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OB Medications (Cheat Sheet)
Outline
Overview
- Anti-contraction meds, labor suppressant
- Tokos = Greek word for childbirth
- Lytic = lysis = decline of disease/symptoms
Nursing Points
General
- Use: prevent preterm labor by suppressing uterine contractions
- Preterm = before 37 weeks
- If preterm labor cannot be stopped, tocolytics allow time for the administration of betamethasone to attempt to quickly increase lung maturity over 24-48 hours
Assessment
- Assess contractions
- True labor v. false labor
- Fetal monitoring
- Assess for fetal distress
Therapeutic Management
- Follow your protocol/order set:
- Frequency of assessments
- Vitals
- Adverse reactions
- I&O
- Terbutaline (Brethine)
- Class: Beta 2 adrenergic-agonist
- MOA: Cause smooth muscle relaxation in uterus
- Nursing Implications
- Most adverse effects are cardiac related
- Maternal tachycardia
- Also causes bronchodilation
- See Autonomic Nervous System lesson in Pharmacology course
- Most adverse effects are cardiac related
- Route
- IV, SubQ
- Nifedipine
- Class: Calcium channel blocker
- MOA: Disrupts calcium entry into the cell, which reduce smooth muscle contractions in uterus
- Nursing Implications
- Rapidly lowers BP, watch closely as you may need to give fluids or other meds to increase BP
- Don’t use with mag unless you really need to b/c it will lower BP further
- Route
- PO
- Multiple dosing options and no clear gold dosing standard
- Indomethacin
- Class: NSAID
- MOA: Inhibits prostaglandins, which cause uterine contractions
- Nursing Implications:
- Same bleeding precautions as other NSAIDs
- Don’t use if patient has peptic ulcers
- Should only be used if <32 weeks
- Can prematurely close fetus’ ductus arteriosus → assessment by ultrasound
- Can decrease fetal urine production → watch for oligohydramnios (deficiency of amniotic fluid)
- Route
- PO, rectal, vaginal
- Always monitor for potential adverse reactions and notify MD when noted
Nursing Concepts
- Pharmacology
- Safety
- Evidence based practice
Patient Education
- Thoroughly educate mother and support system about what to expect
- Medication purpose
- Side effects to notify about
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