NAME: JASH MICHAEL BARBAJO

PALAWAN POLYTECHNIC COLLEGE INC.

OBSTETRIC WARD

DRUG STUDY

OXYTOCIN:

INDICATIONS AND DOSAGES

To reduce postpartum bleeding after expulsion of placenta

Adults: 10 to 40 units in 1000 ml lactated ringer solution. Or plain NSSS IV infused at
rate needed to sustain uterine contraction and control uterine atony.

CONTRAINDICATIONS/CAUTIONS:

Contraindication in patient hypertensive to drug.

Contraindication when vaginal delivery is not advised when cephalopelvic
distroportion is present, or when delivery requires conversion, as in transverse lie.
Contraindicated in fetal distress when delivery is not imminent, in prematurity, in
other obstetric Emergency
Use continuously, if at all, in patients within vassive cervical or uterine surgery.

ADVERSE REACTIONS:

MATERNAL
CNS: subarachnoid, hemorrhage, seizures, coma.
CV: Arrythmias, HTN, PVCs, Hypotension, Tachycardia.
GU: Abruption Placentae.

NURSING CONSIDERATIONS:

All patients receiving oxytocin IV must be under continuous observation by trained

personnel who have a thorough knowledge of the drug and are qualified to identify
complications.
METHERGINE:

INDICATION AND DOSAGES:

Following delivery of the placenta, for routine management of uterine atony,

hemorrhage, and subinvolution of the uterus.
For control of uterine hemorrhage in the second stage of labor following delivery if
the anterior shoulder.

CONTRAINDICATIONS/CAUTIONS

Use of Methergine is contraindicated during pregnancy because of its uterotonic

effects. The uterotonic effect of Methergine is utilized after delivery to assist
involution and decrease hemorrhage, shortening the third stage of labor.
Hypertension; toxemia; pregnancy; and hypersensitivity.

ADVERSE REACTIONS:

nausea,
vomiting,
stomach pain,
diarrhea,
leg cramps,
increased sweating,
skin rash,
headache,
dizziness,
ringing in your ears,
stuffy nose, or
unpleasant taste in your mouth.

NURSING CONSIDERATIONS:

Mothers should not breast-feed during treatment with Methergine and at least 12 hours
after administration of the last dose. Milk secreted during this period should be discarded.
EVENING PRIMROSE:

INDICATION AND DOSAGES:

evening primrose oil dietary supplements are promoted for atopic dermatitis (a type
of eczema), rheumatoid arthritis, premenstrual syndrome (PMS), breast pain,
menopause symptoms, and other conditions. Evening primrose oil may also be
included in products that are applied to the skin.

CONTRAINDICATIONS/CAUTIONS:

Don't take evening primrose if you have a bleeding disorder. Oral use of the
supplement might increase the risk of bleeding. If you're planning to have surgery,
stop taking evening primrose two weeks beforehand. Also, don't take evening
primrose if you have epilepsy or schizophrenia.

ADVERSE REACTIONS:

Evening primrose oil is generally well tolerated. The most common side effects
are temporary gastrointestinal symptoms such as abdominal pain, fullness, or
nausea. Evening primrose oil may increase the effects of the HIV medicine lopinavir.

NURSING CONSIDERATIONS;

Evening primrose is considered possibly safe to use while breast-feeding. Do not use
this product without medical advice if you are breast-feeding a baby. Do not give any
herbal/health supplement to a child without medical advice.

HYDRALAZINE:

INDICATIONS AND DOSAGES:

Adults: initially, 10 mg PO q.i.d first 2 to 4 days, then 25 mg q.i.d for balance of first
week on, based on patient tolerance and response. Maximum dose, 300 mg/day.
Children age 1 and older: initially. 0.75 mg/kg PO in four divided doses; gradually
increase over to 3 to 4 weeks to maximum of 7.5 mg/kg/day in four divided doses or
200 mg/day.
Hypertensive emergency
Adults: 10 to 20 mg IM or IV; repeat as needed every 4 to 6 hours. May increase
dose to a maximum of 40 mg/dose if necessary. Switch to oral form as soon as
possible
Children: 1.7 to 3.5 mg/kg/day IM or IV divided into four to six doses.

CONTRAINDICATIONS/CAUTIONS

Contraindicated in patient hypertensive to drug.

Drug may contain tartrazine and cause allergic reactions, especially in patients
hypertensive to aspirin
Drug may produce a clinical picture consistent with SLE.
Contraindicated in those with CAD or mitral valvular rheumatic heart disease.
May cause blood dyscrasias. Discontinue drug if they occur.
ADVERSE REACTIONS:

CNS: anxiety, headache, depression, dizziness, peripheral neuritis, increased ICP,

psychosis,
CV: Angina pectoris, palpitations, tachycardia, orthostatic hypotension, edema,
flushing, shock.
EENT: conjunctivitis, nasal congestion.
GI: nausea, vomiting, diarrhea, anorexia, constipation, paralytic ileus.

