24.02 Opioid Analgesics in Pregnancy

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Included In This Lesson

Study Tools

OB Medications (Cheat Sheet)

Outline

Overview

  1. Opioids are given for moderate to severe pain
    1. They will not provide the same relief as an epidural
  2. They are typically given IV in labor and fast-acting
  3. Given PO in the postpartum period to treat pain

Nursing Points

General

  1. Ideal to be given when needed for breakthrough/acute pain during labor, not chronically throughout pregnancy
    1. Newborn can be born addicted→ refer to addicted newborn lesson
  2. History taking is essential before administration to make sure they haven’t been taking them during pregnancy
  3. Some meds are contraindicated if someone is already dependent on specific meds, as they may elicit withdrawal symptoms for both baby and mom

Assessment

  1. Patient history
  2. Pain level
  3. How close is the patient to delivery

Therapeutic Management

  1. Medicate properly
    1. Hydromorphone (Dilaudid)
    2. Morphine
    3. Butorphanol tartrate (Stadol)
    4. Nalbuphine (Nubain)
    5. Oxycodone
    6. Hydrocodone
  2. Naloxone available
  3. Anti nausea medications
    1. Nausea is a side effect of Opioids
  4. Monitor for overdose
    1. Respirations less than 12/min is a concern
    2. Hypotension

Nursing Concepts

  1. Pharmacology
  2. Comfort
  3. Safety

Patient Education

  1. Fast acting
  2. Treatment options

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Pharmacology for Nursing (MedMaster)

