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Drugs in Obstetrics

Group of Drug Name of Drug Disease used for Route Dose Remarks
Aluminium Leg cramps in pregnancy To reduce phosphorus
hydroxide absorption
Vitamin B Hyperemesis gravidarium Vit. B1 & 6
Acroparaesthesia (Tingling Vit. B12
sensation in fingers in normal
pregnancy)
Addisonian pernicious anemia IV Vit. B12
Sedation Morphia Eclampsia IM 10 -20 mg
Severe preeclampsia IM 10 mg
Diazepam Severe preeclampsia IV 10 mg
Thiopental If morphia & diazepam
Eclampsia
sodium failed
Calcium Leg cramps in pregnancy
Magnesium Leg cramps in pregnancy
progesterone In threatened abortion With evidence of
Recurrent abortion (luteal progesterone deficiency
phase defect)
Oxytocin Induction of labour IV drip 5 U in 500 In Hypotonic inertia:
Inevitable abortion cc of  Started by a rate of 10
Incomplete abortion glucose 5% drops/min. & adjusted
Missed abortion according to response.
Hypotonic Inertia  Should be continued after
delivery to guard against
atonic PPH & retained
placenta.
Ergometrine Induction of Abortion IV Minimize risk of

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Drugs in Obstetrics

perforation & bleeding


Managment of multifetal It is given after delivary of
pregnancy the 2nd twin
Proper managment of 3rd For prevention of post
stage of pregnany partum hge.
Managment of atonic post- It is given before & after
partum hge. delivary of placenta
Managment of 2ry post- In mild cases
partum hge.
Managment of puerpural Promotion of drainage
sepsis
Antibiotics Rovamycin Treatment of toxoplasmosis In pregnant female
Ampicilin Puerperal Sepsis (until culture 500mg/6hrs
& senstivity of vaginal swab is
obtained)
Puerperal Sepsis (G +ve & 500mg/6hrs
some –ve bact.)
500 mg/ 8
UTI Oral
H
500 mg / 6
Pyelonephritis Oral
H
Cephalosporin Puerperal Sepsis (until culture 500mg/6hrs
& senstivity of vaginal swab is
obtained)
Puerperal Sepsis (G +ve & 500mg/6hrs
some –ve bact.)
UTI
Pyelonephritis

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Drugs in Obstetrics

Septrin Not used in 1st trimester as


UTI Oral 2 tab / 12 h.
it is folic acid antagnoist
Gentamycin Puerperal Sepsis (G –ve bact.) 80mg/8hrs
Metronidazole Puerperal Sepsis(Anaerobes)
Spiramycine
Pyrimethamine
+ sulpha
Combination Septic abortion Ampicillin or
cephalosporins+
gentamicin+metronidazole
Or
Ampicillin then modified
according to culture and
sensitivity

Daraprim + sulfa Habitual abortion caused by If not pregnant, but if


Toxoplasmosis pregnant rovamycin is used
HCG Recurrent abortion (luteal
phase defect cause)
Aspirin Habitual abortion caused by 75 mg Prevent platelet aggregation
antiphospholipid antibody & thrombosis
Coritcosteroids Correction of shock IM Given to mother to
stimulate fetal lung maturity
Preterm labor
Prednisone Premature rupture of (4 doses)
membranes (gestational age 5mg / 12 h ,
29-33 weeks) Cover for 1

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Drugs in Obstetrics

wk

Heparin In DIC IV 5000u/12 h Used only prophylactic


Warfarin TTT of pelvic First with heparin & then
thrombophelepitis alone
Protamine Antidote of heparin
sulphate
K1 Cephalhematoma IM 1mg
Intracranial Hge(to newborn) IM 1mg
Intracranial Hge(to mother) 10mg For prevention
Antidote of warfarin
Preterm labor Given to mother to
improve fetal coagulation
system
Thyroxine Habitual abortion caused by
hypothyroidism
methotrexate Stable tubal ectobic
pregnancy
Cervical pregnancy
Anti D Stable ectobic pregnancy Rh
immunoglobulin negative female
Fluids Management of shock IV drips Maintain blood volume
Crystalloid Glucose
Eclampsia IV drips 40 gms, 800 20 units insulin to prevent
Colloid cc of hypoglycemia
glucose 5 %
Diabetes IV drips

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Drugs in Obstetrics

Antihistaminics Hyperemesis gravidarium

Alpha methyl-
methyl- D.O.C. , full effect after 48
Preeclampsia Oral,IV 2 gms/ day
dopa (aldomet) H.

