Rx: Syntocinon

Oxytocin, Parenteral
Dosage and route Classifications and Action Indications Contraindication Nursing consideration
- IV infusion (Drip method) Antepartum: Induction or stimulation of Hypersensitivity to drug. Significant Don’t confuse Pitocin (oxytocin) with
Induction or stimulation of labor Classifications: labor at term. TO overcome true primary or cephalopelvic disproportion; unfavorable Pitressin ( vasopressin). Don’t confuse
Initial: 0.5-2 milliunits/min. secondary uterine inertia. Induction of labor fetal postion or presentations that are oxytocin with oxycontin.
Oxytoxic drug
Increase dose gradually in with oxytocin is indicated only under certain undeliverable without conversion prior to
increments of no more than 1-2 specific condition and is not usual because delivery. In obstetric emergencies where the 1.) To reconstitute add 1ml to
milliunits/min at 30-60 min Action: serious toxic effects can occur. benefit-to-risk ratio for either the mother or 1000ml of 0.9% aqueous Nacl
intervals until a contraction Acts on smooth muscle of the uterus to fetus favors surgical intervention. Fetal or Ringer’s lactate. Solutions
pattern has been established stimulate contractions; response Oxytocin is stimulated: distress where delivery is not imminent, contain’s 10 milliunits/ml
that is similar to normal labor. depends on the uterine threshold of prolonged use in uterine inertia or severe 2.) Use Y-Tubing system, with one
Rates exceeding 9-10 excitability. Is selective for the uterus, 1.) for uterine inertia toxemia, hypertonic or hyperactive uterine bottle containing IV solution
milliunits/min are rarely required. especially toward the end of pregnancy, 2.) for induction of labor increases of patterns, when adequate uterine activity does and oxytocin, and the other
during labor, and immediately ff. delivery. erythroblastosis fetalis, maternal not achieve satisfactory progress. Induction of containing only the IV solution.
Control of pastpartum Oxytocin stimulate rhythmic contractions diabetes mellitus, eclampsia and augmentation of labor where vaginal delivery This is allows for the drug while
bleeding add 10-40u (maximum of the uterus, increase the frequency of reeclampsia. is contraindicated, including invasive cervical maintaining the patency of the
of 40 u) to 1000ml of a existing contractions, and raises the tone 3.) For induction of labor after cancer, cord presentation or prolapsed, total vein when it is decided to
nonhydrating diluents and run at of uterine musculature, premature rupture of membranes placenta previa and vasa previa, active change to the drug-free
a rate needed to control uterine Onset IV: immediate; duration: within 1 in last moth of pregnancy when herpes genitalis. infusion bottle. Use constant
atony. hr after infusion stopped. labor fails to develop infusion pump to control the
IM: 3-5 min; duration:2-3hrs; t1/2; 1- spontaneously within 12 hr. Special concern: rate of infusion accurately.
Treatment of incomplete or 6min. Plasma clearance occurs mainly 4.) To hasten uterine involution 3.) Oxytocin is rapidly broken
inevitable abortion. Infuse 10u of by the kidney and liver; only small down by sodium bisulfate.
5.) To complete inevitable abortion Oxytocin is indicated for the medical rather
Have Mg sulfate immediately
oxytocin with 500ml amounts excreted unchanged in the after the 20th week of pregnancy than elective induction of labor. Data and
physiological saline solution or urine. information are not available to define the available to relax the uterus in
D5W in physiological saline benefit-to-risk consideration for using oxytoxin case of tetanic uterine
Postpartum: produces uterine contractions
infused at a rate of 10-20 for elective induction. contractions.
during the third stage of labor and to control
milliunits ( 20-40 drops/min). do postpartum bleeding or hemorrhage. 4.) Have the provider immediately
not exceed 30 u in a 12 hr due to available during
the risk of water intoxication. administration.

