1 | P a g e H o l l y L . G a yDrug: (Methergine) / (Generic Name:methylergonovine)Classification:OxytocicsDosage:PO: (Adults) 200-400mcg (0.2-0.4 mg) q 6-12hr for 2-7 daysIM: IV (Adults): 200 mcg (0.2mg) q 2-4hr for up to 5 doses. Routes:PO, IM, and IVIndications:Prevention and treatment of postpartum or postabortion hemorrhage cause by uterine atony or subinvolution. Action:Directly stimulates uterine and vascular smooth muscle. Therapeutic Effects: Uterine Contraction. Side Effects:Stroke, dizziness, HA. EENT: Tinnitus. Resp: dyspnea. CV: Hypertension, arrhythmias, AV block, chest pain, palpitations. GI: nausea, vomiting. GU: cramps. Derm: Diaphoresis. Neuro: paresthesia. Misc: allergic reactions. Contraindications: Hypersensitivity, OB: Should not be used to induce labor; Lactation: do not breast fee during treatment. Concurrent use of potent CYP3A4 Inhibitors. Nursing Implications: Monito BP, Heart Rate, and uterine response frequently during medications administration. Notify HCP if uterine relaxation becomes prolonged or if character of vaginal bleeding changes. Assess for signs of ergotism (cold, numb fingers and toes, chest pain, N/V, HA, muscle pain, weakness). Teaching Points: Pt must avoid smoking, Notify HCP if infection develops. Medications may cause menstrual-like cramps. Drug: (Hemabate):(Generic Name:carboprost)Classification: OxytocicsDosage: IM/Test dose: (adults) mcg.Abortifacient IM: (adults) 250 mcg every 1.5-3.5 hr depending upon uterine response, may be increased to 500 mcg if several doses of 250 mcg produce inadequate response. Refractory Postpartum Uterine Bleeding IM: (adults): 250 mcg; may be repeated every 15-90 mins (total does not to exceed 2 days of continuous therapy or total does of 12 mg). Routes: IMIndications: Induction of mid-trimester abortion. Treatment of postpartum hemorrhage that has not responded to conventional therapy. Action:Causes uterine contractions by directly stimulating the myometrium.
2 | P a g e H o l l y L . G a yTherapeutic Effects: Expulsion of fetus. Control of postpartum bleeding. Side Effects: Dizziness, HA. Resp: wheezing. GI: Diarrhea, N/V, abdominal pain, cramps. GU: Uterine Rupture. Derm: flushing, Misc: Anaphylaxis, Angioedema, fever,chills, shivering. Contraindications: Hypersensitivity; Acute Pelvic Inflammatory Disease, Active pulmonary, renal, or hepatic disease. Nursing Implications: Monitor frequency, duration, and force of contractions and uterine resting tone. Notify HCP if contractions are absent or last more than 1 min.MonitorTemp, pulse BP periodically throughout course of therapy. Large does may cause HTN. Watch for anaphylaxis. Monitor for vaginal discharge and hemorrhage occur. Teaching Points: Explain purpose of vaginal examinations (to assess for trauma tocervix). Pt Should Notify HCP if fever and chills, foul smelling vaginal discharge, lower abdominal pain. Or increased bleeding occurs.
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