OB/GYN/NBN MEDICATIONS
betamethasone (systemic)
Trade Name(s) Betaject [Canada] Celestone Soluspan Ther. Class. anti-inflammatories (steroidal) Pharm. Class. corticosteroids Indications Management of adrenocortical insufficiency; chronic use in other situations is limited because of mineralocorticoid activity. Used systemically and locally in a wide variety of chronic diseases including: Inflammatory, Allergic, Hematologic, Neoplastic, Autoimmune disorders. Replacement therapy in adrenal insufficiency. Unlabeled Use(s): Short-term administration to high-risk mothers before delivery to prevent respiratory distress syndrome in the newborn. Action In pharmacologic doses, suppresses inflammation and the normal immune response. Has numerous intense metabolic effects (see Adverse Reactions and Side Effects). Suppresses adrenal function at chronic doses of 0.6 mg/day. Has negligible mineralocorticoid activity. Therapeutic Effect(s): Suppression of inflammation and modification of the normal immune response. Replacement therapy in adrenal insufficiency.
trimethobenzamide
Trade Name(s) Tigan Ther. Class. antiemetics Pharm. Class. anticholinergics Indications Mild to moderate nausea and vomiting. Action Inhibits emetic stimulation of the chemoreceptor trigger zone in the medulla. Therapeutic Effect(s): Decreased nausea and vomiting.
Erythromycin ophthalmic ointment
Trade name Ilotycin Ophthalmic Pharmaceutical class Macrolide antibiotic Indication Prophylaxis of ophthalmia neonatorum caused by Neisseria gonorrhea and Chlamydia trachomatis Action Inhibits bacterial protein synthesis; more effective against gram-positive than gram-negative bacteria
ampicillin
Ther. Class. anti-infectives Pharm. Class. aminopenicillins Indications Treatment of the following infections: Skin and skin structure infections, Soft-tissue infections, Otitis media, Sinusitis, Respiratory infections, Genitourinary infections, Meningitis, Septicemia. Endocarditis prophylaxis. Unlabeled Use(s): Prevention of infection in certain high-risk patients undergoing cesarean section. Action Binds to bacterial cell wall, resulting in cell death. Therapeutic Effect(s): Bactericidal action; spectrum is broader than penicillin. Spectrum: Active against: Streptococci, nonpenicillinase-producing staphylococci, Listeria, Pneumococci, Enterococci, Haemophilus influenzae, Escherichia coli, Enterobacter, Klebsiella, Proteus mirabilis, Neisseria meningitidis, N. gonorrhoeae, Shigella, Salmonella.
ceFAZolin
Trade Name(s) Ancef Ther. Class. anti-infectives Pharm. Class. first generation cephalosporins Indications Treatment of the following infections due to susceptible organisms: Skin and skin structure infections (including burn wounds), Pneumonia, Urinary tract infections, Biliary tract infections, Genital infections, Bone and joint infections, Septicemia, Bacterial endocarditis prophylaxis for dental and upper respiratory procedures. Perioperative prophylaxis. Not suitable for the treatment of meningitis. Action Binds to bacterial cell wall membrane, causing cell death. Therapeutic Effect(s): Bactericidal action against susceptible bacteria. Spectrum: Active against many gram-positive cocci including: Streptococcus pneumoniae, Group A beta-hemolytic streptococci, Penicillinase-producing staphylococci. Not active against: Methicillin-resistant staphylococci, Bacteroides fragilis, Enterococcus. Active against some gram-negative rods including: Proteus mirabilis, Escherichia coli.
hydrOXYzine
Trade Name(s) Atarax [Canada] Vistaril Ther. Class. antianxiety agents antihistamines sedative/hypnotics Indications Treatment of anxiety. Preoperative sedation. Antiemetic. Antipruritic. May be combined with opioid analgesics. Action Acts as a CNS depressant at the subcortical level of the CNS. Has anticholinergic, antihistaminic, and antiemetic properties. Blocks histamine 1 receptors. Therapeutic Effect(s): Sedation. Relief of anxiety. Decreased nausea and vomiting. Decreased allergic symptoms associated with release of histamine, including pruritus.
bisacodyl
Trade Name(s) Bisac-Evac Bisacolax [Canada] Biscolax Carter's Little Pills [Canada] Codulax [Canada] Correctol Dacodyl Doxidan Dulcolax Ex-Lax Ultra Femilax Fleet Laxative Soflax-Ex [Canada] Ther. Class. laxatives Pharm. Class. stimulant laxatives Indications Treatment of constipation. Evacuation of the bowel before radiologic studies or surgery. Part of a bowel regimen in spinal cord injury patients. Action Stimulates peristalsis. Alters fluid and electrolyte transport, producing fluid accumulation in the colon. Therapeutic Effect(s): Evacuation of the colon.
