Week 5 OB Meds Flashcards

Questions and Answers

What is the classification of Carboprost tromethamine (Hemabate)?

Antihypertensive

Prostaglandin, oxytocic (correct)

Analgesic

Sedative

What action does Carboprost tromethamine (Hemabate) perform?

Stimulates contraction of the uterus

What are the indications for using Carboprost tromethamine (Hemabate)?

Used for the treatment of postpartum hemorrhage caused by uterine atony and for abortion.

The dosage for postpartum hemorrhage using Carboprost tromethamine (Hemabate) is ___ micrograms intramuscularly.

250 Signup and view all the answers

How is Carboprost tromethamine (Hemabate) metabolized?

Metabolized by the liver and by enzymes in the lungs. Signup and view all the answers

How is Carboprost tromethamine (Hemabate) primarily excreted?

Primarily excreted in urine. Signup and view all the answers

What are contraindications for Carboprost tromethamine (Hemabate)?

Hypersensitivity to carboprost or other prostaglandins; acute pelvic inflammatory disease; cardiac, pulmonary, renal, or hepatic disease. Signup and view all the answers

What are some adverse reactions of Carboprost tromethamine (Hemabate)?

Excessive dose may cause tetanic contraction and laceration or uterine rupture. Signup and view all the answers

What nursing considerations should be taken when administering Carboprost tromethamine (Hemabate)?

Should be refrigerated. Give via deep intramuscular injection and aspirate carefully. Signup and view all the answers

The dosage for Misoprostol (Cytotec) is one quarter of a ___ mcg tablet vaginally.

100 Signup and view all the answers

What should be done if hypertonic contractions occur with Misoprostol (Cytotec)?

Place woman in side-lying position and provide oxygen by face mask at 8-10 L/min. Signup and view all the answers

When may Oxytocin induction begin after the last Misoprostol (Cytotec) dose?

At least 4 hours after last dose. Signup and view all the answers

What is a precaution regarding Misoprostol (Cytotec)?

Contraindicated in women with a previous cesarean or other uterine surgery. Signup and view all the answers

What is the classification of Apresoline (Hydralazine)?

Antihypertensive Signup and view all the answers

What action does Apresoline (Hydralazine) perform?

Relaxes arterial smooth muscle to reduce blood pressure. Signup and view all the answers

What are the dosage and route for Apresoline (Hydralazine) in pregnancy-induced hypertension?

Intravenous doses of 5 to 10 mg may be administered as often as every 15 to 20 minutes. Signup and view all the answers

How is Apresoline (Hydralazine) absorbed?

Widely distributed, crosses the placenta; enters breast milk in minimal concentrations. Signup and view all the answers

How is Apresoline (Hydralazine) excreted?

Metabolized and excreted by the liver. Signup and view all the answers

What are contraindications for Apresoline (Hydralazine)?

Contraindicated in coronary artery disease, cerebrovascular disease, and hypersensitivity to hydralazine. Signup and view all the answers

What are some adverse reactions of Apresoline (Hydralazine)?

Headache, dizziness, drowsiness, hypotension that can interfere with uterine blood flow. Signup and view all the answers

Study Notes

Carboprost tromethamine (Hemabate)

Classification: Prostaglandin, oxytocic.
Action: Stimulates uterine contractions.
Indications: Treats postpartum hemorrhage from uterine atony and is used in abortion.
Dosage & Route: For postpartum hemorrhage, administer 250 micrograms intramuscularly, with possible repeats every 15 to 90 minutes; maximum total dose is 2 mg.
Absorption: Metabolized by the liver and lung enzymes.
Excretion: Primarily excreted in urine.
Contraindications: Avoid in women with hypersensitivity to carboprost, acute pelvic inflammatory disease, and specific cardiac, pulmonary, renal, or hepatic diseases. Use caution in those with asthma, hypotension/hypertension, anemia, jaundice, diabetes, epilepsy, or previous uterine surgery.
Adverse Reactions: Excessive doses can cause tetanic contractions, uterine rupture, hypertonus when used with oxytocin, nausea, vomiting, diarrhea, fever, chills, headaches, and changes in blood pressure.
Nursing Considerations: Store refrigerated, administer via deep intramuscular injection, rotate injection sites, monitor vital signs, and administer antiemetics as necessary.

Misoprostol (Cytotec)

Dosage: Administer 25 mcg vaginally from a quarter of a 100-mcg tablet, repeating every 3-6 hours for labor induction; a 50-mcg dose may cause hypertonic contractions.
Actions for Hypertonic Contractions: Place the patient in a side-lying position; provide oxygen and administer tocolytic drugs like terbutaline or magnesium sulfate if necessary.
Oxytocin Induction: Can begin at least 4 hours after the last dose of Misoprostol.
Precautions: Misoprostol is only FDA-approved for peptic ulcer treatment but is commonly used for labor induction and cervical ripening. The manufacturer will not seek additional approval. Contraindicated in women with previous cesarean or uterine surgery. Hospital pharmacy should prepare accurate 25-mcg doses.

Apresoline (Hydralazine)

Classification: Antihypertensive.
Action: Relaxes arterial smooth muscle leading to reduced blood pressure.
Dosage & Route: For pregnancy-induced hypertension, administer 5 to 10 mg intravenously every 15 to 20 minutes as needed; duration of action lasts 3 to 8 hours.
Absorption: Widely distributed; crosses the placenta and enters breast milk in minimal amounts.
Excretion: Metabolized and excreted by the liver.
Contraindications: Avoid in coronary artery disease, cerebrovascular disease, and hypersensitivity to hydralazine. Use cautiously in pregnancy (category C).
Adverse Reactions: May cause headache, dizziness, drowsiness, hypotension (affecting uterine blood flow), and epigastric pain.

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Description

This quiz focuses on essential obstetric medications covered in Week 5, including Carboprost tromethamine (Hemabate). It highlights classifications, actions, and indications for use, particularly related to postpartum care. Prepare to test your knowledge on crucial medications used in obstetrics.