Generic Name (Brand Name)

Generic Name (Brand Name) Hyoscine Butylbromide (Buscopan)

Indication

Dosage, Route, Frequency

Dosage, Route, Frequency Given via IV, 1mg/ml to promote cervical effacement.

Mechanism of Action

Adverse Reaction

Contraindication

Nursing Responsibilities

Indication

Mechanism of Action

Adverse Reaction

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Nursing Responsibility

Indication: To reduce secretions perioperatively.

Hyoscine Butylbromide Inhibits muscarinic actions of acetylcholine in the ANS Affecting neural pathway Relieves spasticity, nausea and vomitting; 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 angleclosure 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.

Methylergonovine maleate (Methergine, Methylergobasine Methylergobrevin Methylergonovine)

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

2 Ampules immediately after the delivery of the Placenta

Methergine Stimulates uterine smooth muscles producing sustained contractions thereby shortens the third stage of labor

Cardiovascular: hypertension, temporary chest pain, palpitation

> contraindicated in patients hypersensitive to methylergonovine or any component CNS:Hallucinations, of the formulation. dizziness, seizure, >ergot alkaloids headache are contraindicated Gastrointestinal: with potent Nausea, vomiting, inhibitors of diarrhea, foul taste CYP3A4 (includes protease Local: inhibitors, azole Thrombophlebitis antifungals, and some macrolide Otic: Tinnitus antibiotics); Renal: Hematuria >hypertension; toxemia of Respiratory: pregnancy (PIH) Dyspnea, nasal congestion Miscellaneous: Diaphoresis

>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. >Monitor Uterine Contractions

Generic Name (Brand Name)

Indication

Dosage, Route, Frequency

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Nursing Responsibility

Oxytocin (Pictopin, Syntocinon)

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

For stimulation of labor: 10 units (1ml) of drug infused in 1L D5LRS before deliver For Reduction of Postpartum bleeding: 1 amp after delivery of placenta

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.

> Monitor and record uterine contractions, heart rate, BP, intrauterine pressure, fetal heart rate, and blood loss q15. > Also >Be alert for adverse contraindicated in reaction cephalopelvic >Monitor I/O. disproportion or Antidiuretic effect may delivery that requires lead to fluid overload, conversion, as in seizures, and coma tranverse lie; in fetal >never give oxytocin distress when simultaneously by delivery isnt more than one route. imminent; in >have 20% solution prematurity and in magnesium sulfate severe toxemia, available for relaxation hypertonic uterine of the myometrium. patterns, total >If contractions are placenta previa or less than 2 minutes vasa previa. apart, if theyre above 50mm Hg ,or if they last 90seconds or longer, stop infusion, > Also and turn patient on contraindicated in her side, and notify fetal distress. physician or midwife.

Generic Name (Brand Name) Generic: midazolam Brand: Dormicum

Indication
-IV or IM: Sedation, anxiolysis, and amnesia prior to diagnostic, therapeutic, or endoscopic procedures or surgery -Induction of general anesthesia -Continuous sedation of intubated and mechanically ventilated patients as a component of anesthesia or during treatment in the critical care setting Unlabeled uses: --Treatment of epileptic seizure

Dosage, Route, Frequency

Mechanism of Action
Exact mechanisms of action not understood; acts mainly at the limbic system and reticular formation; potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic and amnesia effects occur at doses below those needed to cause sedation, ataxia; has little effect on cortical function

Adverse Reaction

Contraindication

Nursing Responsibilities
Tell patient to take drug with or without food. If patient is taking it as a sleeping pill, take drug before going to bed. Advise patient to avoid alcohol and grapefruit juice while taking the drug. Tell patient if he misses a dose take it at his next scheduled dose. Warn patient to avoid hazardous activities that require alertness or good coordination until effects of drug are known. Tell patient to store the drug in a cool, dry place away from the reach of children.

CNS: Oversedation, drowsiness, amnesia, headache, involuntary movements, nystagmus, paradoxical behaviour or excitement. Cardiovascular: Variations in blood pressure and pulse rate. Respiratory: Apnea, decreased respiratory rate, hiccups. Gastrointestinal: Nausea, vomiting.

- Known hypersensitivity to benzodiazepines or to any component of Dormicum. Severe respiratory and hepatic insufficiency, sleep apnea syndrome, myasthenia gravis. Those with acute angle closure glaucoma, shock, coma, or acute alcohol intoxication. Children.

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Nursing

(Brand Name) Generic Name: Nalbuphine hydrochloride Brand Name: Nubain Classification: Narcotic agonisyantagonist analgesic

Relief of moderate to severe IV q4h x pain 6doses, For obstetric analgesia PRN during labor and delivery

Route, Frequency 10 mg/ml

Reaction Nalbuphine acts as an agonist at specific opioid receptors in the Cns to produce analgesia, sedation but also acts to cause hallucinations and is an antagonist at mu receptors
CNS: sedation, clamminess, sweating, headache, nervousness, restlessness, depression, crying, confusion, faintness, hostility, unusual dreams, hallucinations, euphoria, blurred vision CV: hypotension, hypertension, bradycardia, tachycardia Dermatologic: itching, burning, urticaria GI: N/V, cramps, dyspepsia, bitter taste, dry mouth GU: Urinary urgency Respiratory: Respiratory depression, dyspnea, asthma

Responsibilities Contraindicated with hypersensitivity to nalbuphine, sulfites; lactation

Assess hypersensitiv ity to the drug Provide narcotic antagonist, facilitates for assisted or controlled respiration on standby in case of respiratory depression Reassure patient about addiction liability; most patients who receive opiates for medical reasons do not develop dependence syndrome Inform clients about these side effects: dizziness, sedation, drowsiness, impaired visual acuity, nausea,