Generic Name (brand Name) Methergine (methylergonovine Maleate)

Generic Name (Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Methergine (methylergonovine maleate)

PC: Ergot Alkaloid and Derivative

IV: 0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium; may be repeated as required at intervals of 2-4 hours

TC: oxytocic, lactation stimulant Indication: Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

Mechanism of Action Methergin ↓ Stimulates uterine smooth muscles ↓ producing sustained contractions ↓ thereby shortens the third stage of labor

Adverse Reaction

Contraindication

Nursing Responsibility

Cardiovascular: hypertension, temporary chest pain, palpitation

> contraindicated in patients hypersensitive to methylergonovine or any component of the formulation.

>Be alert for adverse reactions and drug interactions.

CNSHallucinations, dizziness, seizure, headache Gastrointestinal: Nausea, vomiting, diarrhea, foul taste Local: Thrombophlebitis

>ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy

>This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.

Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Diaphoresis

Generic Name (Brand Name) Oxytocin

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction

Contraindication

Nursing Responsibility

PC: Exogenous Agent TC: oxytocic, lactation stimulant

I.V.: 10-40 units by I.V. infusion in 1000 mL of intravenous fluid at a rate sufficient to control uterine atony

Oxytocin ↓ Causes potent and selective stimulation of uterine and mammary gland smooth muscles ↓ producing sustained contractions ↓ Induces labor and milk ejection and reduces post partum bleeding

Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias CNS: seizures, coma from water intoxication Gastrointestinal: Nausea, vomiting, GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma Hematologic: afibrinogenemia Respiratory: anoxia, asphyxia

> Contraindicated in patients hypersensitive to the drug or any of its component.

> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15.

> Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isn’t imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa.

>Be alert for adverse reaction

Indication:Induc tion of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion

> Also contraindicated in fetal

>Monitor I/O. Antidiuretic effect may lead to fluid overload, seizures, and coma >never give oxytocin simultaneously by more than one route. >have 20% solution magnesium sulfate available for relaxation of the myometrium.

distress.

>If contractions are less than 2 minutes apart, if they’re above 50mm Hg ,or if they last 90seconds or longer, stop infusion, and turn patient on her side, and notify prescriber

5% Dextrose in Lactated Ringer's Injection provides electrolytes and calories, and is a source of water for hydration. It is capable of inducing diuresis depending on the clinical condition of the patient. This solution also contains lactate which produces a metabolic alkalinizing effect. Sodium, the major cation of the extracellular fluid, functions primarily in the control of water distribution, fluid balance and osmotic pressure of body fluids. Potassium, the principal cation of intracellular fluid, participates in carbohydrate utilization and protein synthesis, and is critical in the regulation of nerve conduction and muscle contraction, particularly in the heart. Chloride, the major extracellular anion, closely follows the metabolism of sodium, and changes in the acid-base balance of the body are reflected by changes in the chloride concentration. Calcium, an important cation, provides the framework of bones and teeth in the form of calcium phosphate and calcium carbonate. Sodium lactate is a racemic salt containing both the levo form, which is oxidized by the liver to bicarbonate, and the dextro form, which is converted to glycogen. Lactate is slowly metabolized to carbon dioxide and water, accepting one hydrogen ion and resulting in the formation of bicarbonate for the lactate consumed. These reactions depend on oxidative cellular activity. Dextrose provides a source of calories. Dextrose is readily metabolized, may decrease losses of body protein and nitrogen, promotes glycogen deposition and decreases or prevents ketosis if sufficient doses are provided

Indications and Usage for Dextrose in Lactated Ringer'sThis solution is indicated for use in adults and pediatric patients as a source of electrolytes, calories and water for hydration. ContraindicationsThis solution is contraindicated where the administration of sodium, potassium, calcium, chloride or lactate could be clinically detrimental.Lactate administration is contraindicated in severe metabolic acidosis or alkalosis, and in severe liver disease or anoxic states which affect lactate metabolism.Solutions containing dextrose may be contraindicated in patients with hypersensitivity to corn products. How supplied:5% Dextrose in Lactated Ringer's Injection is supplied sterile and nonpyrogenic in EXCEL® Containers. The 1000 mL containers are packaged 12 per case and the 500 mL containers are packaged 24 per case. Nsg resp:Check for minute leaks by squeezing solution container firmly. If leaks are found, discard solution as sterility may be impairedNOTE: Before use, perform the following checks:Inspect each container. Read the label. Ensure solution is the one ordered and is within the expiration date. Invert container and carefully inspect the solution in good light for cloudiness, haze, or particulate matter. Any container which is suspect should not be used. Use only if solution is clear and container and seals are intact. Preparation for Administration 1. 2.

Remove plastic protector from sterile set port at bottom of container. Attach administration set. Refer to complete directions accompanying set.

TO Add Medication Before Solution Administration 1. 2. 3.

Prepare medication site. Using syringe with 18–22 gauge needle, puncture medication port and inner diaphragm and inject. Squeeze and tap ports while ports are upright and mix solution and medication thoroughly.

Contents-Vit A 1,660 iu, vit D3 200 iu, vit E 10 iu, vit B1 1.5 mg, vit B2 1.7 mg, vit B3 20 mg, vit B6 1 mg, vit B12 2 mcg, vit C 60 mg, folic acid 100 mg, Na fluoride 1 mg, Fe fumarate 16 mg, Ca carbonate 30 mg, Zn sulfate 1 mg

Indication- Dietary supplement for pregnant & lactating women. Dosage- 1 cap daily. Administration- May be taken with or without food (May be taken w/ meals for better absorption or if GI discomfort occurs.). Classification- Vitamins & Minerals (Pre & Post Natal) / Antianemics A11JB - Vitamins with minerals ; Used as dietary supplements. Vita OB capsule vita OB 100’s Per cap Fe sulfate 250 mg (equiv to 75 mg elemental Fe). Per 5 mL syr Fe sulfate heptahydrate 220 mg (equiv to 44 mg elemental Fe). Per 0.6 mL syr (oral drops) Fe sulfate heptahydrate 75 mg (equiv to 15 mg elemental Fe) Prevention & treatment of anemia due to Fe deficiency, anemia associated w/ undernourishment, pregnancy & menstrual blood loss. Cap 1 cap daily. Syr/Drops Prevention 0.3-0.6 mL daily; therapeutic tid. Adult 1 tbsp, childn 1/2-1 tsp, infants 0.6 mL. Should be taken with food (Take after meals.). GI irritation, blackening of stool. Vitamins & Minerals (Pre & Post Natal) / Antianemics Ferglobin capsule -Ferglobin 100's Ferglobin drops - Ferglobin 15 mL Ferglobin syrup - Ferglobin 60 mL