β blockers Preeclampsia
Alpha-
Alpha-beta
blocker
Preeclampsia
(labetalol)

10 mg/ 4-8 Should not be given with


Nifedipine Preeclampsia Oral
H. MgSO4
A bolus of 5 mg is given
500 cc of over 5 min. An repeated
hydralazine Severe preeclampsia IV drips
fluid every 5 min. Until effect is
obtained
Anticonvulsant Magnesium Intracranial Hge 1cc of 50%
sulphate soluation
Preterm labor Initial dose:
IV 4 gm
Maintenanc
e dose:
adjusted
according to
response &
side effects

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Drugs in Obstetrics

( loading
dose)
Maintenance dose: 3 – 4
Half the
gms/ 4 H.
Severe preeclampsia dose IV 6 – 10 gms
Maximum dose: 24 gms in
Other half
24 H.
is IM or IV
drips
Luminal Intracranial Hge
Nacl Intracranial Hge Per
rectum
oxygen Intracranial Hge
Neonatal asphyxia Small mask or stream in
front of mouse or nose or
Endotracheal tube
especially with:
-apnea or apgar<3
-persistant bradycardia <
100
Espcially in cyanosed
patient and after
convulsions
Amniotic fluid embolism

eclampsia

Iron Prevention of Iron deficiency Oral 200 mg / 60 – 70 mg of elemental


Anemia tablets once daily iron
Oral 200 mg IV – IM iron is
TTT of Iron deficiency anemia
tablets t.d.s after recommended with :

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Drugs in Obstetrics

meals Intolerance to oral route


Or if rapid response is
required
Anemia 2ry to renal disease
Hemolytic anemia
Folic Acid Oral 5 – 10 mg
Megaloblastic anemia
tablets t.d.s.
Analgesics Pethidine Cervical Dystocia If fails CS
Morphine Correction of shock I.V 10 mg
sulphate slowley
Anesthesia Thiopentone Intravenou 0.5-1gm IV Short duration of action
Halothane General Ansesthesia s
Inhalation 0.5% May cause PPH
lignocaine
Local
infiltrate 1% No risk to mother or fetus
ate
Prostaglandins Methyl Managment of atonic post- IM Or 0.25 mg IM : after vaginal delivary
prostaglandins partum hge. intramyo Intramyometrial : after CS
metrial
Fibrinogen Managment of atonic post- IV 4-10 gm For bleeding due to
partum hge. hypofibrinogenemia
Antifibrinolytics EACA Managment of atonic post- I.V 4-6 gms For bleeding due to
partum hge. hypofibrinogenemia

Managment of atonic post- I.V 50.000-


Trazylol partum hge. 100.00 Us
Intestinal antiseptic Paraffin oil

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Drugs in Obstetrics

Nalorphine - Neonatal asphyxia 0.5mg Into Umblical cord if


asphyxia due to mprphia
Sodium Neonatal asphyxia 8.4% If acidosis developed
bicarbonate
Epinephrine Neonatal asphyxia Injected Up to 0.5cc For cardiac resus.
into
Umbilical
vein or
Intra
cadiac
Ritodrine Preterm labor IV drips 50 mg in The infusion should be
500 cc of continued for 24-48 hours
5% glucose. after cessation of
Started at contractions; meanwhile
adose of 10 oral ritodrine is given
drops per simaltaneously one tablet
minute & (10mg) every 2 hours.
increased by The oral ritodrine is given
5 drops one tablet every 8 hours,
every 10 the dose may be adjusted
minutes according to response &
until complications.
contractions
stop or
tixicity
appears
(HR>120/m
in.)
Ethanol Preterm labor

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Drugs in Obstetrics

Anti-
Anti-prostaglandins Indomethacin Preterm labor
phenobarbital Erythroblastosis fetalis (Rh
incompatibility)
Antispasmodics Atropine Cervical Dystocia If fails  CS
Antithyroid Propyl thiouracil Thyrotoxicosis with pregnancy

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