ST.

ANTHONY’S COLLEGE

SAN JOSE ANTIQUE

DRUG STUDY

DRUG DOSE METHOD OF INDICATION EFFECT ON EFFECT ON EFFECT ON FETUS

ADMINISTRATION LABOR PROGRESS MOTHER
GENERIC NAME: -Labor for patients I.V Butorphanol Intravenous Prolonged use of Butorphanol may
at full term; early -Compatible tartrate is butorphanol 1 mg, opioid analgesics be harmful to an
Butorphanol labor (without solutions include indicated for the and meperidine, during pregnancy unborn baby.
tartrate signs of fetal D5W and normal management of 50 mg, reduce pain may cause Butorphanol is
distress) saline solutions. pain when the use intensity and pain neonatal opioid sometime used
BRAND NAME: -Give by direct of an opioid effective withdrawal during early labor,
Adults: 1 or mg I.V. injection into vien analgesic is magnitude by a syndrome. This but using it just
Stadol or I.M; repeat after or into the tubing appropriate. statistically drug is not before childbirth
4 hours as needed. of a free flowing significant amount recommend for can cause
Don’t give dose I.V. solution. 15 min after use during or breathing
less than 4 hours Incompatibilities: injection in women immediately prior problems in a
before anticipated Dimenhydrinate, with moderate to to labor, when newborn.
delivery. pentobarbital severe labor pain. other analgesic Butorphanol
-Preoperative sodium. technique use are passes into
anesthesia or pre I.M. more appropriate, breastmilk and
anesthesia -Give drug I.M.; There are no may harm a
Don’t give controlled data in nursing baby.
Adults: 2 mg I.M. subcutaneously. human pregnancy.
60 to 90 minutes Intranasal:
before surgery. Watch for nasal
-Adjunct balanced congestion with
anesthesia nasal spray use.
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Adults shortly
before induction,
or 0.5. to 1 mg I.V.
in increments
during anesthesia.
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DRUG DOSE METHOD OF INDICATION EFFECT ON EFFECT ON EFFECT ON FETUS

ADMINISTRATION LABOR PROGRESS MOTHER
GENERIC NAME: Adult Dosage: -It administered by -Anesthesia -Bupivacaine This drug can cause Local anesthetics
-Preservative free: spinal injection prior solutions in the range maternal epidly cross the
Bupivacaine 10-0 ml of 0.5% or to total hip from 0.20% to 0.25% hypotension as well placenta, and when
0.5% administer in 3- arthroplasty. It is also wt/vol were used for as fetal bradycardia. used for epidural,
BRAND NAME: 5 ml increments commomly injected labor analgesia,24 Both mother and caudal, or pudendal
allowing sufficient into surgical wound and these were fetus should be block anesthesia, can
Marcaine time to detect toxic sites to reduce pain shown to lead to closely monitored cause varying
Sensorcaine manifestations of for up to 20 hours increased rates of after administration. degrees of maternal,
inadvertent after surgery. In instrumental vaginal -Epidural, caudal, or fetal, and neonatal
intravenous or comparison to other (but not cesarean) pudendal anesthesia toxicity. The
intrathecal (IT) local anesthetics it delivery. may effect uterine incidence and degree
administration has a long duration of contractility and may of toxicity depend
-Surgical procedures action. prolong stages of upon the procedure
requiring high degree - Spinal Anesthesia I labor. performed, the type,
of muscle relaxation commonly used -It is extremely and amount of drug
and prolonged during labor and important to avoid used, and the
effects: 10-20 mL of delivery. Bupivacaine maternal aortocaval technique of drug
0.75%; not to be hydrochloride, when compression by the administration.
used in obstetrical administered gravid uterus during Adverse reactions in
cases. properly, via the administration of the parturient, fetus,
Pediatric Dosage: epidural route in regional block. The and neonate involve
-Children under 12 doses 10 to 12 times patient should be alterations of the
years: not the amount used in maintained in left CNS, peripheral
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recommended spinal anesthesia has lateral decubitus vascular tone, and