Course Description

Jon Haws, BS, BSN, RN, CCRN Alumnus

Tarang Patel, DNP-NA, RN, CCRN, RPh

Nichole Weaver, MSN/Ed, RN, CCRN

Miriam Wahrman, MSN/Ed, RNC-MNN

Kara Tarr, BSN, RN

Nacole Riccaboni, MSN, AGACNP-BC, FNP-BC, CCRN, CMC

Module 0 – Pharmacology Course Introduction

00.01 Pharmacology Course Introduction
Module 1 – NCLEX Must Knows

01.01 12 Points to Answering Pharmacology Questions
  • Questions: 20

01.02 54 Common Medication Prefixes and Suffixes
  • Questions: 20

01.03 Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
  • Questions: 13

01.04 Essential NCLEX Meds by Class
  • Questions: 21

01.05 6 Rights of Medication Administration
  • Questions: 10

01.06 Pharmacodynamics
  • Questions: 5

01.07 Pharmacokinetics
  • Questions: 10

01.08 The SOCK Method – Overview

01.09 The SOCK Method – S

01.10 The SOCK Method – O

01.11 The SOCK Method – C

01.12 The SOCK Method – K
Module 2 – Math for Meds

02.01 Basics of Calculations
  • Questions: 10

Dimensional Analysis Nursing (dosage calculations/med math)
  • Questions: 1

02.03 Oral Medications
  • Questions: 7

02.04 Injectable Medications
  • Questions: 4

02.05 IV Infusions (Solutions)
  • Questions: 3

02.06 Complex Calculations (dosage calculations/med math)
  • Questions: 3

02.07 Interactive Pharmacology Practice

02.08 Interactive Practice Drip Calculations

02.09 Pediatric Dosage Calculations
Module 3 – Disease Specific Medications

03.01 Disease Specific Medications
  • Questions: 10
Module 4 – Antianxiety Agents

04.01 Antianxiety Meds
  • Questions: 2

04.02 Benzodiazepines
  • Questions: 10

04.03 Alprazolam (Xanax)

04.04 Lorazepam (Ativan)

04.05 Midazolam (Versed)

04.06 Diazepam (Valium)

04.07 Buspirone (Buspar)

03.03 Antianxiety Meds
  • Questions: 2
Module 5 – Antiarrhythmics

05.01 ACLS (Advanced cardiac life support) Drugs
  • Questions: 7

05.02 Amiodarone (Pacerone)

05.03 Adenosine (Adenocard)

05.04 Procainamide (Pronestyl)
Module 6 – Anticoagulants & Thrombolytics

06.01 Anti-Platelet Aggregate
  • Questions: 5

06.02 Clopidogrel (Plavix)

06.04 Warfarin (Coumadin)
  • Questions: 1

06.06 Enoxaparin (Lovenox)

06.07 Heparin

06.08 Thrombolytics
  • Questions: 4

06.09 Alteplase (tPA, Activase)

06.10 Streptokinase (Streptase)
  • Questions: 1
Module 7 – Anticonvulsants

07.01 Anticonvulsants
  • Questions: 4

07.02 Carbamazepine (Tegretol)

07.03 Divalproex (Depakote)

07.04 Gabapentin (Neurontin)

07.05 Lamotrigine (Lamictal)

07.06 Levetiracetam (Keppra)

07.07 Phenytoin (Dilantin)
Module 8 – Antidepressants

08.01 Antidepressants

08.02 Bupropion (Wellbutrin)

08.03 MAOIs
  • Questions: 3

08.04 Selegiline (Eldepyrl)

08.05 SSRIs
  • Questions: 5

08.06 Escitalopram (Lexapro)

08.07 Fluoxetine (Prozac)

08.08 Paroxetine (Paxil)

08.09 Sertraline (Zoloft)

08.10 TCAs
  • Questions: 3

08.11 Amitriptyline (Elavil)
Module 9 – Antidiabetic Agents

09.01 Antidiabetic Agents
  • Questions: 4

09.02 Glipizide (Glucotrol)

