A. Maternity and Newborn Medications 1.

Rh(D) Immune Globulin (RhoGAM) IM Administered 28 weeks and again within 72 hrs after delivery, exposure to Rh-Positive blood Adverse reaction: elevated temp., tenderness at inj. site 2. Tocolytics (MINT): smooth muscle relaxation a. Magnesium Sulfate - CNS depressant and anticonvulsant, **antidote calcium gluconate Stop preterm labor b. Indomethacin (Indocin): prostaglandin c. Nifedipine (Procardia, Adalat, Nifedical): Calcium channel blocker d. Terbutaline (Brethine): beta-adrenergic agonist, cause bronchodilation 3. Bethasone and Dexamethasone: corticosteroids that increase production of surfactant Use 28 and 32 weeks gestation Monitor for signs of infection, WBC, blood glucose 4. Opiod Analgesics: moderate to severe pain IM/IV Antidote Naloxone (Narcan); Nalmefene (Revex) longacting opiod antagonist, no repeat doses Withdrawal, hypotension, muscle flaccidity, seizures, stupor, cold clammy skin, cyanosis, coma, resp. depression, dizziness, drowsiness, hypotension, urinary retension, fetal narcosis, sinusoidal-like fetal heart rate b. Meperidine hydrochloride (Demerol) c. Fentanyl (Sublimaze) and sufentanil (Sufenta) d. Butorphanol tartrate (Stadol) and nalbuphine (Nubain) 5. Prostaglandins: ripen cervix, stimulate uterine contractions, admin. vaginally a. Prostaglandin E2: Dinoprostone (Cervidil vaginal insert, Prepidil gel) Have client void before administration of med Discontinue when the Bishop score is 8 or more 6. Oxytocics (Pitocin): uterine stimulant Promotes milk let down Induction of labor Manages an incomplete abortion May cause Hypertonicity IVPB (Normal saline, lactated Ringers or 5% dextrose in water) Do not leave client unattended during infusion Administer 8 -10 liters of oxygen

Stop medication if uterine hyperstimulation or Non reassuring fetal heart rate, turn client on side, increase IV rate of normal saline Monitor signs of water intoxication 7. Ergot alkaloids: postpartum hemorrhage, stimulate uterine muscle, not administered before the delivery of the placenta a. Ergonovine maleate, ergometrine (Ergotrate Maleate): check b/p before administration, can cause hypertension b. Methylergonovine (Methergine) c. Oxcytocin (Pitocin) d. Prostaglandin F2: Carboprost tromethanmine (Hemabate) 8. Rubella Vaccine SQ before d/c to a nonimmune client, if titer is less than 1:8, assess allery to duck eggs, avoid pregnancy for 1 to 3 months 9. Lung surfactants restore surface activity to the lungs to prevent and treat resp. distress, admin. Intratracheal route and avoid suctioning for at least 2 hrs a. Beractant (Survanta) b. Calfactant (Infasurf) c. Poractant alfa (Curosurf) 10. Silver Nitrate: eye prophylaxis for the newborn, can cause chemical conjunctivitis, instillation can be delayed for 1 hr after birth, dont flush eyes after instillation 11. Vitamin K newborns deficient for the first 5 to 8 days, lack of intestinal flora Can cause hyperbilirubinemia in the newborn Admin. In the lateralis muscle of thigh 12. Hepatitis B Virus (HBV) vaccine IM B. Integumentary Medications 1. Poison Ivy treatment a. Calamine lotion, Burows solution compresses and/or Aveeno baths b. Topical corticosteroids c. Oral corticosteroids severe reactions and Benadryl d. Bentoquatam (Ivy Block); hydrocortisone (Ivy soothe, ivy stat); Isopropanol; cetyl alcohol (Ivy cleanse); zinc acetate 2. Atopic Dermatitis chronic inflammatory skin disease (eczema) Tx moisturizer, oral and topical glucocorticoids ( Tacrolimus, Pimecrolimus 1% cream (Elidel)) a. Methotrexate: systemic immunosuppressant b. cyclosporine (Sandimmune): systemic immunosuppressant c. Azathioprine (Imuran): systemic immunosuppressant 3. Topical Glucocorticoids immunosuppressant; anti-inflammatory, antipruritic, vasoconstrictive actions, can be absorbed into systemic circulation