-Children over 12 been used for position or a blanket cardiac function. If
years: 10-20 ml of obstetrical analgesia roll or sand bag may this drug is used
0.25% or 0.5%; and anesthesia be placed beneath during pregnancy, or
administer in 3-5 ml without evidence of the right hip and if the patient
increments allowing adverse effects on graved uterus becomes pregnant
sufficient time to the fetus. displaced to the left. while taking this
detect toxic drug, inform the
manifestation of patient of the
inadvertent potential hazard of
intravenous or IT the fetus.
Administration
(preservative free):
for surgical
procedures requiring
high degree of
muscle relaxation
and prolonged effects
administer 10-20 ml
of 0.75%; not to be
used in obstetrical
cases.
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DRUG DOSE METHOD OF INDICATION EFFECT ON EFFECT ON EFFECT ON FETUS

ADMINISTRATION LABOR PROGRESS MOTHER

GENERIC NAME: Adults: 50 to 100 I.V. Lidocaine lidocaine can soften Fortunately, One study involving
mg (1 to 1.5 - Injections Hydrochloride the cervix and lidocaine, which is lidocaine as a local
Lidocaine mg/kg) by I.V. bolus ( addictive syringes Injection, USP is shorten the first the most commonly anesthetic did not
Hydrochloride at 25 to 50 and single-use indicated for stage of labor by used local anesthetic find a higher chance
wet com- pressing during dental for birth defects.
mg/minute. Bolus vials) containing 40, production of local
and injection of the treatments, is under Also, human case
BRAND NAME: dose is repeated 100, or 200 mg/mL or regional
cervix, has no category B and reports and
every 3 to 5 are for the anesthesia by considered to have experimental animal
LidoPen Auto- adverse effect on
minutes until preparation of I.V. infiltration almost no negative studies do not
the outcome of
Injector,Xylocaine, arrhythmias infusion solutions techniques such as effect on the mother suggest that
mother and child,
Xylocard subside or adverse only and must be percutaneous and the fetus. In lidocaine would
and the safety level
reactions develop. diluted before use. injection and addition, the significantly increase
was high.
Don’t exceed 300- -Prepare I.V. intravenous likelihood of the use the chance of birth
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DRUG STUDY

mg total bolus infusion by adding regional anesthesia of local anesthetics in defects.

during a 1 hour 1 g (using 25 mL of by peripheral nerve dental treatments for
period. 4% or 5% mL of block techniques pregnant women
Simultaneously, 20% injection) to 1 such as brachial negatively affecting
the women and their
constant infusion L of D5W injection plexus and
fetuses appears to be
of 20 to 50 to provide a intercostal and by low. Therefore,
mcg/kg/minute (1 solution containing central neural pregnant women are
to 4 mg/ minute) is 1 mg/ mL. techniques such as reluctant to undergo
begun. If single -Use more lumbar and caudal and dentists
bolus has been concentrated epidural blocks, reluctant to perform
given, smaller solution of up to 8 when the accepted dental treatments
bolus does may be mg/mL in fluid- procedures for when the oral health
repeated 15 to 20 restricted patient. these techniques of the pregnant
women has been
minutes after start -Patients receiving as described in
compromised by
of infusion to infusions must be standard textbooks
physiological changes
maintain on a cardiac are observed. related to pregnancy;
therapeutic level. monitor and must thus, delaying the
be attended at all needed dental
times. Use an treatment is not
infusion control advisable
device for giving
infusion precisely.
Don’t exceed 4
mg/minute; faster
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rate greatly
increases risk
toxicity.
-Avoid giving
injections
containing
preservatives.

