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NSG 307 Meds - medications
Med surg 2 (341)
Marian University
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NSG 307
Common Maternity Drugs Utilized in PP
Postpartum Medications Classification Action
Route/Dosage Indication Side Effects Contraindications Nursing Consideration
Naproxen Nonsteroidal anti- inflammatory, Nonopioid analgesic;
Inhibits COX 1, COX 2 by blocking arachidonate, analgesic, anti- inflammatory, antipyretic (Skidmore-Roth, 2019)
PO 250-500 mg bid, max 1250 mg/day (Skidmore-Roth, 2019)
Decrease pain, inflammation and primary dysmenorrhea (Skidmore-Roth, 2019)
Dizziness, drowsiness, fatigue, tremors, confusion, nausea, anorexia, vomiting, rash, constipation, cramps and diarrhea (Skidmore-Roth, 2019)
Pregnancy, hypersensitivity to NSAIDS and salicylates (Skidmore- Roth, 2019)
Black box warning for GI status: ulceration, bleeding, perforation may be fatal (Skidmore-Roth, 2019)
Check I&O ratio; decreasing output may indicate renal failure (Skidmore-Roth, 2019)
For pregnancy use only if benefits outweigh fetal risk, avoid in >30wk gestation, cautious use in bleeding
(Skidmore-Roth, 2019)
Lortab
Hydrocodone/ acetaminophen
Antitussive opioid analgesic/ Nonopioid analgesic (Skidmore-Roth, 2019)
15 mg HYDROcodone/ 325 mg acetaminophen (Skidmore-Roth, 2019)
Moderate to severe pain (Skidmore- Roth, 2019)
Drowsiness, tachycardia, bradycardia, circulatory depression, headache, sedation, weakness, disorientation, mood changes, dependence, blurred vision, nausea, vomiting and constipation (Skidmore-Roth, 2019)
Respiratory depression may occur; hypersensitivity to product or benzyl, status asthmatics or GI obstruction (Skidmore-Roth, 2019)
Black box warning: accidental exposure to neonatal opioid withdrawal syndrome, potential for overdose or poisoning (Skidmore-Roth, 2019)
Assess pain intensity, duration, location, type before and 1 hr after given medication (Skidmore-Roth, 2019)
Monitor VS after parenteral route; note muscle rigidity, liver, renal failure, respiratory depression (Skidmore-Roth, 2019)
May affect fetus, crosses placental barrier, do not breastfeed (Skidmore-Roth, 2019)
Norco Opioid pain medication; also known as a narcotic; combo drug of acetaminophen and
15 mg HYDROcodone/
325 acetaminophen,
10 mg HYDROcodone/
Moderate to severe pain (Thornton, 2020)
Dizziness, lightheadedness, nausea, loss of appetite, fast heartbeat, skin rash and vomiting
Severe asthma or breathing problems or a blockage in ones stomach or intestines (Thornton, 2020)
Product can pass through breast milk and may harm a nursing baby (Thornton,
2018, p. 510) et al., 2018, p. 510)
(Perry et al., 2018, p. 510)
Dermoplast spray
(Benzocaine)
Anesthetic; inhibits conduction of nerve impulses from sensory nerves (Skidmore-Roth, 2019)
Hold container approximately 6 to 12 inches from skin and spray on affected area until wet as needed up to 4 times a day (Drugs, 2020)
Oral irritation, sore throat, sunburn, minor cuts, pain, itching (Skidmore- Roth, 2019)
Rash, irritation, sensitization (Skidmore-Roth, 2019)
Hypersensitivity, infants <1 year, precaution used with pregnancy, sepsis and denuded skin (Skidmore-Roth, 2019)
Assess pain: location, duration, characteristics, before, after administration (Skidmore-Roth, 2019)
Assess for infection: redness, drainage, inflammation (Skidmore-Roth, 2019)
Epifoam Synthetic corticosteroid used as an anti- inflammatory/ antipruritic agent and local anesthesia (Drugs, 2019)
Apply small amount to affected area 3-4 times daily (Drugs, 2019)
Topical corticosteroid used for relief of the inflammatory and pruritic manifestations (Drugs, 2019)
Dry skin, burning, itching, thinning of skin (Drugs, 2019)