docusate sodium/senna
Trade Name(s) Peri-Colace Senna Plus Senokot-S Ther. Class. laxatives Pharm. Class. stimulant laxatives stool softeners Indications PO: Treatment of constipation associated with dry, hard stools and decreased intestinal motility. Prevention of opioid-induced constipation. Action Senna's metabolite acts as a local irritant on the colon stimulating peristalsis. Docusate promotes incorporation of water into stool, resulting in softer fecal mass. Therapeutic Effect(s): Softening and passage of stool.
alprostadil (systemic)
Trade Name(s) Prostaglandin E1 Prostin VR Pediatric Prostin VR [Canada] Ther. Class. ductus arteriosus patency adjuncts Pharm. Class. prostaglandins Indications IV: Temporary maintenance of patent ductus arteriosus in neonates who depend on patency until surgery can be performed. Action IV: Directly relaxes smooth muscle of the ductus arteriosus. Therapeutic Effect(s): IV: Short-term maintenance of patent ductus arteriosus in neonates born with congenital heart defects who require patency to maintain blood oxygenation and perfusion of the lower body.
cascara sagrada
**Off Market Drug** This medication is no longer available in the United States. Information provided here is for reference purposes only. Ther. Class. laxatives Pharm. Class. stimulant laxatives Indications Treatment of constipation. Particularly useful when constipation is secondary to prolonged bedrest or constipating drugs. Action Stimulates peristalsis. Alters fluid and electrolyte transport, producing fluid accumulation in the colon. Therapeutic Effect(s): Evacuation of the colon. Cascara is another name for cascara sagrada, which is naturally derived from the bark of the buckthorn tree.
PROPOXYPHENE
**Off Market Drug** This medication is no longer available in the United States. Information provided here is for reference purposes only. Trade Name(s) 642 Tab [Canada] Darvon propoxyphene hydrochloride/acetaminophen propoxyphene napsylate Trade Name(s) Darvon N propoxyphene napsylate/acetaminophen Trade Name(s) Darvocet A500 Darvocet-N 50 Darvocet-N 100 Ther. Class. opioid analgesics Pharm. Class. opioid agonists opioid agonists nonopioid analgesic combinations See also Acetaminophen monograph Indications Mild to moderate pain. Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Therapeutic Effect(s): Decrease in mild to moderate pain.
ritodrine
**Off Market Drug** This medication is no longer available in the United States. Information provided here is for reference purposes only. Trade Name(s) Yutopar Ther. Class. tocolytic Pharm. Class. adrenergics Indications Prevention and treatment of premature labor in pregnancy of ≥20 wk duration. Action Stimulates beta-adrenergic receptors in the uterus, resulting in uterine relaxation. Therapeutic Effect(s): Decreased intensity and frequency of premature uterine contractions.
ergonovine
**Off Market Drug** This medication is no longer available in the United States. Information provided here is for reference purposes only. Trade Name(s) ergometrine Ergotrate Pharm. Class. oxytocics Indications Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or involution. Action Directly stimulates uterine and vascular smooth muscle. Therapeutic Effect(s): Uterine contraction.
lactated ringer's
A crystalloid electrolyte sterile solution of specified amounts of calcium chloride, potassium chloride, sodium chloride, and sodium lactate in water for injection. It is used intravenously to replace electrolytes. A physiologic solution of distilled water containing 8.6 g sodium chloride, 0.3 g potassium chloride, and 0.33 g calcium chloride per liter; for topical (Ringer's irrigation) or intravenous use.
Magnesium sulfate
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Pharm. Class. minerals electrolytes Indications Treatment/prevention of hypomagnesemia. Treatment of hypertension. Prevention of seizures associated with severe eclampsia, pre-eclampsia, or acute nephritis. Unlabeled Use(s): Preterm labor. Treatment of torsade de pointes. Adjunctive treatment for bronchodilation in moderate to severe acute asthma. Action Essential for the activity of many enzymes. Plays an important role in neurotransmission and muscular excitability. Therapeutic Effect(s): Replacement in deficiency states. Resolution of eclampsia.
butorphanol
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Stadol Ther. Class. opioid analgesics Pharm. Class. opioid agonists antagonists Controlled Substance Schedule: IV Indications Management of moderate to severe pain. Analgesia during labor. Sedation before surgery. Supplement in balanced anesthesia. Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Has partial antagonist properties that may result in opioid withdrawal in physically dependent patients. Therapeutic Effect(s): Decreased severity of pain.