NURSING CONSIDERATION:

Monitor patient’s BP standing and sitting/supine. HR, and body weight frequently.
Drug may be given with diuretics and beta blockers to decrease sodium Sodium
retention and tachycardia and to prevent angina attacks.
Elderly patients may be more sensitive to drug’s hypotensive effects.
Obtain CBC, Lupus erythematosus cell preparation and ANA titer determination
before theraphy and periodically during long term theraphy.

PARACETAMOL + TRAMADOL:

INDICATIONS/DOSAGES:

PO
Adult: Available preparations:
Tramadol 37.5 mg and paracetamol 325 mg film-coated tab
Tramadol 75 mg and paracetamol 650 mg conventional tab
Tramadol 37.5 mg and paracetamol 325 mg effervescent tab

As tramadol 37.5 mg and paracetamol 325 mg film-coated tab: 1-2 tab(s) 4-6 hourly
as needed. Max: 8 tabs daily. As tramadol 75 mg and paracetamol 650 mg
conventional tab: 1 tab 6 hourly as needed. Max: 4 tabs daily. As tramadol 37.5 mg
and paracetamol 325 mg effervescent tab: 2 tabs 6 hourly as necessary. Max: 8 tabs
daily. Max daily doses are equivalent to tramadol 300 mg and paracetamol 2,600
mg. Use the lowest effective dose for the shortest possible treatment duration. Dose
must be adjusted based on the intensity of pain and individual sensitivity. Dosage
recommendations may vary among countries and individual product (refer to local
detailed product guideline).

CONTRAINDICATION/CAUTION:

Not recommended in patients with severe respiratory insufficiency. Avoid use in

patients with circulatory shock, impaired consciousness or coma, moderate to severe
sleep-disordered breathing and suicidal patients. Cachectic, debilitated or morbidly
obese patients. Avoid abrupt withdrawal.

ADVERSE REACTIONS:

Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or

sweating may occur. Some of these side effects may decrease after you have been
using this medication for a while.
NURSING CONSIDERATIONS:

You should not breastfeed while taking tramadol. Tramadol can cause shallow
breathing, difficulty or noisy breathing, confusion, more than usual sleepiness,
trouble breastfeeding, or limpness in breastfed infants.

MALUNGGAY CAPSULE:

INDICATIONS/DOSAGES:

Moringga Olifera Dosage Strength: 500 mg Dosage form: capsule Indication:

Moringa, or malunggay, capsules are an herbal supplement that acts as a lactation
enhancer. Moringa has been proven to improve the letdown of milk and increase
milk production.

CONTRAINDICATION/CAUTIONS:

Knowing the contraindications of Moringa related to the consumption of the roots becomes

essential in the event of pregnancy because from some studies carried out it would seem
that the substances contained in this part of the plant have even abortive capacity.
Excluding the use of the roots, and in conditions of good health, Moringa Oleifera does not
seem to have other particular contraindications

ADVERSE REACTIONS:

Lower blood pressure and slow heart rate because of the alkaloids in the plant.
Uterine contractions from moringa bark.
Cell mutations caused by a chemical isolated from roasted moringa seeds.
Interference with fertility.
Upset stomach, gas or diarrhea due to laxative properties.
NURSING CONSIDERATION:
Moringa oleifera leaves increases breastmilk volume by increasing prolactin and
providing essential nutrients. It takes about 24 hours after ingestion for the Moringa
oleifera to work.
MAGNESIUM SULFATE:

INDICATIONS/DOSAGES:

In severe renal impairment, reduce dosage and obtain frequent sperm magnesium
levels.

MILD HYPOMAGNESIA

Adults: 1 g IM every 6 hrs. for four doses, depending on magnesium.

SYMPTOATIC SEVERE HYPOMAGNESEMIA, WITH MAGNESIUM LEVEL OF 0.8 mEq/L OR

LESS.

Adults: 5 g IV in 1L of D5W or NSSS over 3 hrs. base subsequent doses in

magnesium level.

MAGNESIUM SUPPLEMENTATION IN TPN.

Adults: 8 to 24 mEq/L IV daily added to TPN solution.

Infants: 2 to 10 mEq/L IV added to TPN solution.

CONTRAINDICATION/CAUTIONS:

Contraindicated in patients with myocardial damage, heart block or coma.

Use cautiously in patients with impaired renal function.