Caution should be exercised when any topical corticosteroid are administered to a nursing woman (Drugs, 2019)
For patients with history of hypersensitivity to any components of preparation (Drugs, 2019)
Avoid abrupt cessation in chronic use. Systemic absorption increased by broken or inflamed skin, prolonged use, application to large surface area, or use of occlusive dressings (Drugs, 2019)
Colace (docusate Laxative, PO 50-300 mg/day Prevent hard, dry Bitter taste, throat Hypersensitivity, Assess
sodium) emollient; increases water, fat penetration in intestine, allows of easier passage of stool (Skidmore- Roth, 2019)
(Skidmore-Roth, 2019)
Dilute oral solution in juice or other fluids to disguise taste (Skidmore-Roth, 2019)
Give tabs or caps with 8 oz of liquid; give on empty stomach for increased absorption (Skidmore-Roth, 2019)
stools, prevent constipation, soften fecal impaction (rectal route) (Skidmore-Roth, 2019)
irritation, nausea, anorexia, cramps, diarrhea and/or rash (Skidmore- Roth, 2019)
obstruction, fecal impaction, nausea/vomiting (Skidmore-Roth, 2019)
cramping, rectal bleeding, nausea, vomiting, if these symptoms occur to discontinue (Skidmore-Roth, 2019)
Pregnancy/ breastfeeding: low risk (Skidmore-Roth, 2019)
Senokot
(Senna)
Natural medication/
herbal supplement with a laxative effect (Sinha, 2019)
Liquid: (8 mg/5 mL): 10 to 15 mL orally once a day; Max dose: 30 mL (Sinha, 2019)
Tablets: 8 mg: 2 tablets orally once a day at bedtime; max dose: 8 tablets/day (Sinha, 2019)
Used as a laxative and aid to treat constipation (Sinha, 2019)
Severe diarrhea, stomach pain, cramps, bloating, gas, discolored urine, tingly feeling or numbness (Sinha, 2019)
Do not take medication with digoxin, diuretics or blood thinner. Contact HCP (Sinha, 2019)
Not all uses for senna have been approved by FDA; often sold as herbal supplement; use as directed on label or as HCP prescribed; do not use this product in larger amounts or for longer than recommended (Sinha, 2019)
Simethicone Antiflatulent (Skidmore-Roth, 2019)
PO 40-125 mg after meals and at bedtime PRN, max 500 mg/day (Skidmore-Roth, 2019)
Used for flatulence and relieve painful pressure caused by excess gas in stomach (Skidmore- Roth, 2019)
Nausea, constipation, tongue edema and/ or rash (Drugs, 2019)
Hypersensitivity, GI obstruction/ perforation (Skidmore-Roth, 2019)
Medication works best at after meals and at bedtime (Drugs,
Inhibits ascending pain pathways in CNS, increase pain thresholds, alters pain perception (Skidmore-Roth, 2019)
patients) (Skidmore- Roth, 2019)
- palpitations, bradycardia, increased urinary output, rash, diaphoresis, change in B/P, fatigue and/or sedation (Skidmore-Roth, 2019)
2019)
Precautions: Pregnancy, breastfeeding, asthma, ileus, addiction (opiate), and/or hypersensitivity (Skidmore-Roth, 2019)
output (Skidmore-Roth, 2019)
Allergic reaction: assess for rash (Skidmore-Roth, 2019)
Assess for constipation, stimulant laxative may be needed with fluids (Skidmore-Roth, 2019)
Assess for respiratory depression and notify HCP if respirations are <10/min (Skidmore-Roth, 2019)
Toradol (ketorolac) Nonsteroidal anti- inflammatory; Nonopioid analgesic (Skidmore-Roth, 2019)
PO continuation from IM/IV only 20 mg; then 10 mg q4-6hr PRN, max 40 mg/day (Skidmore-Roth, 2019) IV/IM route:
Mild to moderate pain (short term) (Skidmore-Roth, 2019)
Dizziness, peripheral edema, fatigue, confusion, insomnia, depression, dry mouth, nausea, vomiting, diarrhea,
Pregnancy (3rd trimester), hypersensitivity, asthma, hepatic disease, peptic ulcer, CV bleeding (Skidmore-Roth,
Assess for pain: type, location, intensity; ROM before and 1- hr after treatment (Skidmore-Roth,
IV: give undiluted > sec