fentaNYL (parenteral)
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Sublimaze Ther. Class. opioid analgesics Pharm. Class. opioid agonists Controlled Substance Schedule: II Indications Analgesic supplement to general anesthesia; usually with other agents (ultra-short-acting barbiturates, neuromuscular blocking agents, and inhalation anesthetics) to produce balanced anesthesia. Induction/maintenance of anesthesia (with oxygen or oxygen/nitrous oxide and a neuromuscular blocking agents). Neuroleptanalgesia/neuroleptanesthesia (with or without nitrous oxide). Supplement to regional/local anesthesia. Preoperative and postoperative analgesia. Unlabeled Use(s): Continuous IV infusion as part of PCA. Action Binds to opiate receptors in the CNS, altering the response to and perception of pain. Produces CNS depression. Therapeutic Effect(s): Supplement in anesthesia. Decreased pain.
americaine spray or ointment
Ther. Class. anesthetics (topical/local) Indications Topical: Relief of pruritus or pain associated with minor skin disorders including burns, abrasions, bruises, insect stings/bites, dermatitis, hemorrhoids, or other forms of skin irritation. Mucosal: Provide local anesthesia to mucosal surfaces before instrumentation, minor procedures, or endoscopy. Decrease irritation caused by minor mouth and throat conditions including sore throat, gingivitis, stomatitis, or teething. Also used to suppress the gag reflex during endoscopy or intubation. Action Inhibit initiation and conduction of sensory nerve impulses. Therapeutic Effect(s): Local anesthesia with subsequent loss of sensation or relief of pain and/or pruritus.
acetaminophen
Trade Name(s) Abenol [Canada] Acephen Acet [Canada] Children Feverhalt [Canada] Fortolin [Canada] Infant's Feverall Pediaphen [Canada] Pediatrix [Canada] Taminol [Canada] Tempra [Canada] Tylenol acetaminophen (intravenous) Trade Name(s) Ofirmev Ther. Class. antipyretics nonopioid analgesics Indications PO: Rect: Treatment of: Mild pain, Fever. IV: Treatment of: Mild to moderate pain, Moderate to severe pain with opioid analgesics, Fever. Action Inhibits synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS. Has no significant anti-inflammatory properties or GI toxicity. Therapeutic Effect(s): Analgesia. Antipyresis.
NIFEdipine
Trade Name(s) Adalat CC Adalat XL [Canada] Afeditab CR Procardia Procardia XL Ther. Class. antianginals antihypertensives Pharm. Class. calcium channel blockers Indications Management of: Hypertension (extended-release only), Angina pectoris, Vasospastic (Prinzmetal's) angina. Unlabeled Use(s): Prevention of migraine headache. Management of HF or cardiomyopathy. Action Inhibits calcium transport into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Therapeutic Effect(s): Systemic vasodilation, resulting in decreased BP. Coronary vasodilation, resulting in decreased frequency and severity of attacks of angina.
ibuprofen
Trade Name(s) Advil Advil Migraine Liqui-Gels Children's Advil Children's Motrin Excedrin IB Junior Strength Advil Medipren Midol Maximum Strength Cramp Formula Motrin Motrin Drops Motrin IB Motrin Junior Strength Motrin Migraine Pain Nuprin PediaCare Children's Fever ibuprofen (injection) Trade Name(s) Caldolor NeoProfen (ibuprofen lysine) Ther. Class. antipyretics antirheumatics nonopioid analgesics nonsteroidal anti inflammatory agents Pharm. Class. nonopioid analgesics Indications PO: IV: Treatment of: Mild to moderate pain, Fever. PO: Treatment of: Inflammatory disorders including rheumatoid arthritis (including juvenile) and osteoarthritis, Dysmenorrhea. IV: Moderate to severe pain with opioid analgesics.Closure of a clinically significant PDA in neonates weighing 500-1500 g and ≤32 weeks gestational age (ibuprofen lysine only) Action Inhibits prostaglandin synthesis. Therapeutic Effect(s): Decreased pain and inflammation. Reduction of fever.
psyllium
Trade Name(s) Alramucil Cillium Effer-Syllium Fiberall Fibrepur Hydrocil Karacil [Canada] Konsyl Metamucil Modane Bulk Mylanta Natural Fiber Supplement Naturacil Caramels Natural Source Fibre Laxative [Canada] Perdiem Prodiem [Canada] Pro-Lax Reguloid Natural Serutan Siblin Syllact Vitalax V-Lax Ther. Class. laxatives Pharm. Class. bulk forming agents Indications Management of simple or chronic constipation, particularly if associated with a low-fiber diet. Useful in situations in which straining should be avoided (after MI, rectal surgery, prolonged bed rest). Used in the management of chronic watery diarrhea. Action Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time. Therapeutic Effect(s): Relief and prevention of constipation.