ADVERSE REACTIONS:

CNS: toxicity, weak or absent of deep tendon reflexes, paralysis, drowsiness, stupor.
CV: slow, weak pulse, flushing.
GI: diarrhea.

NURSING CONSIDERATION:

Keep IV calcium available to reverse magnesium intoxication.

If appropriate, test knee-jerk and patellar reflexes before each additional dose.
Check magnesium level after repeated doses. Monitor levels hourly in patients with
severe hypomagnesemia, normal plasma magnesium level is 1.5 to 2.5 mEq/L.
Monitor renal function.
NEFEDIPINE:

INDICATION/DOSAGES:

Nifedipine capsules are indicated to treat vasospastic angina and chronic stable
angina. Extended-release tablets are indicated to treat vasospastic angina, chronic
stable angina, and hypertension.
The dose of this medicine will be different for different patients. Follow your doctor's
orders or the directions on the label. The following information includes only the
average doses of this medicine. If your dose is different, do not change it unless
your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine.
Also, the number of doses you take each day, the time allowed between doses, and
the length of time you take the medicine depend on the medical problem for which
you are using the medicine.

For treatment of chest pain or high blood pressure:

o For oral dosage form (capsules):
 Adults—At first, 10 milligrams (mg) three times a day. Your doctor
may increase your dose as needed.
 Children—Use and dose must be determined by your doctor.
o For oral dosage form (extended-release tablets):
 Adults—At first, 30 or 60 milligrams (mg) once a day. Your doctor
may increase your dose as needed. However, the dose is usually not
more than 90 mg once a day.
 Children—Use and dose must be determined by your doctor.

CONTRAINDICATIONS/CAUTIONS:

This medicine may cause fluid retention (edema) in some patients. Tell your doctor
right away if you have bloating or swelling of the face, arms, hands, lower legs, or
feet; tingling of the hands or feet; or unusual weight gain or loss.
Do not stop taking this medicine without first checking with your doctor.

ADVERSE REACTION:

The most common adverse effects include flushing, peripheral edema, dizziness,

headache. Tolerance is better with the extended-release preparations than the
immediate-release preparations of nifedipine. Hypersensitivity reactions, such as
pruritus, urticaria, and bronchospasms, are relatively rare.

NURSING CONSIDERATION:

Monitor patient carefully (BP, cardiac rhythm, and output) while drug is being
adjusted to therapeutic dose; the dosage may be increased more rapidly in
hospitalized patients under close supervision.
Do not exceed 30 mg/dose increases. Ensure that patients do not chew or divide
sustained-release tablets.

FERROUS SULFATE:
INDICATIONS/DOSAGES:

oral solution
 220mg (44mg Fe)/5mL
 300mg (60mg Fe)/5mL
 15 mg elemental Fe/mL
oral liquid drops
 75mg (15mg Fe)/mL
tablet
 45mg elemental Fe
 200mg (65mg Fe)
 300mg (60mg Fe)
 325mg (65mg Fe)
tablet, delayed release
 325mg (65mg Fe)
tablet, extended release
 160mg (50mg Fe)
 142mg (45 mg Fe)
 140mg (45 mg Fe)

Recommended Daily Allowance (Elemental Iron)

19-50 years
 Males: 8 mg/day
 Females: 18 mg/day
 Pregnant females: 27 mg/day
 Lactating females: 9 mg/day
>50 years
 8 mg/day
Iron Deficiency Anemia
Treatment expressed as elemental iron
 100-200 mg PO divided q12hr; may administer extended-release form once
daily
Prophylaxis expressed as elemental iron
 60 mg PO once daily

CONTRAINDICATIONS/CAUTIONS:

You should not use this medicine if you have had an allergic reaction to iron
supplements, or if you have a condition called hemachromatosis (iron overload
disease) or hemosiderosis (iron in the lungs), or any type of anemia that is not
caused by iron deficiency.

ADVERSE EFFECT:

feeling or being sick (nausea or vomiting), stomach pain or heartburn.

loss of appetite.
 constipation.
diarrhea.
dark or black poo.
black stained teeth (from the drops)

NURSING CONSIDERATIONS:

May cause seizures, hypotension, constipation, epigastric pain, diarrhea,

skin. staining, anaphylaxis.
Assess nutritional status, bowel function.
Monitor hemoglobin, hematocrit, iron levels.

SENOKOT:

INDICATION/DOSAGES:

Constipation.
 Adult Dosage:
2 tabs once daily; max 4 tabs twice daily.

Children Dosage:
<2yrs: individualize. 2–6yrs: ½ tab once daily; max 1 tab twice daily. 6–12yrs: 1 tab
once daily; max 2 tabs twice daily.