Give IM inj deeply into large muscle mass (Skidmore-Roth, 2019)
dermatitis, depression (Skidmore-Roth, 2019)
2019)
Black box warning: breastfeeding, severe renal disease, labor delivery, hypovolemia, GI bleeding (Skidmore- Roth, 2019)
2019)
Check I&O ratio (Skidmore-Roth, 2019)
Assess for allergic reaction, rash, urticarial; if this occurs product may be discontinued (Skidmore-Roth, 2019)
Black box warning: assess for CV thrombotic events and GI bleeding (Skidmore-Roth, 2019)
TDAP
Tetanus
Diphtheria
Pertusis
Immunization vaccine to prevent tetanus, diphtheria and pertussis (CDC, 2020)
1 dose of Tdap for pregnant women during each pregnancy given as early as 27 to 36 weeks of gestation (CDC, 2020)
For postpartum women who have not previously received the vaccine; given before discharge from hospital or early as possible to protect women from pertussis and decrease risk of
Pain, redness or swelling where shot was given, mild fever, headache, feeling tired, nausea and vomiting, diarrhea or stomach ache (CDC, 2020)
Hypersensitivity, polio outbreak, acute infection, immunosuppression (Skidmore-Roth, 2019)
Women should be advised that other adults and children who will be around newborn should be vaccinated with Tdap if they are not previously vaccinated.
vaccine (Drugs, 2019)
(Drugs, 2019) possibility of contracting rubella in future pregnancies (Perry et al., 2018, p. 478)
al., 2018, p. 478)
Fever, transient arthralgia, rash, lymphadenopathy (Perry et al., 2018, p. 478)
Do not give vaccine if mother or other household members are immunocompromised (Perry et al., 2018, p. 478)
breastfeeding mothers can be vaccinated (Drugs, 2019)
Dulcolax suppository
Bisacodyl
Laxative, stimulant; acts directly on intestine by increasing motor activity; increase water in colon (Skidmore-Roth, 2019)
Lubricate before insertion, patient should retain for ½ hr; insert high in rectum (Skidmore-Roth, 2019)
Short term treatment of constipation, bowel or rectal preparation for surgery, examination (Skidmore-Roth, 2019)
Nausea, vomiting, muscle weakness, cramps, diarrhea, rectal burning, hypokalemia (Skidmore-Roth, 2019)
Hypersensitivity, abdominal pain, nausea, vomiting, fecal impaction, ulcerative hemorrhoids (Skidmore-Roth, 2019)
Precaution: pregnancy, breastfeeding, rectal fissures (Skidmore- Roth, 2019)
Pregnancy: safety not determined, may be used during breastfeeding (Skidmore-Roth, 2019)
Monitor blood, urine electrolytes, check I&O’s (Skidmore-Roth, 2019)
Assess GI symptoms: cramping, rectal bleeding, nausea, vomiting. If these symptoms occur product should be discontinued (Skidmore-Roth,
2019)
Ferrous sulfate Hematinic
Replaces iron stores needed for red blood cell development, energy and oxygen transport, utilization (Skidmore-Roth, 2019)
PO 0.750-1 g/day in divided doses tid-qid (Skidmore-Roth, 2019)
Iron deficiency anemia, prophylaxis for iron deficiency in pregnancy, nutritional supplement (Skidmore-Roth, 2019)
Nausea, constipation, epigastric pain, black and red tarry stools, vomiting, diarrhea, temporarily discolored tooth enamel and eyes (Skidmore-Roth, 2019)
Sideroblastic anemia, hemosiderosis/
Hemochromatosis; Precaution: pregnancy, anemia, peptic ulcers hemolytic anemia (Skidmore-Roth, 2019)
Monitor blood studies: hct, hgb, reticulocytes, bilirubin before treatment, avoid use with blood transfusions (Skidmore-Roth, 2019)
Use in pregnancy only if benefits outweighs fetal risk to fetus, excreted in breast milk, avoid use (Skidmore-Roth, 2019)
Ferosequels
Ferro-sequels
Iron supplements (WebMD, n)
Tablet: 63 mg (20mg Fe)
324 mg (106mg Fe)
325 mg (106 mg Fe) (Medscape, n)
Used to treat or prevent low blood levels of iron especially those with anemia or during pregnancy (WebMD, n).