09.04 Insulin
  • Questions: 12

09.05 Insulin – Rapid Acting (Novolog, Humalog)

09.06 Insulin – Short Acting (Regular)

09.07 Insulin – Intermediate Acting (NPH)

09.08 Insulin – Mixtures (70/30)

09.09 Insulin – Long Acting (Lantus)
Module 10 – Antihistamines

10.01 Histamine 1 Receptor Blockers
  • Questions: 1
  • Cheat Sheets: 1

10.02 Diphenhydramine (Benadryl)

10.03 Promethazine (Phenergan)

10.04 Histamine 2 Receptor Blockers
  • Questions: 2

10.05 Cimetidine (Tagamet)

10.06 Famotidine (Pepcid)

10.07 Ranitidine (Zantac)
Module 11 – Antihypertensives

11.01 Renin Angiotensin Aldosterone System

11.02 Sympatholytics (Alpha & Beta Blockers)
  • Questions: 16

11.03 Atenolol (Tenormin)

11.04 Metoprolol (Toprol XL)

11.05 Propranolol (Inderal)

11.06 ACE (angiotensin-converting enzyme) Inhibitors
  • Questions: 4

11.07 Captopril (Capoten)

11.08 Enalapril (Vasotec)

11.09 Lisinopril (Prinivil)

11.10 Angiotensin Receptor Blockers

11.11 Losartan (Cozaar)

11.12 Calcium Channel Blockers
  • Questions: 3

11.13 Amlodipine (Norvasc)

11.14 Diltiazem (Cardizem)

11.15 Nifedipine (Procardia)

11.16 Verapamil (Calan)

11.17 Cardiac Glycosides
  • Questions: 9

11.18 Digoxin (Lanoxin)
Module 12 – Anti-Infectives

12.01 Anti-Infective – Aminoglycosides
  • Questions: 5

12.02 Gentamicin (Garamycin)

12.03 Anti-Infective – Antifungals
  • Questions: 5

12.04 Metronidazole (Flagyl)
  • Questions: 1

12.05 Nystatin (Mycostatin)

12.06 Anti-Infective – Antitubercular
  • Questions: 5

12.07 Isoniazid (Niazid)

12.08 Rifampin (Rifadin)

12.09 Anti-Infective – Antivirals
  • Questions: 5

12.10 Acyclovir (Zovirax)

12.11 Anti-Infective – Carbapenems
  • Questions: 5

12.12 Meropenem (Merrem)

12.13 Anti-Infective – Fluoroquinolones
  • Questions: 6

12.14 Ciprofloxacin (Cipro)

12.15 Levofloxacin (Levaquin)

12.16 Anti-Infective – Glycopeptide
  • Questions: 4

12.17 Vancomycin (Vancocin)

12.18 Anti-Infective – Lincosamide
  • Questions: 5

12.19 Clindamycin (Cleocin)
  • Questions: 2

12.20 Anti-Infective – Macrolides
  • Questions: 5

12.21 Erythromycin (Erythrocin)

12.22 Azithromycin (Zithromax)

12.23 Anti-Infective – Penicillins and Cephalosporins
  • Questions: 7

12.24 Amoxicillin (Amoxil)

12.25 Ampicillin (Omnipen)

12.26 Cefaclor (Ceclor)

12.27 Cefdinir (Omnicef)

12.28 Cephalexin (Keflex)

12.29 Anti-Infective – Sulfonamides
  • Questions: 5

12.30 Trimethoprim-Sulfamethoxazole (Bactrim)

12.31 Anti-Infective – Tetracyclines
  • Questions: 6

12.32 Tetracycline (Panmycin)
Module 13 – Antipsychotics

13.01 Atypical Antipsychotics
  • Questions: 2

13.02 Chlorpromazine (Thorazine)

13.03 Antipsychotics
  • Questions: 5

13.04 Haloperidol (Haldol)

13.05 Quetiapine (Seroquel)

13.06 Olanzapine (Zyprexa)
Module 14 – Autonomic Nervous System Meds

14.01 Autonomic Nervous System (ANS)
  • Questions: 4

14.02 Methylphenidate (Concerta)

14.03 Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)