atropine
Trade Name(s) Atro-Pen Ther. Class. antiarrhythmics Pharm. Class. anticholinergics antimuscarinics Indications IM: Given preoperatively to decrease oral and respiratory secretions. IV: Treatment of sinus bradycardia and heart block. IV: Reversal of adverse muscarinic effects of anticholinesterase agents (neostigmine, physostigmine, or pyridostigmine). IM: IV: Treatment of anticholinesterase (organophosphate pesticide) poisoning. Inhaln: Treatment of exercise-induced bronchospasm. Action Inhibits the action of acetylcholine at postganglionic sites located in: Smooth muscle, Secretory glands, CNS (antimuscarinic activity). Low doses decrease: Sweating, Salivation, Respiratory secretions. Intermediate doses result in: Mydriasis (pupillary dilation), Cycloplegia (loss of visual accommodation), Increased heart rate. GI and GU tract motility are decreased at larger doses. Therapeutic Effect(s): Increased heart rate. Decreased GI and respiratory secretions. Reversal of muscarinic effects. May have a spasmolytic action on the biliary and genitourinary tracts.
sodium citrate and citric acid
Trade Name(s) Bicitra Oracit PMS-Dicitrate [Canada] Shohl's Solution modified Ther. Class. antiurolithics mineral and electrolyte replacements/supplements Pharm. Class. alkalinizing agents Indications Management of chronic metabolic acidosis associated with chronic renal insufficiency or renal tubular acidosis. Alkalinization of urine. Prevention of cystine and urate urinary calculi. Prevention of aspiration pneumonitis during surgical procedures. Used as a neutralizing buffer. Action Converted to bicarbonate in the body, resulting in increased blood pH. As bicarbonate is renally excreted, urine is also alkalinized, increasing the solubility of cystine and uric acid. Neutralizes gastric acid. Therapeutic Effect(s): Provision of bicarbonate in metabolic acidosis. Alkalinization of the urine. Prevention of cystine and urate urinary calculi. Prevention of aspiration pneumonitis.
sennosides
Trade Name(s) Black-Draught Ex-Lax Ex-Lax Chocolated Fletchers' Castoria Maximum Relief Ex-Lax Sena-Gen Senexon Senokot SenokotXTRA Ther. Class. laxatives Pharm. Class. stimulant laxatives Indications Treatment of constipation, particularly when associated with: Slow transit time, Constipating drugs, Irritable or spastic bowel syndrome, Neurologic constipation. Action Active components of senna (sennosides) alter water and electrolyte transport in the large intestine, resulting in accumulation of water and increased peristalsis. Therapeutic Effect(s): Laxative action.
naloxone
Trade Name(s) Evzio Narcan Ther. Class. antidotes (for opioids) Pharm. Class. opioid antagonists Indications Reversal of CNS depression and respiratory depression because of suspected opioid overdose. Unlabeled Use(s): Opioid-induced pruritus (low-dose IV infusion). Management of refractory circulatory shock. Action Competitively blocks the effects of opioids, including CNS and respiratory depression, without producing any agonist (opioid-like) effects. Therapeutic Effect(s): Reversal of signs of opioid excess.
Hepatitis B vaccine
Trade names Energix-B Recombivax HB Indication Prophylactic treatment against all subtypes of hepatitis B Action Provides passive immunity of newborns of HBsAg-negative and HBsAg-positive mothers; Hepatitis B can be transmitted across the placenta
Percocet
oxycodone + acetaminophen
morphine
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Astramorph AVINza Doloral [Canada] Duramorph Embeda Infumorph Kadian M-Eslon [Canada] Morphine EPD [Canada] Morphine Extra Forte [Canada] Morphine Forte [Canada] Morphine HP [Canada] Morphine LP Epidural [Canada] M.O.S [Canada] M.O.S.-S.R [Canada] MS Contin MS Contin SRT [Canada] Roxanol Statex [Canada] Ther. Class. opioid analgesics Pharm. Class. opioid agonists Controlled Substance Schedule: II Indications Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Moderate to severe chronic pain in opioid-tolerant patients requiring use of daily, around-the-clock long-term opioid treatment and for which alternative treatment options are inadequate (extended-release). Pulmonary edema. Pain associated with MI. Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Therapeutic Effect(s): Decrease in severity of pain. Addition of naltrexone in Embeda product is designed to prevent abuse or misuse by altering the formulation. Naltrexone has no effect unless the capsule is crushed or chewed.
meperidine
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Demerol Ther. Class. opioid analgesics Pharm. Class. opioid agonists Controlled Substance Schedule: II Indications Moderate or severe pain (alone or with nonopioid agents). Anesthesia adjunct. Analgesic during labor. Preoperative sedation. Unlabeled Use(s): Rigors. Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Therapeutic Effect(s): Decrease in severity of pain.