CONTRAINDICATION/CAUTIONS:

You should not use this medicine if you have ever had an allergic reaction to any
stimulant laxatives, or if you have intestinal blockage, signs of appendicitis (severe
stomach pain, nausea, vomiting), or rectal bleeding of unknown cause.

ADVERSE EFFECTS:

rectal bleeding;
no bowel movement within 12 hours after using senna; or.
low potassium level--leg cramps, constipation, irregular heartbeats, fluttering
in your chest, increased thirst or urination, numbness or tingling, muscle
weakness or limp feeling.

NURSING CONSIDERATION:

N/A.

CARBOPROST:

INDICATION/ DOSAGES:

Intramuscular
Pregnancy termination in the 2nd trimester
 Adult: Initially, 250 mcg. Alternatively, initiate w/ test dose of 100 mcg. May be
repeated at 1.5- to 3.5-hr intervals depending on uterine response. May be increased
to 500 mcg if uterine contractility is inadequate. Max: 12 mg. Max duration: 2 days.

Intramuscular
Postpartum hemorrhage.
Adult: Initially, 250 mcg by deep inj. May be repeated every 15-90-min. Max: 2 mg.

CONTRAINDICATIONS/CAUTIONS:
Acute pelvic inflammatory disease; active cardiac, pulmonary, renal or hepatic
disease.
Patient w/ compromised (scarred) uteri; history of asthma, seizure disorders, DM,
anemia, glaucoma or raised intra-ocular pressure, HTN, hypotension, CV disease,
hepatic disease, including jaundice or renal disease. Pregnancy and lactation.

ADVEFRSE REACTIONS:

Vomiting
Diarrhea
Nausea
transient fever
flushing
increased BP
bronchospasm
dyspnea
pulmonary oedema.

NURSING CONSIDERATION:

Monitor uterine contractions and observe and report excessive vaginal bleeding and
cramping pain. Save all clots and tissue for physician inspection and laboratory
analysis.
Check vital signs at regular intervals. Carboprost induced febrile reaction occurs in
more than 10% of patients and must be differentiated from endometritis, which
occurs around third day after abortion.

AMPICILLIN:

INDICATIONS/DOSAGES:

RESPIRATORY TRACT INFECTIONS

Adults and children weighing ore than 20 kg: 250 PO every 6 hours
 Children weighing 20 kg or less: 50 mg/kg/day PO in equally divided doses every 6
to 8 hrs. maximum dose is 250 mg q.i.d.

GI INFECTIONS OR GU INFECTIONS (EXCLUDING GONORRHEA).

Adults and children weighing 20 kg or more: 500 mg PO every 6 hrs. For severe
infections, larger doses may be needed.
Children weighing less than 20 kg: 100 mg/kg/day PO in equally divided doses every
6 hrs. Maximum dose of 500 mg q.i.d.

CONTRAINDICATIONS/CAUTIONS:

Contraindicated in patient hypertensive to drug to other penicillins and in those with

infectious caused by penicillinase – producing organisms.
Ise cautiously in patients with other drug allergies because of possible cross
sensitivity and in those with mononucleosis because of high risk of maculopapular
rash.
Use cautiously in patients with renal impairment.

ADVERSE REACTION:

GI: diarrhea, nausea, pseudomembranous colitis, abdominal pain, black hairy

tongue, entercolotis, gastritis, glossitis, stomatis, vomiting.

NURSING CONSIDERATIONS:

Monitor sodium levels frequently because each gram of ampicillin sodium injection
contains 2. mEq of sodium.
Watch for signs and symptoms of hypertensitivity.

GENTAMICIN:

INDICATION/DOSAGES:

Adults: Systemic infections: if renal function is not impaired, 3-5 mg/kg/day in

divided doses according to severity of infection, adjusting according to clinical
 response and body weight. Serious infections: if renal function is not impaired,
5mg/kg daily in divided doses at six or eight hourly intervals.

CONTRAINDICATION/CAUTIONS:

Contraindicated in patients hypersensitive to drug or other aminoglycosides.

Use cautiously in neonates, infants, elderly patients with impaired renal function or
neuromuscular disorders.
Use drug for short term treatment if possible. Prolonged use may result in fungal ir
bacterial superinfection including CDAD.

ADVERSE REACTIONS:

CNS: encephalopathy, seizures, fever, headache, lethargy, confusion, dizziness,

numbness, depression, peripheral neuropathy, vertigo, ataxia, tingling.
CV: hypotension.

NURSING CONSIDERATION:

Evaluate patient’s hearing before and during therapy. Notify prescriber if patient
complains if tinnitus, vertigo, hearing loss.
Weigh patient and review renal function studies before therapy begins.