maternity drugs

Misoprostol (Cytotec)

Misoprostol is a synthetic prostaglandin usually given with mifepristone. It is the most widely used off-label drug for cervical ripening and the enhancement of uterine muscle tone because it is relatively affordable. Misoprostol is an oral uterine stimulant that helps in inducing labor when the uterus is insensitive to oxytocin. Misoprostol is also a stomach protectant.

Penicillins, macrolides, and cephalosporins

are considered safe drugs during breast-feeding as they are least likely to affect the infant.

Betamimetics

have the unpleasant side effects of nervousness, tremors, and palpitations; clients should be informed that these side effects are expected. If contractions are lessened and the maternal heart rate is less than 120 beats/min and regular, the medication is performing as expected and does not need to be discontinued.

Aminophylline (Theophylline)

is a bronchodilator; it is not used for preterm labor.

Norgestrel

is a contraceptive hormone;

Cyclophosphamide

is a drug used in the treatment of cancer. It is shown to have teratogenic effect if taken during pregnancy. The teratogenic effect includes shortened limbs, internal organ defects, limb malformations, and central nervous system malformation.

Mifepristone

is a progesterone antagonist used along with misoprostol to induce abortion. it also activates uterine contractions and causes abortion. This drug is used in the voluntary termination of pregnancy and is known as the abortion pill.

Heparin

is an anticoagulant. When heparin is taken concurrently during pregnancy, it may cause osteoporosis, which in turn can cause compression fractures of the spine.

Tenormin

is contraindicated for lactating mothers because this drug highly concentrates in breast milk.

Tenormin (atenolol)

is contraindicated for lactating mothers because this drug highly concentrates in breast milk. Labetalol, metoprolol, and propranolol are safe to prescribe to lactating mothers.

Methylergonovine

is used to control postpartum hemorrhage. can cause hypertension and should not be given to a client with an increased blood pressure.

Indomethacin

is used to maintain a pregnancy in preterm labor by inhibiting prostaglandin activity, which is the converse of misoprostol's effects.

Phenothiazine

may cause sudden infant death syndrome.

Nifedipine and indomethacin are used to control

preterm labor.

Probenecid

reduces renal tubular excretion of penicillin

tetracycline and chloramphenicol

should be avoided during breast-feeding.

Kernicterus is a condition seen in newborns due to deposition of bilirubin in the brain and is caused by

sulfonamides

Beta-adrenergic medications are

tocolytic agents that may halt labor, although only temporarily. Other tocolytics that may be used are magnesium sulfate, prostaglandin inhibitors, and calcium channel blockers.

Dexamethasone

a glucocorticoid that stimulates the production of fetal lung surfactants, which are needed for fetal lung maturity; administration is started 48 hours before the expected birth.

Rho(D) immune globulin (RhoGAM)

administered during the twenty-eighth week of gestation reduces an active antibody response in an Rh-negative individual exposed to Rh-positive blood. It is difficult to determine whether Rh sensitization has occurred this early in pregnancy. RhoGAM is given earlier in the pregnancy; it is a preventive measure, not a treatment for a woman who is already sensitized. Forty weeks is around the time of birth; if the client has not been sensitized, she will receive RhoGAM within 72 hours of birth.

Clomiphene

is a fertility drug used to promote ovulation in nonpregnant women. Clients taking this drug should be counseled about the possibility of multiple pregnancies. The client's reproductive and uterine status should be assessed because clomiphene may result in multiple pregnancies. The concomitant use of antidepressants with clomiphene may cause fertility impairment. Assessing the client's family stability and economic status is essential because this can be a risk factor for multiple pregnancies.

Menotropin

is a standardized mixture of follicle-stimulating hormone and luteinizing hormone; these hormones should be monitored. Also, estrogen levels need to be monitored because the luteinizing hormone indirectly stimulates the production of estrogen. Gonadotropin-releasing hormones act at the hypothalamic level; therefore, this hormone does not need to be monitored.

Dinoprostone

is a synthetic derivative of naturally occurring prostaglandin E 2. This drug is used for cervical ripening when there is an obstetric need for labor induction. it is a prostaglandin derivative used to evacuate the contents of the uterus in an intrauterine fetal death for up to 28 weeks of gestation. it is available as a suppository that is administered intravaginally. This drug is used to manage nonmetastatic gestational trophoblastic disease.

Sertraline

is the drug of choice for lactating woman with depression because it does not cause any effects on breast-feeding infants.

Meperidine (Demerol)

is the most commonly used opioid agonist analgesic for women in labor throughout the world. It overcomes inhibitory factors in labor and may even relax the cervix. Because tachycardia is a possible adverse reaction, meperidine is used cautiously in women with cardiac disease.

Magnesium Sulfate

is used for tocolytic therapy and has been somewhat effective in delaying preterm labor. toxicity depresses respiration; therefore it is essential to obtain a baseline respiratory rate before initiating therapy. An absence of deep tendon reflexes is one of the first signs of magnesium sulfate toxicity. Magnesium sulfate interferes with the release of acetylcholine at the synapses, thereby decreasing neuromuscular irritability.