Slide 1

Oxytocin (Pitocin)
Dosage Form: IV, IM
Indications: labor induction, PPH, Abortion adjunct
Class: oxytocic agent
Mechanism of Action: affects uterine myofibril activity, by increasing intracellular Ca+; stimulates mammary smooth muscle.
Common rxns:
Nursing Interventions: Monitor vital signs after administration. Be alert for decreased respiratory rate and BP. Monitor
frequency, durtation, and force of contractions and resting uterine tone every 15 minutes. Monitor FHR every 15 minutes,
notify HCP if significant changes occur. Be alert for hypersensitivity w/ anesthesia. Report changes in LOC. Administer O2 if
necessary. Stop med if uterine hyperstimulation occurs, turn on side, increase fluids. Monitor for water intoxication.
Patient Teaching: Discomfort with injection. Change positions slowly. Avoid task that require alertness. Avoid alcohol.
Nausea and vomiting may occur. Report severe headaches.




Slide 2

Magnesium Sulfate
Dosage Form: IV, IM
Indications: To prevent hypomagnerium; prevention and treatment of seizures in eclampsia. Off-Label: Premature
labor tocolysis.
Class: Antacid, anticonvulsant
Mechanism of Action: blocks neuromuscular transmission , amount of acetylcholine released at motor end plate.
Common rxns:
Nursing Interventions: Monitor renal function, magnesium levels, EKG for cardiac function. Test patellar reflexes before
giving repeat doses. Monitor intake and output hourly. Keep calcium gluconate on hand in case of toxicity.
Patient Teaching: Drink sufficient water to prevent water loss. Repeat doses may have laxative effect. Use short-term.
Do not use if abdominal pain, nausea, vomiting present. Inform physician of any signs of hypermagnesia ( dizziness,
palpitations, altered mental status, fatigue, weakness).




Slide 3

Cytotec (Misoprostol)
Dosage Form: PO
Indications: Medical termination of pregnancy; cervical ripening, labor induction.
Class: prostaglandin
Mechanism of Action: reduces acid secretion from gastric parietal cells, stimulates bicarbonate production from
gastric/duodenal mucosa. Stimulates uterine contractions.
Side effects: Abdominal pain, diarrhea, nausea, flatulence, dyspepsia, headache, vomiting, constipation.
Nursing Interventions: Question possibility of pregnancy before initiating therapy.
Patient Teaching: Avoid magnesium-containing antacids (minimizes potential for diarrhea). Incidence of diarrhea may
be lessened by taking immediately following meals.




Slide 4

Cervidil (Dinoprostone)
Dosage Form: Vaginal insert
Indications: Initiation and/or cervical ripening in pts with medical indication for induction of labor. Induce abortion
from wk 12 through wk 20 of pregnancy.
Class: Prostagladin; Oxycotic
Mechanism of Action: directly acts on myometrium, causing softening, dilation effect of cervix.
Side effects: Vomiting, diarrhea, nausea, headache, chills/shivering, urticarial, bradycardia. Flushing.
Nursing Interventions: check strength, duration, frequency of contractions. Monitor vital signs q15min until stable.
Check resting uterine tone. Monitor fetal status, character of cervix.
Patient Teaching: Report promptly fever, chills, foul-smelling/ increased vaginal discharge, uterine cramps, pain.




Slide 5

Hemabate( Carbapost tromethamine)
Dosage Form: IM
Indications: Post partum hemorrhage; Pregnancy termination.
Class: Prostagladin; Oxycotic
Mechanism of Action: stimulates contraction of the uterus
Side effects: Vomiting, diarrhea, nausea, flushing, hypotension or hypertension, tachycardia, pulmonary edema.
Wheezing, dizziness, headache.
Nursing Interventions: should be refrigerated. Give via deep intramuscular injection and aspirate carefully to avoid IV
injection. Rotate sites if repeated. Monitor vital signs. Monitor frequency, duration, and force of contractions and
uterine resting tone. Asculatate breath sounds, wheezing and sensation of chest tightness may indicate hypersensitivity
reaction. Administer antiemetics and antidirrheals as ordered.
Patient Teaching: Report promptly fever, chills, foul-smelling/ increased vaginal discharge, uterine cramps, pain.




