DRUGS IN OBSTETRICS
DRUG INDICATION
Salbutamol
(B2 agonist)
Indomethacin
(prostaglandin inhinitor)
Nifedipine (Adalat)
(Ca2+ channel blocker)
Methyldopa
(Aldomet)
(alpha2 antagonist)
Labetalol
(Beta Blocker)
Hydralazine
(peripheral vasodilator)
Magnesium Sulphate
(MgSO4)
Calcium Gluconate
Misoprostol (Cytotec)
(prostaglandin E1 analogue)
DOSAGE SIDE EFFECTS CONTRA-INDICATION
250mcg (5ml) diluted in 20ml NS IVI over 5 Postural Hypotension CVS dz, tachycardia, DM
minutes Pulmonary Oedema
Tocolytic agents
(1ml to 9ml NS to make 50mcg/ml to Maternal Depression
(supress uterine administer 5ml) Nausea
contractions) 100mg rectal suppository Tachycardia >32 weeks, Ulcers, Renal Impairment
Tocolytic agent & LD: 10mg PO STAT Headache, Dizziness, Nausea CVS dz, HPT and hypotension
Antihypertensive MD: 10mg PO TDS, up to 20mg PO QID flushing, postural hypotension
Can cause pulmonary oedema
in diabetic patients
LD: 1g PO STAT Sedation, depression, dizziness. acute hepatitis, direct coombs
MD: 500mg PO QID nightmares, headache, dry positive test suggestive of haemolytic
mouth, nasal congestion, salt, anaemia, phaeochromocytoma,
and water retention, abnormal hypersensitivity
LFTs, haemolytic anaemia
(rare), rash, nausea, vomiting
LD: 200mg in 200ml NS over Postural hypotension, hypovolemia, heart attack within last
Antihypertensive
20/40/80ml/hr titrated up against ptx BP headache, wheezing, skin 30 days, CAD, stroke, low BP, Lupus-
every 30min rashes like symptoms, increased ICP
25-50mg PO QID Tachycardia, flushed feeling, obstructed airways like asthma, AV
(max 200mg/day) nausea, vomiting, headache, node block, overt cardiac failure,
anorexia, postural hypotension severe bradycardia, cardiogenic
shock, severe hypotension,
hypersensitivity to drug
Zuspan: Toxicity: myasthenia gravis, severe renal
- LD: 4g in 200ml NS IVI over 20min Respiratory Depression failure, cardiac ischaemia, heart
- MD: 1g/hr by infusion pump Hyporeflexia block, pulmonary oedema
Prichards: Hypotension
Seizure prophylaxis Maternal Death from overdose
- LD (14g): 4g in 200ml NS IVI over
Foetal  reduced HR variability
20min AND 10g (5g in each bum
and respiratory depression
IMI)
- MD: 5g IMI in each bum 4hrly
Treat MgSO4 toxicity 10mg of 10% in 10min
(antidote) (rule of 10s)
Induce labour PV: 50mcg in primi followed 6hr later w Hyperstimulate uterus (risk Previous uterine surgeries e.g., c/s,
oral dose uterine rupture and foetal myomectomy, grand multiparous
 Oral: 200mcg in 200ml H20 (start w this in distress) women
multi) – give 20 ml of solution, 2 hourly N+V, Diarrhoea
(do not exceed 4 doses) Headache, dizziness, fever
Oxytocin Induce strong uterine Post delivery: 10IU/ml IMI N+V Hypertonicity of uterus
(Syntocinon) contractions (used to Primi: 10IU to 1L MRL at 12ml/hr Cardiac arrythmias Risk of uterine rupture
augment labour) Multi: 2IU to 1L MRL at 60ml/hr Hypertonic contractions Obstetric contraindications for NVD
Cardiac dz: 2IU to 200ml MRL at 12ml/hr

Syntometrine Induce strong uterine 0.5mg/ml IMI Cannot use for IOL
(ergometrine + oxytocin) contractions (post HTN, Cardiac dz, Peripheral vascular
delivery to rx PPH) dz
Tranexamic acid Procoagulant (used to 1g stat
(Cyclocapron) Rx PPH)
Warfarin Anticoagulant (used in 5-10mg PO dly pregnancy less than 12 weeks and
cardiac Dz from 13- more than 36 weeks (stop within 48
36wks) hours of delivery), thrombocytopenia,
bleeding diathesis, hypersensitivity,
coagulation defect with > 1.5 INR,
peptic ulcers in last 3 months, binge
alcoholic drinking, poorly controlled
or untreated HTN
Heparin Anticoagulant (used in LD: 5000iU in 200mls normal saline over effect of UFH should be
(UFH) cardiac dz, in 1st 30 minutes reversed with Protamine
trimester and from MD: 20 000iU in 200mls normal saline at Sulphate (1mg/kg for every
36wks+) 10ml.hr 100iu of heparin used in the
last 2hours)
Heparin (LMWH) 1mg/kg
Betamethasone Steroids 12mg IMI, 2 doses, 24hrs apart
Dexamethasone (foetal lung
maturation prior to
delivery in cases of
preterm delivery – ie:
PTL
Maxalon
Sulpiride Stimulate lactation
Domperidone
Cabergoline Supress lactation 1mg po single dose Headache, dizziness, syncope, Hx of pulm disorders, hx of pericardial
confusion, vertigo, depression disorders, hx of peuperal psychosis,
 toxaemia of pregnancy
Bromocriptine 2 N&V, dizziness, drowsiness, Hypertension, CVS dx
5mg po 12hrly for 2 weeks rarely acute
HPT,thromboembolism, MI and
CVA
Pyridoxine 200mg 8hrly 6 days Severe peripheral neuritis Hypersensitivity to active ingredient
Pethidine Analgesia in labour
Aterax (allowed up to: 6cm in 100mg IMI / IVI (1 dose)
primi and 4cm in multi)
Calcium (Ca2+) 1g PO dly (prophylactic for HTN)
Folic acid 5mg PO dly (prevent NTDs)
Supplements
Ferrous sulphate 200mg PO dly (if not anaemic)
60mg PO TDS (if anaemic)
Ampicillin 1g IVI every 6hrs
Metronidazole 400mg IVI 8hrly
Antibiotics
Gentamycin
Erythromycin