HYDROmorphone
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Dilaudid Dilaudid-HP Exalgo Hydromorph Contin [Canada] Jurnista [Canada] Ther. Class. allergy, cold and cough remedies (antitussives) opioid analgesics Pharm. Class. opioid agonists Controlled Substance Schedule: II Indications Moderate to severe pain (alone and in combination with nonopioid analgesics). Moderate to severe chronic pain in opioid-tolerant patients requiring use of daily, around-the-clock long-term opioid treatment and for which alternative treatment options are inadequate (extended-release). Antitussive (lower doses). Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Suppresses the cough reflex via a direct central action. Therapeutic Effect(s): Decrease in moderate to severe pain. Suppression of cough.
promethazine
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Histantil [Canada] Phenergan Ther. Class. antiemetics antihistamines sedative/hypnotics Pharm. Class. phenothiazines Indications Treatment of various allergic conditions and motion sickness. Preoperative sedation. Treatment and prevention of nausea and vomiting. Adjunct to anesthesia and analgesia. Action Blocks the effects of histamine. Has inhibitory effect on the chemoreceptor trigger zone in the medulla, resulting in antiemetic properties. Alters the effects of dopamine in the CNS. Possesses significant anticholinergic activity. Produces CNS depression by indirectly decreased stimulation of the CNS reticular system. Therapeutic Effect(s): Relief of symptoms of histamine excess usually seen in allergic conditions. Diminished nausea or vomiting. Sedation.
HYDROcodone
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Hycodan [Canada] Hysingla ER Zohydro ER HYDROcodone/acetaminophen Trade Name(s) Anexsia Norco HYDROcodone/ibuprofen Trade Name(s) Reprexain Vicoprofen Ther. Class. allergy, cold and cough remedies (antitussive) opioid analgesics Pharm. Class. opioid agonists nonopioid analgesic combinations Controlled Substance Schedule: II Indications Extended-release product: Management of pain that is severe enough to warrant daily, around-the-clock, long-term opioid treatment where alternative treatment options are inadequate. Combination products: Management of moderate to severe pain. Antitussive (usually in combination products with decongestants). Action Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli while producing generalized CNS depression: Suppress the cough reflex via a direct central action. Therapeutic Effect(s): Decrease in severity of moderate pain. Suppression of the cough reflex.
calcium gluconate
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Kalcinate Ther. Class. mineral and electrolyte replacements/supplements Indications PO: IV: Treatment and prevention of hypocalcemia. PO: Adjunct in the prevention of postmenopausal osteoporosis. IV: Emergency treatment of hyperkalemia and hypermagnesemia and adjunct in cardiac arrest or calcium channel blocking agent toxicity (calcium chloride, calcium gluconate). Action Essential for nervous, muscular, and skeletal systems. Maintain cell membrane and capillary permeability. Act as an activator in the transmission of nerve impulses and contraction of cardiac, skeletal, and smooth muscle. Essential for bone formation and blood coagulation. Therapeutic Effect(s): Replacement of calcium in deficiency states.
oxyCODONE
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Oxaydo OxyCONTIN Oxy IR [Canada] OxyNEO [Canada] Roxicodone Supeudol [Canada] Ther. Class. opioid analgesics Pharm. Class. opioid agonists opioid agonists nonopioid analgesic combinations Controlled Substance Schedule: II Indications Moderate to severe pain. Moderate to severe chronic pain in opioid-tolerant patients requiring use of daily, around-the-clock long-term opioid treatment and for which alternative treatment options are inadequate (extended-release) (children ≥11 yr should be tolerating a minimum opioid dose of ≥20 mg of oxycodone or equivalent for ≥5 days before initiating extended-release oxycodone therapy. Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Therapeutic Effect(s): Decreased pain.
oxytocin
High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Trade Name(s) Pitocin Ther. Class. hormones Pharm. Class. oxytocics Indications IV: Induction of labor at term. IV: Facilitation of threatened abortion. IV: IM: Postpartum control of bleeding after expulsion of the placenta. Action Stimulates uterine smooth muscle, producing uterine contractions similar to those in spontaneous labor. Has vasopressor and antidiuretic effects. Therapeutic Effect(s): Induction of labor. Control of postpartum bleeding.
