• short acting opiate agonist, analgesic
• Dosage: 50-100mcg Q2H IV/IM
• Monitor: muscle rigidty, resp depression
• Contrain: opioid dependency

Demerol (meperidine)

CNS agent, analgesic, narcotic agonist

Dosage: IV 2.5-15mg Q4H

IM/subcut 5-20mg Q4H

Monitor: resp depression, convulsions, cardiac arrest, cardiovascular collapse, broncoconstriction

Contra: convulsive disorder

CNS agent, analgesic, narcotic agonist

Dosage: 10-20mg Q 3-6H subcut, IV/IM

Monitor: resp depression

Contra: hypersensitivity to drug

CNS agent, analgesic, narcotic agonist/antagonist

IM 1-2mg Q4H

IV 0.5-2mg Q4H

intranasal 1mg may repeat 90 sec

Monitor: resp depression

Contra: breastfeeidng, HTN, dependency, preeclampsia

Give via IV pump for precise dosage

Therapeutic range: 4-8mg/dl

Tx for preterm labor: loading dose 4-8g in LR sol over 20-60min

Maintenance dose: 2-4g/hr

Tx preeclampsia: loading dose 4-6g over 20-30 min

maintainence: 2-3 g/hr

Check levels Q 6-8H, monitor BP 10 min, assess reflexes, monitor FHR.

Antedote: Calcium gluconate

Induction of Labor: 10U in 1L fluids

Fluid restriction: 10U in 500mL

Expulsion of placenta: p expulsion 1 mL IM/IV

Used to control bleeding p delivery

assess pt Q 15min while receiving IV pitocin

Mgmgt of preterm labor

Route: IV 2.5-10mcg/min, increase by 5mcg/min Q10min until contractions stop

Assess: BP, pulse, contractions, FHR

Tx of infection

Route: PO

Assess: WBC, signs of anaphylaxis

May cause + direct Coombs' test

Apresoline (hydralazine)

HTN 

Route: IM, IV 5mg Q 15-20min if no response pp 20mg consider alternative

Assess BP, pulse, CBC, electrolytes

may cause + direct Coombs' Test

Reversal of folic acid deficiency

Route: PO, IM, IV

Assess: CNS system

Epidural local anesthesia

Route: epidural 10-20mL c continuous infuse at 6-14mL/hr

Assess: sensation, BP, P, resp rate

Adrenalin, antiastmatic, vasopressor, mgmt of reversible airway disease

Route: IM, IV, subcut, inhale

Use onyl if maternal benefit outweighs RISK

Emergency tx of hypermagnesium

Route: IV 7meq

Assess: pulse, BP, ECG

Monitor serum calcium level et mag level

Sedation during labor

Route: IM, IV

Dose: 50mg in early labor, add. dose of 25-75mg may be given 1-2 times at 4hr intervals

Do not exceed 100mg/24H

Assess: resp rate, BP

Mgmgt of HTN

Route: PO-100mg BID

IV-20mg initally

Assess: BP, P, resp depression, monitor I/Os

Antiarrhythmic, atrial fib, atrial flutter

Route: Po 0.75-1.5mg

IV

Assess: apical pulsex1min, ECG

Serum electrolyte levels, hepatic func

Bradycardia

Route: IV 0.5-1mg, may repeat Q5min

Don't exceed 2mg

Assess: vitals, ECG, bowel sounds, angina

electrolyte replacement

Route: PO

Assess: s/s of alkalosis, renal dysfunction

antiulcer agent, histamine H2 antagonist

Route: PO

Assess: abd pain, blood in stool, emesis, gastric aspirate

Monitor: CBC

anesthetic, used for epidural

Route: local

Assess: stinging, burning, contact dermatitis, erythema 

anti-infective to tx chalmydia, syphilis

Route: OU

Assess: WBC, wound, vaginal ithcing/discharge, loose foul smelling stools

Prevention of bleeding d/t hypoprothrombinemia

Route: PO, IV

Assess: PT, BP, P, occult bleeding

contraceptive hormone, tx endometriosis

Route: IM, subcut

Asess: BP, menstal hx, weight gain

anti-infective for bacterial vaginosis, trichomonas

Route: PO 7.5mg/kg, IV 15mg/kg

Assess: WBC, s/s of infection, wound, stool, neuro status

Tx of syphillis, gonorrhea, strep

Route: IM, IV

Assess: infection, WBC, s/s anaphylaxis, bowel func, wheezing

Stimulate uterine contractions

Dose: supp 20mg Q2H

Contra: HTN, asthma, active inflammatory disease

Give to RH- moms to prevent sensivitation to RH factor et prevent hemolytic disease in newborn  in subsequent preg

Dose: IM one vial w/in 72H of birth

IM one vital at 28wks if RH-

Ensure correct vial is crossmatched to correct mom

Adverse effects: soreness at site

Narcotic analgesic for moderate pain

Dose 1-2 tabs PO Q4H PRN

Monitor: Resp depression, apnea, bowel sounds, I/Os

Adverse rxns: hepatotoxicity, hypoglycemia, apnea, resp depression

glucocritcoid used to induce pulmonary maturation et decreased RDS in preterm infants

Dose: IM 12mg Qday for 2 days

Monitor: vitals, electrolytes and FSBS

Contra:

maternal infection, DM, gestational age >34 wks

Reverse resp depression that is caused by admin of opiate

Dosage: IV 0.4 -2mg, can repeat Q2-3 min

Contra: opiate dependency

Prevent et tx uterine atony p failed attempts to control bleeding w oxytocics

dose: 800-1000mcg PR

S/E: diarrhea, abd pain, HA

contra: allergy to prostaglandins

Sustained uterine contractions that help prevent/reverse postpardum hemorrhage caused by uterine atony

mgmt of postpardum subinvolution

Dose: IM 0.2mg Q2-3H onset 2-5min(5dose max)

PO 0.2mg Q4H (6dose max) onset 7-15min

IV-NOT RECOMMENDED

Monitor: HTN, palpations, chest pain, tinnitus, dizziness

Contra: labile or high BP, cardiac disease, use w caution during lactation