Slide 6

Terbutaline
Dosage Form: IV, SubQ, PO
Indications: delays premature labor in pregnancies between 30 to 34 wks.
Class: Sympathomimetic; tocolytic
Mechanism of Action: Stimulates beta2-adrenergic receptors, resulting in relaxation of uterine, bronchial smooth
muscle.
Side effects: Tremors, anxiety, drowsiness, headache, nausea, heartburn, dizziness
Nursing Interventions: check strength, duration, frequency of contractions. Monitor fetal and maternal heart rate. Vital
signs. Hypoglycemia in neonates. Monitor VS, report tachycardia.
Patient Teaching: inform physician if palpitations, chest pain, muscle tremor, dizziness, headache, flushing, breathing
difficulties continue. May causes nervousness , anxiety, shakiness. Avoid caffeine derivatives.




Slide 7

Demerol (Merperdine)
Dosage Form: IV, IM, PO
Indications: Pain relief, Pre- OP sedation
Class: Narcotic agonist
Mechanism of Action: Binds to opiod receptors within CNS. Alters pain perception, emotional response to pain.
Side effects: Sedation, hypotension, diaphoresis, facial flushing, dizziness, nausea and vomiting, constipation. Allergic
reaction rare (pruritus, rash) Overdose results in respiratory depression, muscle flaccidity, cyanosis.
Nursing Interventions: monitor vitals (hypotension, change in rate quality of pulse). Monitor pain level, sedation
response. Monitor for constipation. Initiate deep breathing, coughing exercises.
Patient Teaching: Medication should be taken before pain filly returns, within ordered intervals. Discomfort may occur
with injection. Change positions slowly to avoid hypotension. Increase fluids to prevent constipation. Avoid alcohol,
other CNS depressants. Avoid task requiring mental alertness.




Slide 8

Vistaril (hydroxyzine)
Dosage Form: IM, PO
Indications: Pruritus, N&V, pre-op sedation, anxiety
Class: Antihistamine, antiemetic
Mechanism of Action: competes with histamine for receptor sites in GI tract, blood vessels, respiratory tract.
Side effects: Drowsiness, dry mouth, marked discomfort with IM injection. Dizziness ataxia, slurred speech, headache,
agitation. Hypersensitivity reaction (wheezing, dyspnea, chest tightness)
Nursing Interventions: Monitor lung sounds for signs of hypersensitivity reaction. Monitor serum electrolytes in
patients with severe vomiting. Assess for paradoxical reaction. Assist with ambulation if drowsiness, light-headedness
occur.
Patient Teaching: marked discomfort may occur with I injection. Sugarless gum, sips of tepid water ay relieve dry outh.
Avoid task that require alertness.




Slide 9

Fentanyl (sublimaze)
Dosage Form: IV, transdermal, buccal film, buccal tablet, sublingual spray/tablet, nasal, transmucosal
Indications: Pain relief, Pre- OP medication
Class: Opioid , Narcotic agonist
Mechanism of Action: Binds to opioid receptors within CNS. Reducing stimuli from sensory nerve endings, inhibits
ascending pathways. Increases pain threshold.
Side effects: Post op drowsiness, nausea and vomiting. Headache, pruitis, diaphoresis, diarrhea, constipation,
decreased appetite. Blurred vision, hypotension. Overdose can cause severe respiratory depression, muscle rigidity.
Nursing Interventions: resuscitative equipment, naloxone. Establish baseline bp, respirations. Assess pain. Assist with
ambulation. Monitor VS. assess for relief of pain.
Patient Teaching. Avoid alcohol, other CNS depressants. Avoid task requiring mental alertness. Teach proper
administration. Report absence of pain relief, constipation.




Slide 10

Narcan (Naloxone)
Dosage Form: IV, IM
Indications: Complete or partial reversal of opioid depression including respiratory depression.
Class: Narcotic antagonist
Mechanism of Action: Displaces opioid-occupied receptor sites in CNS. Reverse opiod induced sleep/sedation, increase
RR, raises BP to normal range
Side effects: Unknown side effects. Too rapid reversal of narcotin induced repiratory depression may result in agitation,
N&V, tremors, increased BP, Tachycardia. Hypotension or hypertension, v-tach, pulmonary edema with excessive
dosage.
Nursing Interventions: maintain clear airway. Monitor VS especially respiration. Carefully observe pt. assess for
increased pain with reversal of opiate.
Patient Teaching. Report postoperative pain that emerges after administration of this drug to physician.




