Drugs used during Labor and

Delivery
By Kelly Burgess

Prepared by: Ilona Rosabel G. Bitalac

BSN 412
 Intravenous line
 An intravenous line is usually inserted into
the woman's arm during labor in a hospital.
This line is used to give the woman fluids to
prevent dehydration and, if needed, to give
drugs.
 Premature Labor:
  The aim of medication in preterm labor is to prevent
delivery for as long as possible, with a focus on
holding off delivery for at least 24 hours to allow time
for lung-strengthening steroids to take effect on the
baby. Depending on the pregnancy, the patient and the
progression of the preterm labor, the following
medications may be used:
 Terbutaline: Used most commonly to treat asthma,
terbutaline is thought to relax the muscles of the
uterus.
 Drugs Used in Pregnancy

 While most people think of drugs and pregnancy only

in the context of pain relief, Dr. Blaskiewicz points
out that there are other situations during pregnancy
when a woman may be put on medication. Below is a
list of some conditions that may require the use of
drugs and what a doctor may prescribe:
Severe Nausea (also known as hyperemesis
gravidarum):
  This is estimated to affect up to 2 percent of pregnant
women. Medications that can be prescribed include
the following:
 Zofran: This is an antiemetic that is effective against
vomiting and nausea. Although it's a newer drug,
preliminary studies indicate that it causes no harm to
either Mother or Baby.
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: Prophylaxis and •Use with caution •Diarrhea A- document
Ondansetron prevention of during lactation. •Abdominal indication for
hydrochloride nausea and •Under 3 years of pain therapy
vomiting age •Malaise - assess for
Classification: •Chest pain dehaydration
Antiemetic •Fatigue P
•Agitation -report any rash/
Brand Name: •Blurred vision diarrhea
Zofran I-
Monitor vital signs
stricly
E-Prophylaxis and
prevention of
nausea and
vomiting
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: relax the During lactation •Wheezing A-
Terbutaline muscles of the •Flushing Document type,
sulfate uterus. •Sweating onset, characteristics
•Bad taste of symptoms
Classification: Used for •CNS P-
Sympathomim preterm labor stimulation Notify provider
etic direct •Muscle immediately if labor
acting cramps resumes
I-
Brand Name: Increase fluid intake
Bricanyl to help liquefy
secretions

Take medication
with meals
E-
Inhibition of
premature labor
Procardia: A calcium channel blocker, this treats pregnancy-
induced hypertension and inhibits preterm labor.
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: PID Hypersensitivity •Peripheral and A-
Nifedipine Premature and pulmonary Document indication
labor lactation edema for therapy
Classification: •Hypotension Note any pulmonary
Calcium •Palpitations edema
channel •Nausea P-
blocker •Constipation May take with or
•Depresion without food
Brand Name: •insomia I-
Procardia Note any
hypotensive
response
Maintain fluid intake
of 2-3L
E-
Decrease BP

Prevent premature
labor
 Indomethacin: Given as a suppository in the short
term. Delays premature labor by reducing uterine
contractions through inhibition of prostaglandins.

 Magnesium sulfate: Used to treat pre-eclampsia,

eclampsia and preterm labor
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: . Delays GI lesions •Parkinsonism A-
Indomethacin premature Rectal bleeding •Epilepsy Note disease onset,
labor by Defects of problems surgery and previous
Classification: reducing coagulation •Psychiatric treatments
NSAID uterine problems P-
contractions Store in amber
Brand Name: through colored containers
Indocin inhibition of I-
prostaglandin Take with foods or
s. milk
Withhold drug and
report lack of
response
Record weight
E-
Decrease pain and
inflammation
Reduce uterine
contractions
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: For Heart block/ MI •Depression A-
Magnesium eclampsia Patients with •Flushing Evaluate cardiac status
sulfate renal disease •Hypotension and ECG
Inhibits •Sweating P-
Classification: premature •Muscle Continually asses FHT
Anticonvulsan labor paralysis intensity and
t, laxative, •hypocalemia contraction.
saline I-
Adjust dose for CNS
depressants
Do not administer for
2 hr preceding
delivery
E-
Treatment of
eclampsia and inhibits
premature labor
 Induction of Labor
 : This is often done for a variety of medical reasons
and rarely just for convenience. A patient who is
being induced will be watched carefully for rare side
effects that are possible with the following
medications:
 Cervidil and Cytotec:
 Both are administered as vaginal suppositories to
ripen the cervix prior to delivery. This is the first step
in preparing the cervix to respond to contractions.
Cytotec, while very effective, has been implicated in
some uterine ruptures and should not be used under
certain circumstances.
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: Produce Allergy to •Diarrhea A-
Misoprostol cervical prostaglandin •N & V Document any ulcer
ripening and •Spotting disease
Classification: labor lactation •Vaginal P-
Prostaglandin induction bleeding Do not share
(used Po and •Headache medications
Brand name: vaginally) •Flatus I-
Cytotec •contipation Avoid caffeine alcohol
Report any abnormal
bleeding
E-Produce cervical
ripening and labor
induction
 Pitocin
 : The synthetic form of oxytocin, which is a
natural hormone produced by a woman's body,
Pitocin is used to start or improve contractions
Name of Drug Indication Contraindication Adverse Effect Nursing
Consideration
Generic: Induction or Hypersensitivity •N & V A-
Oxytocin stimulation of to drug •Cardiac Determine fetal
labor at term arrhytmia maturity
Classification: •Pelvic P-
Oxytocic drug hematoma Provide continous
•Tachycardia observation.
Brand name: •Edema I-
Pitocin •Anxiety Remain with the client
•cyanosis during the induction
Assess for water
intoxication
E-
Induction of labor
with effective uterine
contractions.
 Drugs Used for Delivery
 By far the most common use of all drugs in active
labor are for pain relief. Dr. Samuel Hughes, professor
of clinical anesthesia and peri-operative says today's
focus is on finding a balance between providing
effective pain relief and allowing the mother to
actively engage in the process.
 Making birth enjoyable (or at least bearable!) is the
point of pain relief. These are some of the medications
anesthesiologists and nurse anesthetists use to help
patients in labor:
 Narcotics: Marketed under various names, narcotics
are used early in labor to take the edge off pain.
They're generally administered by injection or
intravenously. The drawbacks are that they do cross
the placenta and should not be given if birth is
imminent or if labor is progressing quickly.
 Sedatives: Given to ease anxiety, these are usually
injected. They do not provide pain relief and are not
commonly used unless the patient is in very early
labor.
 Nitrous oxide: This is used frequently in the United
Kingdom, less so in the United States, mostly for
reasons having to do with ventilation issues. This is
an inhaled gas that can ease pain early in labor.
 Spinal blocks and epidurals
 : Technically, these are not medications, but they're
important delivery methods for reg ional pain
medications. Dilute local anesthetics and opiates are
the most common drugs given this way. With a spinal
block, the medication is given only once, by injection
into the spinal fluid. This gives immediate relief from
pain, but it can wear off before labor is done.
 With an epidural, the doctor has greater control over
long-term pain relief and a greater variety of drug
combinations and dosages. Sometimes both
techniques are used in combination to provide both
immediate and long-term pain relief. This
combination is part of a trend to tailor analgesics to
provide pain relief while maximizing the mother's
mobility. Either of these techniques can be used in
case of a Cesarean section.
 Local anesthesia
  numbs the vagina and the tissues around its opening.
Commonly, this area is numbed by injecting a local
anesthetic through the wall of the vagina into the area
around the nerve that supplies sensation to the lower
genital area (pudendal nerve). This procedure, called a
pudendal block, is used only late in the second stage
of labor, when the baby's head is about to emerge
from the vagina.