Constipation, diarrhea or upset stomach, dark stool, heart burn, nausea, gastrointestinal discomfort (WebMD, n)
Hemochromatosis, hemosiderosis, hemolytic anemia, hypersensitivity (Medscape, n)
Consult with HCP if one has a history/use of alcohol, stomach or intestinal problems (WebMD, n)
Product inhibits tetracycline absorption (WebMD,
ointment bactericidal for Neisseria gonorrhoeae (Perry et al., 2018, p. 573)
of ointment to lower conjunctival sac of each eye (Perry et al., 2018, p. 573)
neonatorum in newborns of mothers who are infected with Neisseria gonorrhea through birthing canal and born cesarean (Perry et al., 2018, p. 573)
conjunctivitis that lasts 24 to 48 hours; vision can be blurred temporarily (Perry et al., 2018, p. 573)
erythromycin (Skidmore-Roth, 2019)
within 1 to 2 hours of birth. Wear gloves. Use a sterile cotton ball to wipe each eyelid prior to administering the ointment. Open eyes by placing thumb and finger at the corner of each lid and gently pressing on periorbital ridges. Squeeze tube and spread ointment from inner canthus of eye to outer canthus. Do not tube to the eye. Gently massage the closed eyelids to disperse the ointment. After 1 minute, excess ointment may be wiped away (Perry et al., 2018, p. 573)
Hepatitis B Vaccine induces protective antihepatitis B antibodies in 95% to 99% of healthy
Neonatal dosage: Recombivax HB 5 mcg/ o mL or Engerix-B 10 mcg/0 mL intramuscularly at birth,
HepB vaccine is for immunizing against infection caused by all known subtypes of hepatitis B virus
Rash, fever, erythema, swelling and pain at injection site (Perry et al., 2018,
Hypersensitivity may occur (Perry et al., 2018, p. 586)
If infant needs hepatitis B immune globulin, use separate sites for
infants who receive the recommended three doses (Perry et al., 2018, p. 586)
at 1 to 2 months and at 6 to 18 months (Perry et al., 2018, p. 586)
(Perry et al., 2018, p. 586)
p. 586) two injections (Perry et al., 2018, p. 586)
For infants of mothers with neg Hep B, administer Hep B vaccine before discharge from birthing facility (Perry et al., 2018, p. 586)
For infants born to hepatitis B surface antigen- positive mothers, administer Hep B vaccine and HBIG within 12 hours after birth (Perry et al., 2018, p. 586)
Infant liquid Tylenol Nonopioid (Perry et al., 2018, p. 805)
10-15 mg/kg/dose q 4- h PO not to exceed five doses in 24 hrs or 75 mg/kg/day, or 4000 mg/ day (Perry et al., 2018, p. 805)
Used for mild to moderate pain; antipyretic, anti- inflammatory (Perry et al., 2018, p. 805)
Nausea, vomiting, leukopenia, trouble sleeping, abdominal pain, rash, GI bleeding (Skidmore-Roth, 2019)
Hypersensitivity to this product; hepatotoxicity (Skidmore-Roth, 2019)
Most NSAIDS take about 1 hour for effect, so timing is crucial (Perry et al., 2018, p. 805).
NSG 307 Meds - medications
Course: Med surg 2 (341)
University: Marian University
