DRUG NAME CLASSIFIC-

ATION
THERAPEUTIC
ACTION
INDICATIONS CONTRAINDICATIO
N
ADVERSE
EFFECTS
NURSING
CONSIDER-
ATION
Oxytocin
(Pitocin)
Oxytocic;
hormone
Synthetic form of
an endogenous
hormone
produced in the
hypothalamusan
d stored in the
posterior
pituitary;
stimulates the
uterus, especially
the gravid uterus
just before
parturition, and
causes
myoepithelium of
the lacteal
glands to
contract, which
results in milk
ejection in
lactating women.
- 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; 2nd
trimester
abortion
- Postpartum:
to produce
uterine
contractions
during the
third stage of
labor tocontrol
postpartum
bleeding or
hemorrhage
Significant
cephalopelvic
disproportion,
unfavorable fetal
positions
orpresentations,
obstetric
emergencies that
favor surgical
intervention,prolonge
d use in severe
toxemia, uterine
inertia, hypertonic
uterine
patterns,induction or
augmentation of
labor when vaginal
delivery is
contraindicated,
previous cesarian
section.
CV: cardiac
arrhythmias,
PVCs,
hypertension
subarachnoid
hemorrhage
Fetal effects:
fetal
bradycardia,
neonatal
jaundice, low
Apgar scores
GI: nauseas,
vomiting
GU:
postpartum
hemorrhage,
uterine
rupture, pelvic
hematoma,
uterinehyperto
nicity, spasm


Ensure fetal
position and
size and
absence of
complication
s that
arecontraindi
cated 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
- Lactation
defieciency
administratio
n
Methylergono
vine maleate
(Methergine)
Oxytocic A partial agonist
or antagonist at
alpha receptors;
as a result, it
increases
thestrength,
duration, and
frequency of
uterine
contractions.
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.
Contraindicated with
allergy to
methylergonovine,
hypertension,
toxemia,lactation,
pregnancy.
CNS:
Dizziness,
headache,
tinnitus,
diaphoresis
CV: Transient
hypertensionp
alpitations,
chest pains,
dyspnea
GI: Nausea
and vomiting
Assess
history of
allergy to the
drug.

Administer
by IM
injection or
orally unless
emergency
requires IV
use.Complic
ations 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
coldextremiti
es, severe
abdominal
cramping
Lidocaine
hydrochloride
(Dilocaine)
Local
anesthetic
Blocks the
generation and
conduction of
action potentials
in sensory
nerves by
reducing sodium
permeability,
reducing height
and rate of rise
of the action
potential,
increasing
excitation
threshold, and
slowing
conduction
velocity
Infiltration
anesthesia,
peripheral and
sympathetic
nerve blocks,
central nerve
blocks, spinal
and caudal
anesthesia
Contraindicated with
allergy to lidocaine or
amide-type local
anesthetics, CHF
cardiogenic shock,
2
nd

or 3
rd
degree AV
blocks
CNS:
headache,
backache,
septic
meningitis,
persistent
sensory
CV:
hypotensionD
ermatologic:
urticaria,
pruritus,
erythema,
edema
GU: urinary
retention,
urinary or
fecal
incontinence
Check drug
concentratio
ns carefully

Establish
safety
precautions
if CNS
changes
occur

Teach client
to report
difficulty
speaking,
thick tongue,
numbness,
tingling,diffic
ulty
breathing,
pain or
numbness at
site, swelling
or pain at
site
Terbutaline
Sulfate
(Brethine)
Tocolytic In low doses,
acts relatively
selectively at
beta 2-
adrenergic
receptors to
cause
bronchodilation
and relax the
pregnant uterus;
at higher doses,
beta 1selectivity
is lost and the
drug acts at beta
2 receptors to
cause typical
sympathomimeti
c cardiac effects
Tocolytic to
prevent
preterm labor
Contraindicated with
hypersensitivity to
terbutaline,
tachyarrythmias,
tachycardia,
hypertension,
lactation.
CNS:
restlessness,
apprehension,
anxiety, fear,
CNS
stimulation,
hyperkinesias,
insomnia,
tremors
CV: cardiac
arrhythmias,
palpitations,
angina pain,
changes in BP
and ECG
GI: Nausea,
vomiting,
heartburn,
unusual or
bad taste
Respiratory:
Respiratory
difficulties,
pulmonary
edema,
coughing,
bronchospasm
Use minimal
doses for
minimal
periods of
time; drug
tolerance
can occur

Maintain a
beta-
adrenergic
blocker on
standby in
case cardiac
arrhythmias
occur

Teach client
to report
chest pain,
dizziness,
insomnia,
weakness,
tremor
Nalbuphine
Hydrochloride
(Nubain)
Opioid
agonist-
antagonist
Nalbuphine acts
as antagonist at
specific
relief of
moderate to
severe pain,
Hypersensitivity to
nalbuphine or any
component, including
CNS:
Nervousness,
depression,res
Monitor BP
carefully
during IV

analgesic opioidreceptors
in the CNS
toproduce
analgesia
andsedation but
also acts tocause
hallucinations
andits antagonist
at mureceptors
used as a
supplement to
balanced
anesthesia, for
preoperative
and
postoperative
analgesia, and
for obstetrical
analgesia
during labor
and delivery.
sulfites;
pregnancy(prolonged
use or high dosages
at term)
tlessness,cryin
g,euphoria,flo
ating,hostility,
unusualdream
s,confusion,fai
ntness,halluci
nations
CV:
Hypertension,
hypotension,
bradycardia,
tachycardia
GI: Cramps,
dyspepsia,
bitter taste
administratio
n.

Monitor for
extrapyramid
al reactions,
and consult
physician if
they occur.

Monitor
diabetic
patients,
arrange for
alteration in
insulin dose
or timing if
diabetic
control is
compromise
d by
alterations in
timing of
food
absorption