name: Cytotec
Drug Classification: cytoprotective agent, prostaglandins
Pregnancy Risk Category: X
Indication for use in this area: cervical effacement/thinning and induction of labor acting as a cervical
ripening agent, also used to treat serious postpartum hemorrhage in the presence of uterine atony
Route and usual range of dose: 25 mcg vaginally every 3 to 4 hours (maximum dose, 400
mcg) for induction of labor or initially 50 mcg orally every 4 hours for 2 doses, then
100 mcg every 4 hours until membrane rupture (maximum of 5 doses).
Specific dosing for your patient: not used for my patient.
Potential side effects/adverse reactions/ nursing considerations: Cardiac dysrhythmia,
anemia, abdominal pain, or diarrhea
Evaluation of Medication: induction of labor or decrease in bleeding following serious postpartum
hemorrhage.

Drug name: Methergine
Drug Classification: oxytocic, ergot alkaloids
Pregnancy Risk Category: C
Indication for use in this area: prevention and treatment of postpartum hemorrhage caused by uterine
atony or failure of the uterus to return to normal size following childbirth.
Route and usual range of dose: 0.2 mg IM/IV (may be repeated at 2 to 4 h intervals up to 5
doses) then 0.2 mg PO 3 to 4 times a day as needed (MAX duration: 7 days); PO, 0.2 mg 3-
4x/day in the puerperium for a maximum of 1 week
Specific dosing for your patient: not used for my patient.
Potential side effects/adverse reactions/ nursing considerations: Angina, HTN, associated with
HA/seizures
Evaluation of Medication: shortening of third labor stage and reduction of blood loss causing
a rapid and sustained spasmodic uterine contraction by stimulating the rate, tone and
amplitude of uterine contraction; hold medication if HTN or if patient is pregnant.

Drug Name: Fentanyl
Drug Classification: local anesthetic
Pregnancy Risk Category: B
Indication for use in this area: decrease pain during vaginal childbirth.
Route and usual range of dose: epidural, 5-100 mcg
Specific Dosing for your patient: 50 mcg epidural
Potential side effects/adverse reactions/nursing considerations: intense itching, increased urination,
nausea, vomiting, increased risk of cardiac arrhythmias
Evaluation of medication: decrease of pain/increased pain tolerance