Trade/generic: Pitocin (oxytocin) Class : Oxytocic, hormones Indications: Stimulates or induces labor. Facilitates of threatened abortion, Post-partum control of bleeding Action : Stimulates uterine smooth muscle, produces contraction similar to those in spontaneous labor. Has vasopressor and antidiuretic effects. Induction of labor, control of postpartum bleeding. Contraindications : Hypersensitivity, anticipated nonvaginal delivery. Use cautiously in first and second stages of labor S/E : Maternal: come, seizures, hypotension, hypochloremia, hyponatremia, water intoxication, increases uterine motility, painful contractions, decreased uterine blood flow, hypersensitivity. Fetal: intracranial hemorrhage, asphyxia, hypoxia, arrhythmias Implications : Asses character, frequency and duration of contractions. Assess fetal heart rate Dosage : Stimulation of labor: IV: 0.5-1milliunits/ min, increase by 1-2 milliunits/min q 30-60min until desired contraction pattern is established. Post-partum Hemorrage: IV: 10 units infused at 20-40 miliunits/min IM: 10 units after delivery of placenta. Incomplete abortion: IV: 10 units at a rate of 20-40 milliunits/min Interactions : Severe hypertension may occur if oxytocin follows administration of vasopressors
Trade Name(s): Narcan (naloxone) Classification : Opioid antagonist, antidotes (for opiods) Use(s): Reverses narcotics, treat respiratory depression caused by narcotics and narcotic overdose Action : Competes with opioids at opiate receptor sites without producing any agonist effects. Contraindications : Hypersensitivity. May cause acute withdrawal syndrome in mother na fetus if morhter is opiod dependent. Safety not establishd in lactation. May cause acute withdrawl syndrome in neonates of opiod-dependent mothers Side Effects : Ventricular arrhythmias, hypertension, hypotension, nausea and vomiting Nursing implications : Withdrawal symptoms, respiratory & cardiac status, pain. Dosage : Post-operative opiod-induced respiratory depression: [Adults] IV: 0.02-0.2 mg q2-3 min until response obtained, repeat q1-2 hours if needed. [Neonates] IM,IV Subcut: 0.01 mg/kg; may repeat q2-3 min until response obtained Interactions : can precipitate withdrawl in pts physically dependent on opiod analgesics.
Trade Name(s): Stadol (butorphanol) Classification : Narcotic analgesic, opiate analgesic CONTROLLED SUBSTANCE IV Use(s) : Moderate to severe pain. Analgesia during labor, sedation before surgery, supplement in balances anesthesia. Action : Decreases pain impulse at the spinal cord level by interacting with opioid receptors. Contraindications : Hypersensitivity, Pts physically dependent on opiods OB, Lactation: Safety not established but has been used during labor Side Effects : confusion, dysphoria, hallucinations, sedation, euphoria, headache, respiratory depression, hypertension, hypotension, palpiations, nausea, constipation, dry mouth, urinary retention, sweating, clammy feeling, physical dependence Nursing implications : Assess pain, decreased output, CNS changes, allergic Rx and respiratory dysfunction.
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- Fall '19