AE: adrenal suppression (monitor cortisol levels); cushings syndrome, striae, skin atrophy, glaucoma, cataracts Monitor for infections a. Pimecrolimus 1% cream (Elidel) b. Tacrolimus (Protopic) 4. Actinic Keratosis prolonged exposure to sun, can progess to squamous cell carcinoma; topical medications a. Flurorouracil (Carac, Efudex, Fluoroplex)- effects DNA and RNA synthesis, results 2 to 6 wks, 1 to 2 mos for complete healing b. Diclofenac sodium (Solaraze) nonsteroidal anti-inflammatory, 3 mos to be effective c. Imiquimod 5% cream (Aldara) also used to treat venereal warts, 4 mos to be effective d. Aminolevulinic Acid (Levulan Kerastick) used with blue light photoactivation 5. Sunscreens apply 30 minutes before exposure to the sun, PABA or padimate O require 2 hrs application before sun exposure Can cause contact dermatitis and photosensitivity UV light greatest between the hours of 10:00 am and 4:00 pm 6. Psoriasis chronic inflammatory disorder that has varying degrees of severity Treatment to suppress the proliferation of kerationcytes or suppress the activity of inflammatory cells a. Topical med glucocorticoids for mild psoriasis; dont apply to face, groin, axilla, gentalia b. Anthralin (Dritho-Scalp, Psoriatec) at bedtime, can stain clothing, skin, hair c. Tazarotene (Tazorac) vit. A derivative, once daily in evening d. Calciportriene (Dovonex) analogue of vit. D, 1 to 3 wks to work, may cause hypercalcemia e. Coal tar suppress DNA synthesis, mitotic activity and cell proliferation, unpleasant odor f. Keratolytics soften scales and loosen the horny layer of the skin (salicylic acid, sulfur g. Systemic meds methotrexate; Acitretin (Soriatane): inhibits keratinization, proliferation and differentiation of cells; embryotoxic and teragenic, hepatotoxic, vit. A toxicity, dont take with tetracycline can cause ICP, kidney damage Cyclosporine (Neoral): immunosuppressant that inhibits proliferation of B and T cells h. Systemic biological medications Alefacept (Amevive) CD4 t-cell and lymphocytes Ustekinumab (Stelara) - monoclonal antibody; SE (upper respiratory infections);

 Phototherapy coal tar and UV B irradiation 7. Acne Products a. Topical Antibiotics Benzoyl peroxide Clindamycin (Cleocin) and erythromycin (Erythroderm) Dapsone (Aczone) Fixed dose combo: clindamycin/benzoyl peroxide (BenzaClin) and erythromycin/benzoyl peroxide (Benzamycin) b. Topical Retinoids Adapalene (Differin) Azelaic acid (Azelex) Tazarotene (Tazorac) vit. A derivative Tretinoin (Retin-A, Avita) c. Oral Medications Doxycycline (Vibramycin) Erythromycin (Ery-Tab) Isotretinoin (Accutane) highly teratogenic and cause fetal abnormalities; iPLEDGE Program Minocycline (Dynacin, Minocin, Solodyn) Tetracycline (Sumycin) d. Hormonal Meds Oral contraceptives Sipronolactone (Aldactone) 8. Burn Products a. Mafenide acetate (Sulfamylon): topical; SE hemolytic anemia, bone marrow depression b. Nitrofurazone (Furacin): topical, (1/16-inch film directly to burn); broad spectrum antibacterial activity c. Silver sulfadiazine (Silvadene): topical, broad spectrum activity, used to prevent sepsis, monitor CBC, WBC