Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Methergine(methylergonovine maleate)

PC: Ergot Alkaloid and Derivative

TC: oxytocic, lactation stimulant

Indication:Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

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

Methergin↓

Stimulates uterine smooth muscles

↓producing sustained

contractions↓

thereby shortens the third stage of

labor

Cardiovascular: hypertension, temporary chest pain, palpitation

CNSHallucinations, dizziness, seizure, headache

Gastrointestinal: Nausea, vomiting, diarrhea, foul taste

Local: Thrombophlebitis

Otic: Tinnitus

Renal: Hematuria

Respiratory: Dyspnea, nasal congestion

Miscellaneous: Diaphoresis

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

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

>Be alert for adverse reactions and drug interactions.

>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.

HERRERA, Perry Lee B.BSN III – A3a

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Oxytocin PC: Exogenous Agent

TC: oxytocic, lactation stimulant

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

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.

> 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.

> Also contraindicated in fetal distress.

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

>Be alert for adverse reaction

>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.

>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

HERRERA, Perry Lee B.BSN III – A3a

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Cefazolin Sodium

PC: first-generation cephalosporin

TC: antibiotic

Indication:Perioperative prophylaxis in contaminated surgery.

IV:250 mg to 2 g every 6-12 (usually 8) hours, depending on severity of infection; maximum dose: 12 g/day

Cefazolin ↓

Inhibits cell-wall synthesis

↓Promoting osmotic

instability↓

Hinders/kills susceptible bacteria

CNS: dizziness, headache, malaise

GI: nausea, vomiting, diarrhea, glossitis, dyspepsia,

Respi: Dyspnea

Skin: Erythematous rashes

> contraindicated in patients hypersensitive to cephalosporins

>use cautiously in patients with history of sensitivity to penicillin because of cross-allergic reaction

>use cautiously in pregnant and lactating women

>ask patient about previous reaction to cephalosporin or penicillin before starting the therapy

>If GI reaction occurs, monitor hydration

HERRERA, Perry Lee B.BSN III – A3a

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Hyoscine Butylbromide

PC: anticholinergic

TC: antimuscarinic, antiemetic, antivertigo drug, antiparkinsonism

Indication:To reduce secretions perioperatively.

IV:1 mg/ml

HBB↓

Inhibits muscarinic actions of

acetylcholine in the ANS

↓Affecting neural

pathway↓

Relieves spasticity, nausea and

vomittin; reduces secretions; and blocks cardiac vagal reflexes.

↓

Promotes cervical effacement

CNS: dizziness, headache, restlessness, disorientation, irritability, fever

GI: constipation, dry mouth, nausea, vomiting

CV: palpitations, tachycardia, flushing

EENT: dilated pupils, blurred vision, photophobia, dysphagia

GU: urinary hesitancy, urinary retention

Skin: rash, dryness

Contraindicated in patients with angle-closure glaucoma, obstructive uropathy, asthma, COPD, myasthenia gravis, paralytic ileus, intestinal atony, & unstable CV.

>Be alert for adverse reactions and drug interactions.

>Encourage pt. to void

>Monitor BP for possible hypotension.

>Monitor cervical effacement and dilatation.

HERRERA, Perry Lee B.BSN III – A3a

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Hydralazine PC: peripheral vasodilator

TC: anti-hypertensive

Indication:Pre-eclampsia /eclampsia

5 mg/dose then 5-10 mg every 20-30 minutes as needed.

Hydralazine ↓

Directly relaxes arteriolar smooth

muscle↓

Vasodilaion↓

Lowers Blood Pressure

CNS: peripheral neuritis, headache, dizziness

CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations.

GI: n/v, diarrhea, anorexia

Hematologic: neutropenia, leukopenia, agranulocytopenia

Metabolic: weight gain, sodium retention

Skin: rash

Contraindicated to pt.s hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease.

Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.

Assess blood pressure before starting therapy and regularly thereafter.

Instruct client to take oral form with meals.

Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly.

Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs.

Tell client to limit sodium intake.

HERRERA, Perry Lee B.BSN III – A3a

Generic Name(Brand Name)

Drug Classification & Indication

Dosage, Route, Frequency

Mechanism of Action

Adverse Reaction Contraindication Nursing Responsibility

Magnesium Sulfate

PC: Magnesium Salt

TC: Anti-convulsant, Mineral

Indication: 1. Control seizures in preeclampsia and eclampsia

2. To manage preterm labor

I.M.: 1-4 g every 4 hours I.V.: Initial: 4 g, then switch to I.M. or 1-4 g/hour by continuous infusion

Magnesium Sulfate ↓

may decrease acetylcholine

released by nerve impulses

↓but anticonvulsant

mechanism is unknown.

↓Control seizures

CNS: drowsiness, depressed reflexes, flaccid paralysis and hypothermia.

CV: hypotension, flushing, circulatory collapsed, decreased cardiac function and heat block.

Metabolic: hypoglycemia

Respiratory:Respiratory paralysis

Skin: diaphoresis

Parenteral administration contraindicated in patients with heart block or myocardial damage.

Use cautiously in patients with impaired kidney function.

> Assess pt.’s condition before therapy and regularly thereafter to monitor the drug’s effectiveness.

> BP monitoring, and hold if BP is <80/60

>withhold if urine output is <30 cc/hour

>withhold if respiration <12 cpm

> Keep I.V. calcium gluconate at all times to reverse magnesium intoxication.

(↓ RR, ↓ BP, ↓ UO)

HERRERA, Perry Lee B.BSN III – A3a