terbutaline
Trade Name(s) Bricanyl Ther. Class. bronchodilators Pharm. Class. adrenergics Indications Management of reversible airway disease due to asthma or COPD; inhalation and subcut used for short-term control and oral agent as long-term control. Unlabeled Use(s): Management of preterm labor (tocolytic) (the FDA has recommended that injectable terbutaline should not be used in pregnancy for the prevention or prolonged treatment [>48-72 hr] of preterm labor in either the inpatient or outpatient settings because of the potential for serious maternal heart problems and death; oral terbutaline should not be used for the prevention or any treatment of preterm labor because of a lack of efficacy and the potential for serious material heart problems and death). Action Results in the accumulation of cyclic adenosine monophosphate (cAMP) at beta-adrenergic receptors. Produces bronchodilation. Inhibits the release of mediators of immediate hypersensitivity reactions from mast cells. Relatively selective for beta2 (pulmonary)-adrenergic receptor sites, with less effect on beta1 (cardiac)-adrenergic receptors. Therapeutic Effect(s): Bronchodilation.
dinoprostone
Trade Name(s) Cervidil Vaginal Insert Prepidil Endocervical Gel Prostin E Vaginal Suppository Ther. Class. cervical ripening agent Pharm. Class. oxytocics prostaglandins Indications Endocervical Gel, Vaginal Insert: Used to "ripen" the cervix in pregnancy at or near term when induction of labor is indicated. Vaginal Suppository: Induction of midtrimester abortion, Management of missed abortion up to 28 wk, Management of nonmetastatic gestational trophoblastic disease (benign hydatidiform mole). Action Produces contractions similar to those occurring during labor at term by stimulating the myometrium (oxytocic effect). Initiates softening, effacement, and dilation of the cervix ("ripening"). Also stimulates GI smooth muscle. Therapeutic Effect(s): Initiation of labor. Expulsion of fetus.
MAGNESIUM LAXATIVES
Trade Name(s) Citrate of Magnesia Citroma Citromag [Canada] magnesium hydroxide Trade Name(s) Dulcolax Magnesia Tablets Phillips Magnesia Tablets Phillips Milk of Magnesia MOM Ther. Class. laxatives Indications As a: Laxative, Bowel evacuant in preparation for surgical/radiographic procedures. Action Essential for the activity of many enzymes. Play an important role in neurotransmission and muscular excitability. Are osmotically active in GI tract, drawing water into the lumen and causing peristalsis. Therapeutic Effect(s): Replacement in deficiency states. Evacuation of the colon.
clindamycin
Trade Name(s) Cleocin Cleocin T Clinda-Derm Clinda-T [Canada] Clindagel Clindesse Clindets Dalacin C [Canada] Dalacin T [Canada] Evoclin Ther. Class. anti-infectives Indications PO: IM: IV: Treatment of: Skin and skin structure infections, Respiratory tract infections, Septicemia, Intra-abdominal infections, Gynecologic infections, Osteomyelitis, Endocarditis prophylaxis. Topical: Severe acne. Vag: Bacterial vaginosis. Unlabeled Use(s): PO: IM: IV: Treatment of Pneumocystis carinii pneumonia, CNS toxoplasmosis, and babesiosis. Action Inhibits protein synthesis in susceptible bacteria at the level of the 50S ribosome. Therapeutic Effect(s): Bactericidal or bacteriostatic, depending on susceptibility and concentration. Spectrum: Active against most gram-positive aerobic cocci, including: Staphylococci, Streptococcus pneumoniae, other streptococci, but not enterococci. Has good activity against those anaerobic bacteria that cause bacterial vaginosis, including Bacteroides fragilis, Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis, and Corynebacterium. Also active against Pneumocystis jirovecii and Toxoplasma gondii.
clomiPHENE
Trade Name(s) Clomid Serophene Ther. Class. ovulation inducer Indications Induces ovulation in anovulatory women who desire pregnancy. Requires intact anterior pituitary, thyroid, and adrenal function. Unlabeled Use(s): Male infertility due to oligospermia. Action Stimulates release of pituitary gonadotropins, follicle-stimulating hormone, and luteinizing hormone, resulting in ovulation and the development of the corpus luteum. Therapeutic Effect(s): Induction of ovulation.
glycopyrrolate
Trade Name(s) Cuvposa Robinul Robinul-Forte Ther. Class. antispasmodics Pharm. Class. anticholinergics Indications Inhibits salivation and excessive respiratory secretions when given preoperatively. Reverses some of the secretory and vagal actions of cholinesterase inhibitors used to treat nondepolarizing neuromuscular blockade (cholinergic adjunct). Adjunctive management of peptic ulcer disease. Oral solution: Reduce chronic severe drooling in children with neurologic conditions associated with drooling. Action Inhibits the action of acetylcholine at postganglionic sites located in smooth muscle, secretory glands, and the CNS (antimuscarinic activity). Low doses decrease sweating, salivation, and respiratory secretions. Intermediate doses result in increased heart rate. Larger doses decrease GI and GU tract motility. Therapeutic Effect(s): Decreased GI and respiratory secretions.
danazol
Trade Name(s) Cyclomen [Canada] Danocrine Ther. Class. hormones Pharm. Class. androgens Indications Treatment of moderate endometriosis that is unresponsive to conventional therapy. Palliative therapy of fibrocystic breast disease. Prophylaxis of hereditary angioedema. Action Inhibits pituitary output of gonadotropins, resulting in suppression of ovarian function. Has weak androgenic-anabolic activity. Therapeutic Effect(s): Atrophy of ectopic endometrial tissue in endometriosis. Decreased pain and nodularity in fibrocystic breast disease. Correction of biochemical abnormalities in hereditary angioedema.
misoprostol
Trade Name(s) Cytotec Ther. Class. antiulcer agents cytoprotective agents Pharm. Class. prostaglandins Indications Prevention of gastric mucosal injury from NSAIDs, including aspirin, in high-risk patients (geriatric patients, debilitated patients, or those with a history of ulcers). With mifepristone for termination of pregnancy. Unlabeled Use(s): Treatment of duodenal ulcers. Cervical ripening and labor induction. Action Acts as a prostaglandin analogue, decreasing gastric acid secretion (antisecretory effect) and increasing the production of protective mucus (cytoprotective effect). Causes uterine contractions. Therapeutic Effect(s): Prevention of gastric ulceration from NSAIDs. With mifepristone terminates pregnancy of less than 49 days.
flurazepam
Trade Name(s) Dalmane Som Pam [Canada] Ther. Class. sedative/hypnotics Pharm. Class. benzodiazepines Controlled Substance Schedule: IV Indications Short-term management of insomnia (<4 wk). Action Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Therapeutic Effect(s): Relief of insomnia.
secobarbital
Trade Name(s) Novosecobarb [Canada] Seconal Ther. Class. sedative/hypnotics Pharm. Class. barbiturates Controlled Substance Schedule: II Indications Short-term treatment of insomnia. Adjunctive agent for anesthesia. Action Produces CNS depression through GABA-like effects. Therapeutic Effect(s): Induction of sleep, sedation, or anesthesia.
metroNIDAZOLE
Trade Name(s) Flagyl Flagyl ER MetroCream MetroGel MetroGel-Vaginal MetroLotion Metro IV Nidagel [Canada] Noritate Novo-Nidazol [Canada] Nuvessa Vandazole Ther. Class. anti-infectives antiprotozoals antiulcer agents Indications PO: IV: Treatment of the following anaerobic infections: Intra-abdominal infections (may be used with a cephalosporin), Gynecologic infections, Skin and skin structure infections, Lower respiratory tract infections, Bone and joint infections, CNS infections, Septicemia, Endocarditis. IV: Perioperative prophylactic agent in colorectal surgery. PO: Amebicide in the management of amebic dysentery, amebic liver abscess, and trichomoniasis: Treatment of peptic ulcer disease caused by Helicobacter pylori. Topical: Treatment of acne rosacea. Vag: Management of bacterial vaginosis. Unlabeled Use(s): Treatment of giardiasis. Treatment of anti-infective associated Clostridium difficile-associated diarrhea (CDAD). Action Disrupts DNA and protein synthesis in susceptible organisms. Therapeutic Effect(s): Bactericidal, trichomonacidal, or amebicidal action. Spectrum: Most notable for activity against anaerobic bacteria, including: Bacteroides, Clostridium. In addition, is active against: Trichomonas vaginalis, Entamoeba histolytica, Giardia lamblia, H. pylori, Clostridium difficile.
gentamicin
Trade Name(s) Garamycin Ther. Class. anti-infectives Pharm. Class. aminoglycosides Indications Treatment of serious gram-negative bacterial infections and infections caused by staphylococci when penicillins or other less toxic drugs are contraindicated. In combination with other agents in the management of serious enterococcal infections. Prevention of infective endocarditis. Topical: Ophth: Treatment of localized infections due to susceptible organisms. Action Inhibits protein synthesis in bacteria at level of 30S ribosome. Therapeutic Effect(s): Bactericidal action. Spectrum: Notable for activity against: Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Proteus, Serratia, Acinetobacter, Staphylococcus aureus. In treatment of enterococcal infections, synergy with a penicillin is required. Not active against: : Streptococci , Anaerobes.
carboprost
Trade Name(s) Hemabate Ther. Class. abortifacients Pharm. Class. oxytocics prostaglandins Indications Induction of mid-trimester abortion. Treatment of postpartum hemorrhage that has not responded to conventional therapy. Action Causes uterine contractions by directly stimulating the myometrium. Therapeutic Effect(s): Expulsion of fetus. Control of postpartum bleeding.
