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DRUGS FOR GESTATIONAL TROPHOBLASTIC DISEASE

DRUG CLASSIFICATION ACTION INDICATION/CONTRAINDICATION NURSINGRESPONSIBILITY

Methotrexate Antineoplastic Inhibits dihydrofolicacid reductase, leadingto inhibition of DNA

synthesis and inhibitionof cellular replication.

Indication: Treatment of Hydatidiformmole.Contraindication: Used cautiously with

renal disease, infection, peptic ulcer,ulcerative colitis, debility.

Arrange for teststo evaluate CBC,urinalysis, liver and renal functiontests, and chest x-rat before theapy,and duringtherapy and for several weeksafter therapy,severe toxicitycould occur.Reduce dosage or discontinue if renal failureoccurs.Arrange for antiemetic if nausea andvomiting aresevere.Arrange adequatehydration duringtherapy to reducethe risl of hyperuricemia.Do not administer any other medicationcontainingalcohol.

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Dactinomycin

Oxytocin

AntibioticAntineoplastic

HormoneOxytocic

Cytotoxic: inhibitsynthesis of messenger RNA, causing celldeath.

Stimulate the uterusespecially the graviduterus just beforeparturition, and causemyoepithelium of thelacteal glands tocontract, which resultsin milk ejection inwomen.

Indication: gestational trophoblasticneoplasia, as monotherapy or combination.Contraindication: allergy toDactinomycin, pregnancy, lactation andchicken pox.

Indication: To produce uterinecontraction during the third stage of labor and to control post partumbleeding or hemorrhage.Contraindication: unfavorable positionor presentation, cephalopelvicdisproportion, previous cesareansection, pregnancy.

Use strict handlingprocedures, drug isextremely toxic to skinand eyes.Do not give IM or subcutaneously, severelocal reaction and tissuenecrosis occur, IV useonly.Monitor injection site for extravasation, burning, or stinging. Discontinueinfusion immediately,apply cold compress tothe area, and restart inanother vein.

Monitor maternal BPduring oxytocinadministration;discontinue drug andnotify physician with anysign of hypertensiveemergency.

Jean arellano B.S Nursing A303

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DRUG FOR INCOMPETENT CERVIX

DRUG CLASSIFICATION ACTION INDICATION/CONTRAINDICATION

NURSINGRESPONSIBILITY

Tocolytics

Terbutaline Sulfate

Tocolytic drug Relax the pregnant uterus, Indication: prevent pretermlabor.

Contraindication: Usecautiously with diabetes,hypertension.

Use minimal doses for minimal period of time,

drug tolerance can occur for prolonged use.

Do not exceedrecommended dosage.

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