DRUG DOSE METHOD OF INDICATION EFFECT ON EFFECT ON EFFECT ON FETUS

ADMINISTRATION LABOR PROGRESS MOTHER
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DRUG NAME: Adult: Dose is For slow Pentothal This Drug readily This drug can cross Thiopental should
individualized and intravenous (Thiopental sodium crosses the the placenta and only be used during
Thiopental Sodium adjusted based on injection after for injection, USP) placental barrier; reach the fetus, pregnancy if
patients response reconstitution. is indicated (1) as the concentration potentially leading prescribed. It may
BRAND NAME: and factors 100-150 For intravenous the sole anesthetic in cord vein blood to adverse be harmful to a
mg via slow inj over administration only. agent for brief (15 is at its maximum 2 outcomes. The fetus . This
Sodium Pentothal 10-15 seconds; may Extravasation minutes) to 3 minutes after main concern lies in medication can
repeat dose after 1 causes local tissue procedures, (2) for an IV dose is its ability to pass into breast
minute if needed. necrosis and severe induction of administered to the depress the central milk and may harm
Alternately, 50-75 pain. Accidental anesthesia prior to mother . The fetal nervous system, a nursing baby.
mg at intervals of intra-arterial administration of blood level is which can affect Consult your doctor
20-40 seconds, injection site. If this other anesthetic related to maternal the fetal brain before
according to occurs, the agents, (3) to blood level but is development. breastfeeding.
response or 3-6 injection needle supplement considerably lower. Thiopental sodium Thiopental may be
mg/kg as a single should be left in- regional This drug can be has been habit-forming.
dose (Max total: situ so that an anesthesia, (4) to used without associated with
500 mg). Once antispasmodic can provide hypnosis adverse effect respiratory
anesthesia has be administered. during balanced during pregnancy; depression in
been established Anticoagulant anesthesia with however, it should newborns, posing a
may give additional therapy may also other agents for only be used when risk for oxygen
doses of 25-50 mg be required to analgesia or muscle the expected deprivation during
as necessary. If minimize the risk of relaxation, (5) for benefits outweigh delivery.
given as a sole thrombosis. the control of any potential risks.
anesthetic agent: convulsive states
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The desired level of during or following

anesthesia can be inhalation
maintained by inj of anesthesia, Local
small, repeated anesthesia, or
doses as needed or other causes, (6) in
using a continuous neurosurgical
IV infusion of 0.2 or patients with
0.4% increased
concentration. intracranial
Dosing pressure, if
recommendations adequate
may vary among ventilation is
individual products provided, and (7)
and between for narcoanalysis
countries (refer to and narcosynthesis
specific product in psychiatric
guidelines). disorders.
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DRUG STUDY

DRUG DOSE METHOD OF INDICATION EFFECT ON EFFECT ON EFFECT ON FETUS

ADMINISTRATION LABOR PROGRESS MOTHER
DRUG NAME: Adult: As naloxone Intranasal spray It indicated for the It is not known if It is not known Naloxone does not
hydrochloride: 0.4- (into the nose), complete or partial naloxone whether naloxone have any adverse
Naloxone 2 mg repeated if Intramuscular (into reversal of opioid hydrochloride is excreted in effects on the
Hydrochloride necessary at 2-3 the muscle), depression, injection affects the human milk. developing fetus
minute intervals. If subcutaneous including duration of labor Because many when administered
BRAND NAME: there is no (under the skin), or respiratory and/or drugs are excreted to pregnant woman
response after a Intravenous depression, delivery .However In human milk. experiencing opioid
Narcan, Evzlo, total of 10 mg has injection. induced by natural the administration Caution should be overdose.
Nyxold. been given, synthetic opioids of naloxone during exercised when
consider the including labor did not naloxone
possibility o propoxyphene, adversely affect hydrochloride is
overdosage with methadone, and maternal or administered to a
other drugs. certain mixed neonatal status. nursing woman
Child: As naloxone agonist-antagonist
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hydrochloride: analgesics.
Initially, 10 mcg/kg
followed by 100
mcg/kg, if
necessary.
Alternatively, may
be given via IM inj,
if IV admin is not
possible.