14.04 Dobutamine (Dobutrex)

14.05 Dopamine (Inotropin)

14.06 Carbidopa-Levodopa (Sinemet)

14.07 Parasympathomimetics (Cholinergics)

14.08 Neostigmine (Prostigmin)

14.09 Parasympatholytics (Anticholinergics)
  • Questions: 2

14.10 Atropine (Atropen)

14.11 Benztropine (Cogentin)

14.12 Diphenoxylate-Atropine (Lomotil)
Module 15 – Bronchodilators & Respiratory Drugs

15.01 Guaifenesin (Mucinex)

15.02 Bronchodilators
  • Questions: 2

15.03 Albuterol (Ventolin)

15.04 Montelukast (Singulair)

15.05 Salmeterol (Serevent)
Module 16 – Diuretics

16.01 Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
  • Questions: 1

16.02 Furosemide (Lasix)
  • Questions: 4

16.03 Hydrochlorothiazide (Hydrodiuril)

16.04 Spironolactone (Aldactone)

16.05 Mannitol (Osmitrol)
Module 17 – GI Meds

17.01 Bisacodyl (Dulcolax)
  • Questions: 1

17.02 Bismuth Subsalicylate (Pepto-Bismol)

17.03 Lactulose (Generlac)

17.04 Loperamide (Imodium)

17.05 Metoclopramide (Reglan)

17.06 Ondansetron (Zofran)

17.07 Pancrelipase (Pancreaze)

17.08 Sucralfate (Carafate)

17.09 Proton Pump Inhibitors

17.10 Omeprazole (Prilosec)

17.11 Pantoprazole (Protonix)
Module 18 – Hormone & Immune Related Drugs

18.01 Epoetin Alfa
  • Cheat Sheets: 2

18.02 Epoetin (Epogen)

18.03 Glucagon (GlucaGen)
  • Questions: 1

18.04 Iodine

18.05 Levothyroxine (Synthroid)

18.06 Propylthiouracil (PTU)

18.07 Cyclosporine (Sandimmune)
Module 19 – Lipid Lowering Drugs

19.01 HMG-CoA Reductase Inhibitors (Statins)
  • Questions: 2

19.02 Atorvastatin (Lipitor)
Module 20 – Mineral and Electrolyte Drugs

20.01 Magnesium Sulfate
  • Questions: 1
  • Cheat Sheets: 1

20.02 Magnesium Sulfate in Pregnancy

20.03 Magnesium Sulfate

20.04 Calcium Acetate (PhosLo)

20.05 Calcium Carbonate (Tums)

20.06 Ferrous Sulfate (Iron)
  • Questions: 4

20.07 Alendronate (Fosamax)
Module 21 – Mood Stabilizers

21.01 Mood Stabilizers

21.02 Lithium (Lithonate)
Module 22 – Non-Opioid Analgesics

22.01 Acetaminophen (Tylenol)

22.02 Phenazopyridine (Pyridium)
  • Questions: 1

22.03 NSAIDs
  • Questions: 4

22.04 ASA (Aspirin)
  • Questions: 1

22.05 Celecoxib (Celebrex)

22.06 Ibuprofen (Motrin)

22.07 Indomethacin (Indocin)

22.08 Ketorolac (Toradol)

22.09 Naproxen (Aleve)
Module 23 – OB Meds

23.01 Tocolytics
  • Questions: 2

23.02 Terbutaline (Brethine)

23.03 Uterine Stimulants (Oxytocin, Pitocin)
  • Questions: 6

23.04 Meds for Postpartum Hemorrhage (PPH)
  • Questions: 9
  • Cheat Sheets: 1

23.05 Methylergonovine (Methergine)

23.06 Oxytocin (Pitocin)

23.07 Prostaglandins in Pregnancy
  • Questions: 1

23.08 Rh Immune Globulin in Pregnancy
  • Questions: 2

23.09 Lung Surfactant for Newborns
  • Questions: 4

23.10 Eye Prophylaxis for Newborn
  • Questions: 2

23.11 Phytonadione (Vitamin K) for Newborn
  • Questions: 4

23.12 Hepatitis B Vaccine for Newborns
  • Questions: 4
Module 24 – Opioid Analgesics

24.01 Opioids
  • Questions: 7

24.02 Opioid Analgesics in Pregnancy

24.03 Butorphanol (Stadol)

24.04 Codeine (Paveral)

24.05 Fentanyl (Duragesic)

24.06 Hydrocodone-Acetaminophen (Vicodin, Lortab)

24.07 Hydromorphone (Dilaudid)

24.08 Meperidine (Demerol)

24.09 Methadone (Methadose)

24.10 Morphine (MS Contin)

24.11 Nalbuphine (Nubain)

24.12 Oxycodone (OxyContin)
Module 25 – Sedatives / Hyponotics

25.01 Sedatives-Hypnotics

25.02 Barbiturates
  • Questions: 3

25.03 Phenobarbital (Luminal)

25.04 Pentobarbital (Nembutal)

25.05 Anesthetic Agents
  • Questions: 5

25.06 Propofol (Diprivan)

25.07 Lidocaine (Xylocaine)
Module 26 – Steroids

26.01 Corticosteroids
  • Questions: 5
  • Cheat Sheets: 1

26.02 Betamethasone and Dexamethasone in Pregnancy
  • Questions: 2

26.03 Cortisone (Cortone)

26.04 Dexamethasone (Decadron)

26.05 Fluticasone (Flonase)

26.06 Methylprednisolone (Solu-Medrol)
Module 27 – Vasodilators

27.01 Hydralazine
  • Questions: 2

27.02 Hydralazine (Apresoline)

27.03 Nitro Compounds
  • Questions: 4
  • Cheat Sheets: 2

27.04 Nitroglycerin (Nitrostat)

27.05 Nitroprusside (Nitropress)
Module 28 – Vasopressors

28.01 Vasopressin
  • Questions: 1

28.02 Epinephrine (EpiPen)
  • Questions: 2

28.03 Norepinephrine (Levophed)

28.04 Vasopressin (Pitressin)
Module 29 – Medications By Class

29.01 ACLS (Advanced cardiac life support) Drugs

29.02 Anti-Infective – Aminoglycosides

29.03 Anti-Infective – Carbapenems

29.04 Anti-Infective – Macrolides

29.05 Anti-Infective – Fluoroquinolones

29.06 Anti-Infective – Sulfonamides

29.07 Anti-Infective – Tetracyclines
  • Questions: 6

29.08 Anti-Infective – Antifungals

29.09 Anti-Infective – Antivirals

29.10 Anti-Infective – Lincosamide

29.11 Thrombolytics

29.12 Anticonvulsants

29.13 Antidiabetic Agents

29.14 Sympatholytics (Alpha & Beta Blockers)

29.15 Anti-Infective – Antitubercular

29.16 Anti-Infective – Glycopeptide

29.17 Bronchodilators

29.18 Opioids

29.19 Barbiturates

29.20 Anesthetic Agents
Module 30- Antineoplastics

30.01 Antineoplastics

30.02 Alkylating Agents

30.03 Antimetabolites

30.04 Anti Tumor Antibiotics

30.05 Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Module 31 – Medication Infusion

31.01 Patient Controlled Analgesia (PCA)

31.02 Epidural

31.03 Insulin Drips