- IM
Control of postpartum bleeding,
give 10u after delivery of the
placenta.
Rx: Methergine
Methylerogonovine Maleate
Dosage and route Classifications and Action Indications Contraindication Nursing consideration
-IM; IV (Emergencies only) 1.) Management anf prevention of Pregnancy, toxemia, hypertension 1.) Store tablets below 25ºC(77ºF) in
0.2 mg q 2-4 hr following Classifications: postpartum and postabortal hemorrhage Ergot hypersensitivity. To induce tight, light-resistant containers.
delivery of placenta, of the Oxytoxic drug by producing firm uterine contractions labor or threatened spontaneous
anterior shoulder, or during the and decreasing uterine bleeding. abortions. Administration before 2.) Administer slowly over 1 min;
puerperium. Action: delivery of the placenta. Use with check V.S for evidence of shock or
Synthetic drug related to ergonovine. 2.) During the second stages of labor CYP3A4 Inhibitors (e.g. protease hypertension after IV administration.
-tablets Acts directly on the uterine smooth following delivery of the anterior shoulder, inhibitors, macrolide antibiotics,
0.2 mg 3-4 times per muscle to stimulate the rate, tone, but only under full obstetric supervision. azole antifungal drugs). 3.) Give only if solution is clear and
day in the puerperium and amplitude of uterine contractions. Investigational: Ergonovine has been colorless; discard ampules if discolored
It induces a rapid, sustained tetanic used to diagnose Prinzmetal's angina Special precaution:
uterotonic effect that shortens the (variant angina). Use with the caution in sepsis, 4.) Store ampule from 2-8ºC(36-46ºF)
third stages of labor and reduces obliterative vascular didease, protect from light.
blood loss. The uterus becomes more impaired renal or hepatic function,
sensitive to the drug towars the end during the second stage of labor, and
of pregnancy. Decreases the during lactation. Don't routinely use
boiavialability after Po use probably IV due to possible induction of
due to first-pass metabolism in the sudden hypertension and CVA.
liver. Onset (uterine contraction), Po:
5-10 min; IM 2-5 min; IV immediate
t 1/2, IV 2-3 min (initial) and 20-30
min (final) duration, Po,IM; 3hr, IV:
45 min. t 1/2 elimination : 3.4 hr
Rx: carbazochrome Na
Sulfonate 1mg
Vitamin k 10 mg
Vitamin k
Dosage and route Classifications and Action Indications Contraindication Nursing consideration
- 1 tablet daily Prevention of hemorrhage before and after Patient’s with a tendency to thrombophlebitis 1.) Explain to patient family the
It is recommended that 2 tablet Classifications: minor operation; purpuras, epistaxis, or phlepothrombosis. the indications for therapy and expected
daily be given for 1 week before gingival bleeding, hemoptysis, GIT result.
Hemostatic drug
and 1 week after operation. 2 bleeding, uterine bleeding and hemorrhage Special concerns:
tablet may be given 3-5 days due to hypoprothrombinemia. -G6PD deficiency 2.) stress the need for periodic lab test
before and 3-5 days after tooth Action: -Pregnancy to monitor coagulation levels
extraction and operation. Cardiovascular and hematopoietic
system. 3.) teach patient necessary foods high in
IM: Vitamin K to be included in diet

The recommended route of 4.) caution patient not to use OTC meds
administration is intramuscular, or take other supplements unless
being given at birth, and that this directed by physician.
should be as a single IM
injection: 5.) instruct patient to report symptoms of
bleeding

• Term babies 0.5-1mg 6.) stress the need to carry emergency.

