Oxytocin

A. Generic name: Oxytocin
B. Drug classification and Mechanism: Oxytocin is a protein produced by the pituitary gland of
mammals including man. Pitocin is a man-made version of oxytocin used for stimulating
contraction of the uterus. Oxytocin works by increasing the concentration of calcium inside
muscle cells that control contraction of the uterus. Increased calcium increases contraction of
the uterus. The FDA approved oxytocin in November 1980.
C. Dosage, frequency, and route: For inducing labor the dose is 0.5 to 1 milliunits/minute given by
intravenous injection and increased by 1 to 2 milliunits/minute every 15 to 60 minutes until
contraction pattern is close to normal. For controlling bleeding after birth the dose is 10 units by
injection at a rate of 20 to 40 milliunits/minute. Inevitable abortion is treated with 10 to 20
milliunits/minute not to exceed 30 units in a 12 hour period.
D. Side effects/adverse effects: Side effects of oxytocin include nausea, vomiting, severe allergic
reactions, bleeding after child birth, abnormal heart beats, high blood pressure, and rupture of
the uterus.
E. Nursing Implications/responsibilities:

Methergine
A. Generic name: Methergine
B. Drug classification and Mechanism: This medication is used after childbirth to help stop
bleeding from the uterus. Methylergonovine belongs to a class of drugs known as ergot
alkaloids. It works by increasing the rate and strength of contractions and the stiffness of the
uterus muscles. These effects help to decrease bleeding. Take this medication by mouth with or
without food, usually 3 to 4 times daily for up to 1 week after delivery or as directed by your
doctor.Dosage is based on your medical condition and response to treatment.Use this
medication regularly to get the most benefit from it. To help you remember, take it at the same
times each day.Tell your doctor if your condition persists or worsens.
C. Dosage, frequency, and route:
a. Parenteral drug products should be inspected visually for particulate matter and
discoloration prior to administration.

Intramuscularly
1 mL, 0.2 mg, after delivery of the anterior shoulder, after delivery of the placenta, or during
the puerperium. May be repeated as required, at intervals of 2-4 hours.

Intravenously
1 mL, 0.2 mg, administered slowly over a period of no less than 60 seconds (See WARNINGS)

Orally
One tablet, 0.2 mg, 3 or 4 times daily in the puerperium for a maximum of 1 week.
D. Side effects/adverse effect: Headache, nausea, vomiting, or dizziness may occur. If any of these
effects persist or worsen, tell your doctor or pharmacist promptly.Remember that your doctor
has prescribed this medication because he or she has judged that the benefit to you is greater
than the risk of side effects. Many people using this medication do not have serious side effects.
E. Nursing Implications/responsibilities:

Cytotec
A. Generic name: misoprostol
B. Drug classification and Mechanism: Misoprostol is a synthetic (man-made) prostaglandin that is
used to reduce the risk of stomach ulcers in patients treated with nonsteroidal antiinflammatory
drugs (NSAIDs, for example, aspirin, ibuprofen, etc.) that are used for pain and various
inflammatory conditions, for example, arthritis. Misoprostol is used primarily in patients at high
risk for stomach ulcers when treated with NSAIDs, for example, the elderly, patients with
concomitant debilitating diseases, and patients with a history of ulcers. Prostaglandins are
chemicals that are made within many organs of the body including the stomach. In the stomach,
prostaglandins are believed to protect the inner lining of the stomach from the ulcer-producing
effects of NSAIDs. Scientists now believe that NSAIDs produce ulceration by preventing the
production of prostaglandins in the stomach. Synthetic prostaglandins such as misoprostol given
orally "replace" the prostaglandins whose production is inhibited by NSAIDs and have been
shown to protect the lining of the stomach from NSAID-induced ulcers. Misoprostol was
approved by the FDA in December 1988.
C. Dosage, frequency, and route: The recommended adult oral dose for reducing the risk of
NSAID-induced gastric ulcers is 200 mcg four times daily with food. If this dose cannot be
tolerated, a dose of 100 mcg can be used.
D. Side effects/adverse effect: Common side effects include diarrhea and abdominal pain.
Diarrhea is more common with higher doses and usually goes away with continued
administration. Rarely, profound and persistent diarrhea necessitates stopping the drug. Less
common side effects include headache, menstrual cramps, nausea, and flatulence.
E. Nursing Implications/responsibilities:

Vitamin K
A. Generic name: Vitamin K
B. Drug classification and Mechanism: Vitamin K is used to treat and prevent low levels of certain
substances (blood clotting factors) that your body naturally produces. These substances help
your blood to thicken and stop bleeding normally (e.g., after an accidental cut or injury). Low
levels of blood clotting factors increase the risk for unusual bleeding. Low levels may be caused
by certain medications (e.g., warfarin) or medical conditions (e.g., obstructive jaundice). Vitamin
K helps to treat and prevent unusual bleeding by increasing the body's production of blood
clotting factors.
C. Dosage, frequency, and route:
D. Side effects/adverse effect: Pain, swelling, or soreness at the injection site may occur.
Temporary flushing, taste changes, dizziness, rapid heartbeat, sweating, shortness of breath, or
bluish lips/skin/nails may also infrequently occur.
E. Nursing Implications/responsibilities:

Lidocaine
A. Generic name: Lidocaine
B. Drug classification and Mechanism: Lidocaine is an antiarrhythmic agent (affects heart rhythm)
as well as a local anesthetic (amide type). It is similar to bupivacaine and procaine. Lidocaine,
like other local anesthetics causes a loss of sensation by reducing the flow of sodium in and out
nerves to decrease the initiation and transfer of nerve signals. Compared to procaine, lidocaine
has a more rapid onset, longer duration of action, and more potent activity. Lidocaine works as
an antiarrhythmic by also decreasing conduction of electrical signals in damaged (ischemic)
heart tissue. Lidocaine was approved by the FDA in November 1948.
C. Dosage, frequency, and route: The initial dose for anesthesia in adults depends on the
procedure, necessary depth of anesthesia, blood flow to the region, desired duration of
anesthesia, and condition of the patient. For anesthesia, the maximum dose is 4.5 mg/kg and
should not exceed 300 mg per dose. For control of arrhythmias (abnormal heart rhythm), an
initial intravenous or intraosseous (injected into bone) dose is 1 to 1.5 mg/kg. If providing dose
by endotrachial tube the initial dose is 2 to 3.75 mg/kg. Lidocaine is rapidly metabolized. Any
conditions that later liver functions may alter the half live of lidocaine.
D. Side effects/adverse effect: Side effects vary by dose and site of administration. The most
common adverse reactions include low heart rate, low blood pressure, backache, dizziness,
lightheadedness, and numbness. Additional side effects include shivering, tingling, sedation,
blurry vision, confusion, nervousness, and euphoria. Rare, but serious side effects include
cardiac arrest, methemoglobinemia, breakdown of cartilage, seizure, and loss of consciousness.
E. Nursing Implications/responsibilities:

Demerol
A. Generic name: Demerol
B. Drug classification and Mechanism:
C. Dosage, frequency, and route:
D. Side effects/adverse effect:
E. Nursing Implications/responsibilities: