Term
Magnesium Sulfate
Classification
Anticonvulsant
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Definition
Uses
1. Used to manage pregnancy-associated hypertention to prevent seizures in severe preclampsia
2. Used to inhibit preterm labor because of the additional effect in quieting uterine activity (Tocolytic).
Administration (Tocolytic, IV)
Loading dose- 4-6 g given over 30 minutes
Maintenance- 1-4 g/hr
Administration guidlines
Urine output of at least 30 ml/hr
Presence of deep tendon reflexes
At least 12 respirations/min
Contraindications
Patients with myocardial damage, heart block, myasthenia gravis, impaired renal function
Adverse reactions
Flushing, sweating, hypotension, depressed deep tendon reflexes, CNS/Respriatiory depression
Nursing Interventions
Check heart and lung sounds with hourly vitals
Check bowel sounds every 4-8 hrs
Check Serum Magnesium levels and use Calcium gluconate (10%) as an antidote |
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Term
Terbutaline (Brethine)
Classification
Beta adrenergic agent |
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Definition
Action
Stimulate beta-adrenergic receptors of sympathetic CNS. Brochodilation, inhibition of uterine muscle activity, increase pulse rate, increase pulse pressure
Indications
Stop preterm labor. Tolerance and loss of tocolytic effect occurs with prolonged usage
Dosage and Route
IV: 0.01 to 0.05 mg/min. Increase rate if needed to stop contractions by 0.01 every 10-30 min (maximum of 0.08) Maintain dose for 1 hour and decrease rate slowly at 20 min intervals if pulse rate remains over 120 bpm or systolic bp falls below 80-90 mmHg.
SubQ: Most common route. 0.25 mg every 4 hrs.
Oral: 2.5-5 every 2-4 hrs
Contraindications
Hypersensitivity. 20 weeks of gestation and if continuing the pregnancy is hazardous to mother or fetus
Adverse Reactions
Cardio- Maternal and fetal tachycardia, palpations, dysrhythmias, chest pain, wide pulse pressure
Respiratory- Dyspnea, chest discomfort
CNS- Dizziness, headache
Metabolic- Hypokalemia, Hyperglycemia
Nursing Considerations
Explain common side effects and check vital signs |
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Term
Misoprostol (Cytotec)
Classification
Antiprogesterone |
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Definition
Used in conjuction with Mifepristone as means for fetal abortion up to 9 weeks of gestation. Also used to treat post partum hemmorage
Administration-
Initial dose is 600 mg PO of Mifepristone followed by 400 mcg (PO or vaginal) of misoprostol 48 hrs later
Contraindications
Women with hypersensitivity to prostaglandins; acute inflammatory pelvic disease, cardiac/pulmonary/renal/hepatic disease, anemia, jaundice, diabetes, epilepsy, uterine scarring
Adverse reactions
Nausea, Vomiting, Diarreah, fever, chills hyper/hypotention
Nursing considerations:
Inform patient of risk and adverse reactions associated with this drug.
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Term
Nifedipine (Procardia)
Classification
Calcium channel blocker (tocotytic)
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Definition
Dosage/Route
Continued PO therapy- 10-20 mg every 3-6 hrs until muscle contractions are rare. Then administer 30-60 mg every 8-12 hrs until antepartum steroids have been administered.
Contraindications
Patients with low BP
Adverse effects
Orthostatic hypotention, Dizziness, Headace, nausea, Tachycardia
Nursing Considerations
Moniter vital signs and glucose levels |
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Term
Carboprost Tromethamine (Hemabate, Prostin/15m)
Classification
Prostaglandin, Oxytocin
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Definition
Used in abortion. Also used to treat post partum hemmorage
Administration-
Postpartum hemorage- 250 mcg IM. May repeat at 15-90 min intervals. Not to exceed 2 mg.
Contraindications
Women with hypersensitivity to prostaglandins; acute inflammatory pelvic disease, cardiac/pulmonary/renal/hepatic disease, anemia, jaundice, diabetes, epilepsy, uterine scarring
Adverse reactions
Nausea, Vomiting, Diarreah, fever, chills hyper/hypotention
Nursing considerations:
Inform patient of risk and adverse reactions associated with this drug. |
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Term
| Methylergonovine Maleate (Methergine) |
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Definition
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Action- increases strength, uterine contraction, decreases uterin bleeding.
Uses - prevenstion/treatment of postpartum, postabortion hemorrhage due to atony
Dosage - PO,IV, IM
Consideration- Contraindicated during pregnancy. Small amounts distributed in breast milk.
Side effects- nausea, uterine cramping, vomiting. Occasional abdominal pain, diarrhea, dizziness
Adverse effects- Severe hypertensive episodesmay result in CVA, serious arrhythmias, seizures.
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Term
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Definition
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Action- Prevents allergic responses mediated by histamine. Prevents, relieves nausea/vomiting.
Uses- treatment of allergic conditions, motion sickness, nausea, vomiting.
Dosage- PO,IV,IM
Considerations- crosses placenta, unknow if in breast milk.
Side effects- drowsiness, disorentation, hypotension, confusion, syncope in elderly.
Adverse effects- paradoxical reaction manifested as excitation, anxiety, tremor, hyperactive reflexes, seiures.
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