Trade Name: Methergine Classification : ergot alkaloids Uses : Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or subinvolution. Action : Directly stimulates uterine and vascular smooth muscle. Contraindications : Hypersensitivity; OB: Should not be used to induce labor; Lactation: Do not breast feed during treatment and for 12 hours after the last dose Side effects : STROKE, dizziness, headache, HYPERTENSION, arrhythmias, AV block, chest pain, palpitations, dyspnea, tinnitus Nursing implications : Monitor BP, heart rate, and uterine response frequently during medication administration. Notify health care professional promptly if uterine relaxation becomes prolonged or if character of vaginal bleeding changes. Dosage : PO: (Adults) 200–400 mcg (0.2–0.4 mg) q 6–12 hr for 2–7 days. IM: IV: (Adults) 200 mcg (0.2 mg) q 2–4 hr for up to 5 doses. Interactions : Nicotine, Dopamine, Beta-Blockers, Clarithromycin, Ritonavir, Indinavir, Nelfinavir, Ketoconazole, Intraconazole, Voriconazole, Saquinavir, Nefazodone, Fluconazole, Fluoxetine, Flyvoxamine, Zileuton, Nevirapine, Rifampin.
Trade Name: Hemabate (carboprost tromethamine) Classification : oxytocics, prostaglandins Uses : 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. Contraindications : Hypersensitivity Acute pelvic inflammatory disease, Active pulmonary, renal, or hepatic disease. Side effects: UTERINE RUPTURE, ANAPHYLAXIS, ANGIOEDEMA, fever, chills, shivering, wheezing Nursing implications : Monitor for signs and symptoms of anaphylaxis (wheezing, chest tightness, dyspnea, rash, pruritus, swelling of face, lips, or throat). Provide supportive care if symptoms occur. Dosage : IM: (Adults) 100 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 (not to exceed 2 days of continuous therapy or total dose of 12 mg). Refractory Postpartym Uterine Bleeding - IM: (Adults) 250 mcg; may be repeated every 15–90 min (total dose not to exceed 2 mg). Interactions : Augments the effects of other oxytocic agents.
Trade Name: Cytotec Classification : prostaglandins Uses : Prevention of gastric mucosal injury from NSAIDs, including aspirin, in high-risk patients (geriatric patients, debilitated patients, or those with a history of ulcers). Action : Acts as a prostaglandin analogue, decreasing gastric acid secretion (antisecretory effect) and increasing the production of protective mucus (cytoprotective effect Contraindications : OB: Should not be used to prevent NSAID- induced gastric injury due to potential for fetal harm or death; Lactation: May cause severe diarrhea in the nursing infant.
- Fall '19