Labor and Delivery Unit Drugs

Drug

Phytonadion
e inj.
(VitK)

Rout
Nursing
e of
Resp.
Adm
in
injection Avoid IM inj;
use soft
toothbrush;
report
symptoms of
bleeding;
teach about
the
importance of
frequent lab
tests
PO

Cytotec
(Misoprostol
):

inj
Duramorph

Do not take if
pregnant; do
not take for
more than 4
wks unless
directed;
avoid OTC
preparations:
aspirin,
cough, cold
products,
condition may
worsen

Contra

Mechanism
of action

Hypersensitivit
y, severe
hepatic
disease, last
few weeks of
pregnancy

Needed for
adequate blood
clotting (factors
II, VII, IX,X)

Hypersensitivit
y to this
product or
prostaglandins;
Pregnancy (X)

Inhibits gastric
acid secretion;
may protect
gastric mucosa;
can increase
bicarbonate,
mucus
production

Allergy to other
opiates, acute
bronchial
asthma, upper

Pain relief

Side effects

Class

(CNS) HA, brain

damage
(GI) nausea,
decreased LFTs
(HEMA) hemolytic
anemia,
hemoglobinuria,
hyperbilirubinemia
(INTEG) rash, uticaria
(RESP) bronchospasm,
dyspnea, feeling of
chest constriction, resp
arrest
(GI) diarrhea, N/V,
flatulence,
constipation,
dyspepsia, abdominal
pain
(GU) spotting, cramps,
hypermenorrhea,
menstrual d/os

Vit K; fatsoluble
vitamin

Hypotension, resp
depression and/or resp
arrest; pruritus, urinary
retention, constipation,

opium

Gastric
mucosa
protectan
t;
antiulcer

(for
intrathecal
inj.)

Fentanyl

Magnesium
Sulfate, IV:

airway
obstruction

HA

Transdermal
Nasal
spray
SL spray
Inj

About CNS
changes,
physical
dependence,
not to use
with alcohol
or other CNS
depressants
(transdermal)
excessive
heat may
increase
absorption

Hypersensitivit
y to opiates,
myasthenia
gravis;
Pregnancy

Inhibits
ascending pain
pathways in
CNS, increases
pain threshold,
alters pain
perception by
binding to
opiate
receptors

IV,
Direct
IV,
Continu
ous IV
INF
route

Not for longterm; chilling

improves
taste; shake
suspension;
not to give at
bedtime; give
citris fruite
after to
counteract
taste;
expected
results

Hypersensitivit
y, abdominal
pain, N/V,
obstruction,
acute surgical
abdomen,
rectal bleeding,
heart block,
myocardial
damage

Inreases
osmotic
pressure, draws
fluid into colon,
neutralizes HCl

(CNS) dizziness,
delirium, euphoria,
sedation
(CV) bradycardia,
arrest,
hypo/hypertension
(EENT) blurred vision,
miosis
(GI) N/V, constipation
(gu) urinary retention
(INTEG) rash,
diaphoresis
(MS) muscle rigidity
(RESP) resp
depression, arrest,
laryngospasm
(CNS) muscle
weakness, flushing,
sweating, confusion,
sedation, depressed
reflexes, flaccid
paralysis, hypothermia
(CV) hypotension,
heart block, circulatory
collapse, vasodilation
(GI) N/V, anorexia,
cramps, diarrhea
(HEMA) prolonged
bleeding time
(META) electrolyte,
fluid imbalances

Opioid
analgesic

Electrolyt
e; anticonvulsan
t; saline
laxative;
antacid

IV
Penicillin G,
IVPB:

Carry ID if
allergic, shake
susp well;
report sore
throat, fever,
fatigue; report
diarrhea

Notify if you
are taking
OTCs or other
medications;
Betamethas
may interfere
one, IM
with vaccines;
(Celestone)
may need to
be on a saltrestriction diet
or take K+
supplements
Vag sup; Remain
Gel
supine for 10(prefille 15 min after
d
insertion of
syringe) sup, 2 hr after
;
insert, 15-30
Vag
mins after gel;
insert
report
excessive
cramping,
bleeding,
Cervidil
chills, fever;
(Dinoproston
avoid

Hypersensitivit
y to penicillin,
corn;
pregnancy (B)

IM

Intereferes with
cell-wall
replication of
susceptible
organisms; in
cell death

Decreases
inflammation

C-section,
surgery, fetal
distress,
multiparity,
vaginal
bleeding,
cephalopelvic
disproportion
Pregnancy (C)

Stimulates
uterine
contractions,
causing
abortion; acts
within 30 hr for
complete
abortion

(RESP) resp
depression
(CNS) lethargy,
hallucinations,
depression, twitching
(GI) N/V, diarrhea
(GU) vaginitis,
moniliasis
(META) alkalosis,
hypernat
hypo/hyperkalemia
(MISC) local pain
Black/tarry stools;
blurred vision; bluish
skin; unusual bleeding
or bruising; muscle
weakness/cramps;
sudden/severe
stomach pain, n/v

(CNS) HA, dizziness,

chills, fever, flushin
(CV) hypotension,
dysrhythmias, DIC
(EENT) blurred vision
(SYST) anaphylactoid
syndrome of
pregnancy
(FETAL) bradycardia
(GU) baginitis, vaginal
pain, vulvitis,
vaginismus
(GI) N/V, diarrhea

Broadspectrum
antiinfective

Corticosteroid

Oxytocic,
abortifacient

e)