Slide 11

Celestone( Betamethasone)
Dosage Form: PO, IM
Indications: For client in preterm labor between 28 and 32 weeks gestation whose labor can be inhibited for 48 hours
without jeopardizing the mother or fetus
Class: Adrenocorticosteroid
Mechanism of Action: Corticosteroids that increase the production of surfactant to accelerate fetal lung maturity and
reduce the incidence or severity of respiratory distress syndrome
Side effects: May decrease the mothers resistance to infection, pulmonary edema secondary to sodium and fluid
retention. Elevated blood glucose levels can occur in a client with DM. Increased appetite, abdominal distention,
nervousness.
Nursing Interventions: Monitor maternal VS, lung sounds, and for edema. Monitor mother for signs of infection.
Monitor WBCs and blood glucose.
Patient Teaching: take with food, milk. Take single dose in the morning. Do not stop abruptly. Do not receive smallpox
vaccine during or immediately after therapy.




Slide 12

RhoGAM
Dosage Form: IM
Indications: suppression of Rh isoimmunization in Rh-negative clients exposed or potentially exposed to Rh-positive
red blood cells
Class: Immune globulin
Mechanism of Action: suppresses active antibody response formation of anti-Rho(D) in Rho(D)-negative women
exposed to Rho(D)-positive fetus or transfusion with Rho(D) immune globulin into Rh-positive pt.
Side effects: Elevated temperature, tenderness at injection site, hypotension, pallor, vasodilation, abdominal pain,
diarrhea, headache. Acute renal failure occurs rarely.
Nursing Interventions: administer to the client by the IM injection at 28 weeks gestation and within 72 hours after
delivery. Never administer by IV, monitor for temperature elevation, monitor injection site for tenderness. Assess for
S+S of hemolysis.
Patient Teaching: IM injection ay be painful. Notify physician if chills, dizziness, fever, headache, rash occur.




Slide 13

Percocet (oxycodone/acetaminophen)
Dosage Form: PO
Indications: Pain reliefmoderate to severe
Class: Opioid analgesic
Mechanism of Action: Binds to opioid receptors within CNS. Alters pain perception, emotional response to pain.
Side effects: Dizziness, n&v, hypotension, drowsiness, hypotension, confusion, urinary retention. Allergic reaction.
Overdose results in respiratory depression, flaccidity, cyanosis.
Nursing Interventions: Palpate bladder for urinary retention. Monitor bowel patterns, and stool consistency. Initiate
deep breathing , coughing exercise. Monitor pain relief, RR, LOC, and BP.
Patient Teaching: May cause dry mouth, drowsiness. Avoid task that require alertness. Avoid alcohol. Do not chew,
crush, dissolve or divide.




Slide 14

Epifoam
Dosage Form: aerosol foam, cream, lotion
Indications: Topical inflammation; hemorrhoids
Class: anesthetic, corticosteroid
Mechanism of Action: may decrease inflammation by suppressing migration PMS, and reversing capillary permeability.
Side effects: thinning, softening, or discoloration of the skin; unusual weight gain, especially in the face. Severe allergic
reactions; acne-like rash; excessive hair growth; inflamed hair follicles; inflammation around the mouth;
Nursing Interventions: Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood
glucose. Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential.
Patient Teaching: In breastfeeding mothers - corticosteroids should not be applied to the breasts just before nursing.
Teach pt to be careful not to get this medicine in their eyes. Wash hands after using your finger to apply the medicine.
If it accidentally gets in your eyes, flush them with water. Keep allied area open to air to avoid over absorption.




Slide 15

Tucks ointment(Pramoxine/mineral oil/zinc oxide)
Dosage Form: topical
Indications: pain/itching
Class: anesthetic
Mechanism of Action: inhibits conduction of nerve impulses from sensory nerves by decreasing neuronal membranes
permeability to sodium ions
Side effects: irritation; pruritus
Nursing Interventions: Teach to apply to episiotomy, lacerations, & hemorrhoids to relieve pain and discomfort prn.
Warn pt. it feels cold when applied initially.
Patient Teaching:




Slide 16

Anusol
Dosage Form: topical
Indications: Topical corticosteroids are indicated for the relief of the inflammatory and pruritic manifestations of
corticosteroid-responsive dermatoses.
Class: corticosteroid
Mechanism of Action: may decrease inflammation by suppressing migration PMS, and reversing capillary permeability.
Side effects: Burning, dryness, itching, folliculitis, irritation, hypopigmentation, pain
Nursing Interventions: Establish baseline and continuing data on BP, weight, fluid and electrolyte balance, and blood
glucose. Lab tests: Periodic serum electrolytes blood glucose, Hct and Hgb, platelet count, and WBC with differential
Patient Teaching:In breastfeeding mothers - corticosteroids should not be applied to the breasts just before nursing.
Teach pt to be careful not to get this medicine in their eyes. Wash hands after using your finger to apply the medicine.
If it accidentally gets in your eyes, flush them with water. Keep allied area open to air to avoid over absorption.