Generic Name

Generic Name 1. Nalbuph ine

Brand Name Nubain

Dosage 10mg-70kl 20 mg per dose

Mechanism of Action Nalbuphine antagonize s mu opiate receptors. (1) Other opioids agonize mu opiate receptors.

Indicatio n For the relief of moderate to severe pain.

ContraIndication Hypersensiti vity to nalbuphine or its inactive ingredients

Adverse Reaction

CNS: nervousness, crying, depression, restlessness, euphoria, hostility, confusion, faintness, floating, unusual dreams, numbness, feeling of heaviness, and psychotomimetic effects such as hallucinations, feeling of unreality and dysphoria. Cardiovascular: hypertension, hypotension, bradycardia, tachycardia. Gastrointestinal: cramps, dyspepsia, bitter taste.

Nursing Responsibilities Monitor respiratory rate before and after giving nubain because it causes respiratory depression Monitor I and O to determine if there is excessive fluid loss Monitor Bp before and after administering the medication to prevent any complication

Respirati on: depression, dyspnea, asthma. Dermatologica l: itching, burning, urticaria. Miscellaneous: speech difficulty, urinary urgency, blurred vision, flushing and warmth.

–

Mether gine

Methylergo novine Maleate

Methergine is available in sterile ampuls of 1 mL, containing 0.2 mg methylergo novine maleate for intramuscul ar or intravenous injection and in tablets for oral ingestion containing 0.2 mg methylergo novine maleate.

Parenteral

Monitor Bp before and after administering methergine

Methylergono vine acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions through binding and

Serious Reactions •

seizures

•

HTN

•

MI

drug products should be inspected visually for particulate matter and discoloration prior to administratio n. Intramuscul arly 1 mL, 0.2 mg, after delivery of the anterior shoulder, after delivery of the placenta, or during the puerperium. May be repeated as required, at intervals of 24 hours. Intravenousl y

the resultant antagonism of the dopamine D1 receptor. Thus, it induces a rapid and sustained tetanic uterotonic effect which shortens the third stage of labor and reduces blood loss.

For routine manage ment after delivery of the placenta; postpart um atony and hemorrh age; subinvol ution. Under full obstetric supervisi on, it

•

arterial spasm

•

arrhythmias

•

thrombophl ebitis

•

anaphylaxis

Common Reactions

.

Patient with hypertensio n

Any cardiovascul ar diseases

•

HTN

•

seizures

•

headache

•

hypotension

•

nausea

•

vomiting

Dosage same as intramuscular . Orally One tablet, 0.2 mg, 3 or 4 times daily in the puerperium for a maximum of 1 week.

may be given in the second stage of labor following delivery of the anterior shoulder.

Bonifacio, Liezl G Block 001 4th year St. Jude College Mrs. Paderanga Re-Thinking Delivery Room Design Eases Labor

By Rose Hoban Washington, D.C. 13 July 2009 Doctors and midwives agree it's better for a woman to move around while she's in labor. Walking and changing position makes her more comfortable and helps the labor progress. But in many countries, women giving birth in hospitals are often instructed to lie in bed while their labor progresses. University of Toronto nursing professor Ellen Hodnett observed that in many modern - and even some not-so-modern hospitals - a bed was at the center of the labor room. "That bed is a problem," Hodnett says. "Because it's a central focus of the room, and it sends messages that that's where you're supposed to be in labor. And yet, we have pretty good evidence The bed is the central focus of that spending long periods of time in bed, particularly confined in the way that a hospital labor bed most labor and delivery rooms confines you, is not conducive to normal, healthy labor progress." Hodnett has spent years investigating how environment affects the health outcomes for her patients. She began to believe that beds in labor rooms were more for the convenience of the medical and nursing staff than the health of the mothers. Hodnett compared these women's experiences to those of women who gave birth at home. "They used a dining room table to lean over. They used the bathtub. They walked around the garden. They were moving, or on all fours, or side-lying on a mat on the floor… a variety of things…" she says. "And that struck me, even then, that there were more opportunities, more ways for a woman to help herself to be more comfortable and perhaps her labor to be more effective if she were not confined to a bed." Hodnett convinced several hospitals to change the configuration of their labor rooms. Instead of a high bed in the middle of the room, she put a mattress on the floor, in the corner, with lots of pillows. She also dimmed the lights and had a selection of soothing music and videos of nature scenes for the women to listen to and watch as they went through labor. The result: The women had an easier time, requiring fewer medical interventions. Most significantly, fewer women needed the use of the artificial hormone oxytocin for their labor to progress. And the women who did require oxytocin required less of the drug.

"[This] suggests that the labor for the women in this ambient or modified room was actually more effective than labor in the traditional hospital room," Hodnett concludes. "But more importantly, if you look at the results in terms of length of time in labor, the women in the ambient room … their labors were about an hour and a quarter shorter than those in the standard rooms." Hodnett says one of the biggest obstacles to trying these different methods has been getting health care providers to go along. She says several hospitals would not even consider altering the configuration of labor rooms so she could study the effects. She hopes that results such as these will make doctors and nurses more willing to try new ways of configuring the places where women give birth.

Reaction: It is better to have safe, quiet and clean delivery room, because it helps the mother to focus in pushing, to prevent any distraction so that the delivering of the fetus will not be long and stressfull.