Ephedrine
Sulfate:

intercourse,
tub baths,
douches,
tampon use
for at least 2
wks

Inj
subcut
IM
IV

Angle closure
glaucoma; if
vasopressor
drugs may be
contraindicated

Inj
IM

Possible
cervical
trauma

IV
SUBCUT
IM

Report CNS
Addiction;
changes,
pregnany (C)
physical
dependency
can result
with long term
use;
withdrawal
symptoms

Hemabate

Nubain
(Nalbuphine)

(INTEG) rash, skin

color changes
(MS) leg cramps, joint
swelling, weakness
(GEL) uterine
contractile
abnormality, back pain,
fever
(INSERT) uterine
hyperstimulation,
fever, N/V, diarrhea,
abdominal pain
(SUPPOSITORY)
uterine rupture,
anaphylaxis
Nervousness, anxiety,
dizziness, HA, N/V, loss
of appetite, or trouble
sleeping

Bronchodilator

Indices abortion Pelvic pain, cramping,

oxytocic
vaginal bleeding; high
fever; lightheadedness or SOB;
N/V diarrhea; increased
BP
Depresses pain (CNS) drowsiness,
Opioid
implse
dizziness, confusion,
analgesic
transmission at HA, sedation, euphoria
the spinal cord
(CV) palpatations,
level by
bradycardia, change in
interacting with bp
opioid
(EENT) tinnitus,
receptors
blurred vision
(GI) N/V anorexia,

may occur;
avoid CNS
depressants/E
TOH

inhalant

Terbutaline
(Brethine)

inj
Bupivacaine
(for
intrathecal
inj.)

IM
IV

No smoking;
up fluids by
>2 L/day;
allow 15 mins
btwn
inhalation of
product &
inhaled
product
containing
steroid; if
missed, not to
make up after
1 hr, to wait
until next
dose
Alert if you
have asthma,
diabetes,
liver, kidney,
heart disease,
seizures, MG,
thyroid
problems,
circulations,
hypo/HTN
Report
increased
blood loss,

Hypersensitivit
y to
sympathomime
tic, closed
angle
glaucoma,
tachydysrthymi
as

Serum toxemia,
cephalopelvic
disproportion,

Relaxes
bronchial
smooth muscle;
bronchodilation
, diuresis,; CNS,
cardiac
stimulation
occur; relaxes
uterine smooth
muscle

constipation, cramps
(GU) increased urinary
output, urinary
retention
(INTEG) rash
(RESP) resp
depression
(CNS) tremors,
anxiety, insomnia, HA,
dizziness, stimulation
(CV) palpitations,
tachycardia, HTN,
dysrhythmias
(GI) N/V
(META) hypokalemia,
hyperglycemia
(RESP) paradoxical
bronchospasm,
dyspnea

Selective
B2agonist;
bronchodilator

May prevent
pain

Aniety, depression,
tinnitus, blurred vision,
chest pain, fast,
pounding, slow, or
uneven heartbeat,
trouble breathing, N/V,
chills, seizures

Local
anestheti
c

Acts directly on
myofibtils,
thereby

(CNS) seizures, tetanic

contractions
(CV) hypo/HTN

hormone

Oxytocin
(Pitocin for
IOL):

ointmen
t
Erythromyci
n
ophthalmic
oint.:

inj
Hepatitis B
Vaccine:

Lidocaine

Inj
solution

abdominal
cramps,
feverl, foul
smelling
lochia;
contractions
will be similar
to menstrual
cramps,
gradually
increasing in
intensity
Notify of
diarrhea
stools, dark
urine, pale
stools,
jaundice of
eyes or skin

fetal distress,
hypertonic
uterus;
prolapsed
umbilical cord;
active gential
herpes

producing
uterine
contraction;
stimulates milk
ejection;
vasoactive
antidiuretic
effect

(FETUS)
dysrhythmias,
jaundice, hypoxia
(GI) anorexia, N/V,
constipation
(GU) abrupto
placentae, decreased
uterine blood flow
(HEMA)
hyperbilirubinemia
(INTEG) rash

Preexisting
hepatic
disease;
Pregnancy (B)

Binds to 50S
ribosomal
subuniys of
susceptible
bacteria and
suppresses
protein
synthesis

Antiinfective

Report rash,
wheezing,
inability to
breathe

Coagulation
Provides
d/os; Pregnancy passive
( C)
immunity to
Hep B

(CNS) siezures
(CV) dusrhythmias, QT
prolongation
(EENT) hearing loss,
tinnitus
(GI) N/V diarrhea
(GU) vaginitis,
moniliasis
(INTEG) rash
(CNS) HA, dizziness,
fever
(GI) N/V
(INTEG) swelling
Uneven heartbeats;
drowsiness/confusion;
tremors, seizures;
blurred vision

Local
anestheti
c

Known history
of
hypersensitivity
to local
anesthetics

Prevent pain

Immune
globulin

Postparrum/Newborn Care Drugs

Drug
Route Nursi
of
ng
Admi resp.
n
Dermoplast
(Americaine) Spray
Naproxen
Lansinoh Cream
Methergin
e:
TDAP
Colace (Docusate
Sodium
Rhogam
Injection:

Tucks
(Witch
Hazel
pads)

Mylicon
(Simethic
one)

Oxycodon
e:

Epifoam
(Pramixin
e):

Rubella

Contr
a

Mecha Side
nism
Effect
of
s
Action

Classifi
cation

Vaccine:
Vicodin
Infant
liquid
Tylenol: