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postpartem med

meds for obstetric procedures and pharm calc

QuestionAnswer
Prostaglandins. Oxytocin. Induction and augmentation of labor:
Cervical ripening: Prostaglandins. misoprostol (Cytotec). Magnesium sulfate.
Use of prostaglandins as a cervical gel are for: Endocervical Gel, Vaginal Insert: used to "ripen" the cervix in pregnancy at or near term when induction of labor is indicated.
prostaglandins as a vaginal insert are for: Induction of midtrimester abortion. Management of missed abortion up to 28 wk. Management of nonmetastatic gestational trophoblastic disease (benign hydatidiform mole).
prostaglandin Action: Produces contractions similar to those occurring during labor at term by stimulating the myometrium (oxytocic effect). Initiates softening, effacement, and dilation of the cervix ("ripening"). Also stimulates GI smooth muscle.
Therapeutic effects are what: Initiation of labor. Expulsion of fetus.
classification of prostaglandins in postpartum tx: Therapeutic: cervical ripening agent. Pharmacologic: oxytocics , prostaglandins. Example: dinoprostone (Prepidil): prostaglandin gel. dinoprostone (Cervidil): vaginal insert.
absorbed and distributed how? Absorption: rapidly absorbed. Distribution: unknown. Action is mostly local. Metabolism and Excretion: metabolized by enzymes in lung, kidneys, spleen, and liver tissue.
Prostaglandin dosage and route in post partum period is vaginal and cervical how? Endocervical gel: 0.5 mg; if response is unfavorable, may repeat in 6 hr (not to exceed 1.5 mg/24 hr). Vaginal insert: one 10-mg insert. Vaginal suppository: One 20-mg suppository, repeat q 3-5 hr (not to exceed 240 mg total or longer than 48 hr).
The gel/insert should be avoided in situations in which prolonged uterine contractions should be avoided, including: Previous cesarean section or uterine surgery. Cephalopelvic disproportion. Traumatic delivery or difficult labor. Multiparity (>6 term pregnancies). Hyperactive or hypertonic uterus. Fetal distress (delivery not imminent)
The gel/insert should be avoided in situations in which prolonged uterine contractions should be avoided, including (part two): Unexplained vaginal bleeding. Placenta previa. Vasa previa. Active herpes genitalis. Obstetric emergency requiring surgical intervention. Situations in which vaginal delivery is contraindicated.
Prostaglandin contraindications Presence of acute pelvic inflammatory disease or ruptured membranes. Concurrent oxytocic therapy (wait for 30 min after removing insert before using oxytocin.
Created by: redhawk101
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