IM soon after birth
• Preterm 0.5mg IM soon
after birth
Rx: Hyoscine hydrobromide
Scopolamine Hydrobromide
Dosage and route Classifications and Action Indications Contraindication Nursing consideration
- Opthalmic solution Opthalmic Use of transdermal system in children or 1.) give drops into the conjunctival sac
Cycloplegia/ mydriasis Classifications: 1.) For cycloplegia and Mydriasis in lactating women. followed by digital pressure for 2-3 min
diagnostic procedures. Ophthalmic use in glaucoma or infants less after instillation.
Cholinergic blockin drug, antiemetic
Adults 1-2 gtt of the 0.25% 2.) Preoperatively and postoperatively than 3 moths of age. Use of prophylaxis of 2.)not give alone for pain because it may
solution in the conjunctiva 1hr Rx: Isopthyoscine pothalmic, scopace intreatment of iriclaycutis. excess secretion in children, infants, geriatric cause delirium; use an analgesic or
prior to refraction. Action: 3.) Dilate the pupil in treatment of clients, diabetes, hypo or hyper thyroidism, sedative as needed
Anticholinergic with CNS depressants uveitis or posterior synehiae. narrow anterior chamber angle. 3.) Protect the solution from light.
Children 1 gtt of the 0.25% effects; produces amnesia when given
solution twice a day for 2 days with morphine and mepenidine. Inhibits Oral
prior to refraction uveitis. excessive motility and hyper tonus of the 1.) Prevention of motion sickness
GIT. 2.) Inhibits excessive motility and
Adults and children 1gtt of the In the presence of pain, delirium maybe hyper tonus of the GIT, including
0.25% solution in the conjunctiva produced. Causes pupillary dilation and conditions such as arritable bowel
1-4 times per day, depending in paralyzes the muscle required to syndrome, mild dysentery,
the severity of the condition. accommodate for dose vision. diverticulitis, pylorospasm,and
cardiospasm.
-Tablets, soluble
Prevent motion sickness. GIT Parenteral
motility and hyper tonus 0.4- 1.) Preanesthetic sedation and
0.8mg obstetric amnesia in conjunction
with analgesic
-Transdermal system 2.) Calming delirium
Antiemetic, antivertigo Transdermal: in adults for
Adults: 1 Transdermal system prevention of NSV associated with
placed on the poatauricular skin motion sickness or recovery from
to deliver 1mg over 3 days. anesthesia and surgery.
(apply at least 4hrs before
antiemetic effect is required) the
canadian product should be
applied about 12hr before the
antiemetic effect is desired.
Rx: ADCO-MEFENAMIC
ACID
Mefenamic
Dosage and route Classifications and Action Indications Contraindication Nursing consideration
Adult dose: Classification: 1.) give drops into the conjunctival sac
500 mg of mefenamic acid three Anti-pyretic or Anti-pyretic and Anti- Mefenamic acid is used for the relief of Mefenamic acid is contra-indicated in followed by digital pressure for 2-3 min
times daily with food. The inflammatory analgesics mild to moderate pain in acute and chronic patients with known sensitivity and in after instillation.
conditions including: pain of traumatic, patients who respond to aspirin and aspirin- 2.)not give alone for pain because it may
dosage may be reduced to 1 cause delirium; use an analgesic or
capsule (250 mg) three times arthritic or muscular origin; like medicines with sensitivity reactions like
sedative as needed
daily Action: dysmenorrhoea; headache and dental pain. bronchoconstriction, skin rashes and 4.) Protect the solution from light.
Mefenamic acid has analgesic, anti- Mefenamic acid reduces blood loss in urticaria. Mefenamic acid is contra-indicated
Children: inflammatory and anti-pyretic properties. menorrhagia where menorrhagia is due to in patients with peptic ulceration or having a
It inhibits the synthesis of ovulatory dysfunctional bleeding. Uterine history of gastro-intestinal bleeding and or
6 months to 5 mL three and other pathology should first be inflammatory bowel disease.
prostaglandins. Mefenamic acid shows
1 year: times per day excluded before prescribing Mefenamic Safety in pregnancy and lactation has not
central and peripheral action and it owes
2 - 4 years: 10 mL three these properties to its capacity to inhibit acid for this indication. It is also indicated been established. Do not use in epileptic
times per day cyclooxygenase. as an anti-pyretic in febrile conditions. patients or in patients with impaired hepatic
5 - 8 years: 10 mL four Mefenamic acid is used for the treatment of function.
times per day post traumatic conditions such as pain,
swelling and inflammation, for a maximum
9 - 12 years: 15 mL four
period of five days.
times per day

Mefenamic acid should not be

used for longer than seven days
at a time.