Rho(D) IMMUNE GLOBULIN
Trade Name(s) HyperRHO S/D Full Dose RhoGAM Rho (D) immune globulin microdose IM Trade Name(s) HyperRHO S/D Mini-Dose MICRhoGAM Mini-Gamulin R Rho (D) immune globulin IV Trade Name(s) WinRho SDF Rho (D) immune globulin microdose IM, IV Trade Name(s) Rhophylac Ther. Class. vaccines/immunizing agents Pharm. Class. immune globulins Indications IM: IV: Administered to Rho (D)-negative patients who have been exposed to Rho (D)-positive blood by: Pregnancy or delivery of a Rho (D)-positive infant, Abortion of a Rho (D)-positive fetus, Fetal-maternal hemorrhage due to amniocentesis, other obstetrical manipulative procedure, or intra-abdominal trauma while carrying a Rho (D)-positive fetus, Transfusion of Rho (D)-positive blood or blood products to a Rho (D)-negative patient. IV: Management of immune thrombocytopenic purpura (ITP). Action Prevent production of anti-Rho (D) antibodies in Rho (D)-negative patients who were exposed to Rho (D)-positive blood. Increase platelet counts in patients with ITP. Therapeutic Effect(s): Prevention of antibody response and hemolytic disease of the newborn (erythroblastosis fetalis) in future pregnancies of women who have conceived a Rho (D)-positive fetus. Prevention of Rho (D) sensitization following transfusion accident. Decreased bleeding in patients with ITP.
indomethacin
Trade Name(s) Indocin Tivorbex Ther. Class. antirheumatics ductus arteriosus patency adjuncts (IV only) nonsteroidal anti inflammatory agents Indications PO: Inflammatory disorders including: Rheumatoid arthritis, Gouty arthritis, Osteoarthritis, Ankylosing spondylitis. Mild-to-moderate acute pain IV: Alternative to surgery in the management of patent ductus arteriosus (PDA) in premature neonates. Action Inhibits prostaglandin synthesis. In the treatment of PDA, decreased prostaglandin production allows the ductus to close. Therapeutic Effect(s): PO: Suppression of pain and inflammation. IV: Closure of PDA.
cephalexin
Trade Name(s) Keflex Panixine Ther. Class. anti-infectives Pharm. Class. first generation cephalosporins Indications Treatment of the following infections caused by susceptible organisms: Skin and skin structure infections, Respiratory tract infections, Otitis media, Urinary tract infections, Bone infections. Action Binds to bacterial cell wall membrane, causing cell death. Therapeutic Effect(s): Bactericidal action against susceptible bacteria. Spectrum: Active against many gram-positive cocci including: Streptococcus pneumoniae, Group A beta-hemolytic streptococci, Staphylococci (including penicillinase-producing strains). Active against the following gram-negative organisms: Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Proteus. Not active against methicillin-resistant staphylococci or enterococci: Enterococcus. Not active against anaerobes.
phytonadione
Trade Name(s) Mephyton vitamin K Pharm. Class. fat soluble vitamins Indications Prevention and treatment of hypoprothrombinemia, which may be associated with: Excessive doses of oral anticoagulants, Salicylates, Certain anti-infective agents, Nutritional deficiencies, Prolonged total parenteral nutrition. Prevention of hemorrhagic disease of the newborn. Action Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, and X. Therapeutic Effect(s): Prevention of bleeding due to hypoprothrombinemia.
methylergonovine
Trade Name(s) Methergine Ther. Class. oxytocic Pharm. Class. ergot alkaloids Indications Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or subinvolution. Action Directly stimulates uterine and vascular smooth muscle. Therapeutic Effect(s): Uterine contraction.
PENTobarbital
Trade Name(s) Nembutal Ther. Class. anticonvulsants sedative/hypnotics Pharm. Class. barbiturates Controlled Substance Schedule: II(oral and parenteral) Indications Hypnotic agent (short-term). Preoperative sedation and other situations in which sedation is required. Treatment of seizures. Unlabeled Use(s): IV: Induction of coma in selected patients with cerebral ischemia and management of increased intracranial pressure (high doses). Action Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Produces all levels of CNS depression, including the sensory cortex, motor activity, and altered cerebellar function. Anticonvulsant effect due to decreased synaptic transmission and increased seizure threshold. May decrease cerebral blood flow, cerebral edema, and intracranial pressure (IV only). Therapeutic Effect(s): Sedation and/or induction of sleep.
