Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Methylergonovine maleate(Methergine, MethylergobasineMethylergobrevinMethylergonovine)

Indication:Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

2 Ampules immediately after the delivery of the Placenta

Methergine↓

Stimulates uterine smooth muscles

↓producing sustained

contractions↓

thereby shortens the third stage of

labor

Cardiovascular: hypertension, temporary chest pain, palpitation

CNS:Hallucinations, dizziness, seizure, headache

Gastrointestinal: Nausea, vomiting, diarrhea, foul taste

Local: Thrombophlebitis

Otic: Tinnitus

Renal: Hematuria

Respiratory: Dyspnea, nasal congestion

Miscellaneous: Diaphoresis

> contraindicated in patients hypersensitive to methylergonovine or any component of the formulation.

>ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics);

>hypertension; toxemia of pregnancy (PIH)

>Be alert for adverse reactions and drug interactions.

>This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.

>Monitor Uterine Contractions

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Oxytocin(Pictopin, Syntocinon)

Indication:Induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion

For stimulation of labor: 10 units (1ml) of drug infused in 1L D5LRS before deliver

For Reduction of Postpartum bleeding: 1 amp after delivery of placenta

Oxytocin↓

Causes potent and selective

stimulation of uterine and

mammary gland smooth muscles

↓producing sustained

contractions↓

Induces labor and milk ejection and

reduces post partum bleeding

Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias

CNS: seizures, coma from water intoxication

Gastrointestinal: Nausea, vomiting,

GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma

Hematologic: afibrinogenemia

Respiratory: anoxia, asphyxia

> Contraindicated in patients hypersensitive to the drug or any of its component.

> Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isn’t imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa.

> Also contraindicated in fetal distress.

> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15.

>Be alert for adverse reaction

>Monitor I/O. Antidiuretic effect may lead to fluid overload, seizures, and coma

>never give oxytocin simultaneously by more than one route.

>have 20% solution magnesium sulfate available for relaxation of the myometrium.

>If contractions are less than 2 minutes apart, if they’re above 50mm Hg ,or if they last 90seconds or longer, stop infusion, and turn patient on her side, and notify physician or midwife.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Hyoscine Butylbromide(Buscopan)

Indication:To reduce secretions perioperatively.

Given via IV, 1mg/ml to promote cervical effacement.

Hyoscine Butylbromide

↓Inhibits muscarinic

actions of acetylcholine in the

ANS↓

Affecting neural pathway

↓Relieves spasticity,

nausea and vomitting; reduces

secretions; and blocks cardiac vagal reflexes.

↓

Promotes cervical effacement

CNS: dizziness, headache, restlessness, disorientation, irritability, fever

GI: constipation, dry mouth, nausea, vomiting

CV: palpitations, tachycardia, flushing

EENT: dilated pupils, blurred vision, photophobia, dysphagia

GU: urinary hesitancy, urinary retention

Skin: rash, dryness

Contraindicated in patients with angle-closure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.

>Be alert for adverse reactions and drug interactions.

>Encourage pt. to void

>Monitor BP for possible hypotension.

>Monitor cervical effacement and dilatation.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Hydralazine(Apresoline)

Indication:Pre-eclampsia /eclampsia

5 mg/dose then 5-10 mg every 20-30 minutes as needed.

Hydralazine ↓

Directly relaxes arteriolar smooth

muscle↓

Vasodilaion↓

Lowers Blood Pressure

CNS: peripheral neuritis, headache, dizziness

CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations.

GI: n/v, diarrhea, anorexia

Hematologic: neutropenia, leukopenia, agranulocytopenia

Metabolic: weight gain, sodium retention

Skin: rash

Contraindicated to pt.s hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.

Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.

>Assess blood pressure before starting therapy and regularly thereafter.

>Instruct client to take oral form with meals.

>Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.

>Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs.

>Tell client to limit sodium intake.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Hydralazine(Apresoline)

Indication:Pre-eclampsia /eclampsia

5 mg/dose then 5-10 mg every 20-30 minutes as needed.

Hydralazine ↓

Directly relaxes arteriolar smooth

muscle↓

Vasodilaion↓

Lowers Blood Pressure

CNS: peripheral neuritis, headache, dizziness

CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations.

GI: n/v, diarrhea, anorexia

Hematologic: neutropenia, leukopenia, agranulocytopenia

Metabolic: weight gain, sodium retention

Skin: rash

Contraindicated to patients who are hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.

Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.

>Assess blood pressure before starting therapy and regularly thereafter.

>Instruct client to take oral form with meals.

>Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Phytomenadione(Vitamin K, Phylloquinone, menaquinone)

>To stimulate the clotting factors of the newborn>To prevent hemorrhagic disease of the Newborn.

0.1 cc via IM to the Vastus Lateralis of the newborn

Sterility of GI tract↓

Administration of Vitamin K

↓Increased Synthesis

of precursor proteins in the GIT mainly factors II, VII, IX, and X are

produced and increased.

↓From 30-60%

compared to adult clotting factor values, blood

clotting factors increase.

>The synthetic form of Vitamin K and Vitamin K3 (Menadione) can cause allergic reaction, Hemolytic Anemia, and Cytotoxicity in liver cells.

>Contraindicated to those who are hypersensitive to any component of Vitamin K containing products.

>Ensure that the adequate dose is given while following the proper IM Drug Administration.

>Apply pressure to the injection site to prevent further bleeding.

>Document the giving of the medication to newborn to prevent an accidental doubling of the dose.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Oxytetracycline(Terramycin Opthalmic Ointment, Terak, Terramycin with Polymyxin B)

To prevent infection of the eye which may derive from flora or present infections of the vagina during normal spontaneous delivery

To prevent Opthalmia neonatorum in infants.

1 cm strip applied from the inner canthus of the eye to the outer canthus

>Irritation>Redness>Tearing>Iching sensation

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Nubaine

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Lidocaine(Xylocaine)

>Injected prior to normal spontaneous delivery to anesthetize the area of the perineum to be used for episiotomy.

>Used as a local anesthesia for Cesarean section.

For normal vaginal delivery:50mg/ml of a 5% hyperbaric solution or 9mg-15mg (0.6ml-1ml) of a 1.5% solution.

For Cesarean Section:Up to 75 mg (1.5ml) of a 5% hyperbaric solution.

Lidocaine↓

Stabilizes the neuronal membrane

↓Inhibits sodium ion

movemnts↓

Conduction of impulses are

inhibited↓

Local loss of pain sensation

> Dizziness>Paresthesia>Drowsiness>Confusion>Respiratory Depression>Convulsions

>Hypovolemia>Heartblock>Other Conduction Disturbances

> Observe for untoward reactions such as drowsiness, depressed respiration, or seizures.

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Duvadilan

Maniulit, Joeanne Mae A.N-304 Group 3

Generic Name(Brand Name)

Indication Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Epinephrine

Maniulit, Joeanne Mae A.N-304 Group 3

Maniulit, Joeanne Mae A.N-304 Group 3