Labor & Delivery Drugs to Know

Only available on StudyMode
  • Download(s) : 16
  • Published : April 19, 2013
Open Document
Text Preview
Duramorph (morphine)
Classifications: Opioid
Route: intrathecally or epiduarally. Larger doses increase the side effects without increase the length of time the drug works. Nurses don’t give this?? OB use: For pain 24 hours after birth/most commonly used with C sections. Side Effects: pruritus, nausea and vomiting, and urinary retention Nursing implications: works in 30-60 minutes.

Contraindications: allergy/hypersensitivity to morphine.
Maternal Side effects: most common: confusion, sedation, constipation, hypotension, pruritus, urinary retention, nausea, and vomiting. Can cause resp depression which can cause neuro problems. Give they are obese taking mag. Sulfate or have sleep apnea are at a greater risk for resp depression. You can give Naloxone (Narcan) to reverse resp depression. Nursing considerations: Make sure they don’t have an allergy to morphine when getting hx. Assess vital signs and LOS after giving. Make sure they are breathing okay. Watch voiding habits. Check pain score. If they have puritius then give lotions, backrubs, cool or warm packs admin prescribed meds prn. Have Narcan on hand at all times. Check BP. Asses pt when she ambulates for the first time. Provide assistants and watch when caring for newborn. ASSESS resp status hourly for the first 12 hours and q everyother hour for the next 12 hours. Teaching: headaches are uncommon but can happen 2-5 days after anesthesia: sleeping in a dark room, caffeine and hydration might help. Naloxone (Narcan)

Class: opioid antagonist
Ob Use: used to reverse the mild resp depression caused by butorphanol (Standol, nalbuphine (Nubain) and meperidine hydrochloride (Demerol), sedation, and hypotension following small doses of opiates. NOTE: this is the drug of choice when the cause of resp depression is unknown./Given to the laboring mother or newborn. Route: To mother: may be injected undiluted at a rate of 04.mg over 15sec into the tubing of a running IV. Also can be diluted in 5% dextrose (more often in postop settings when epidurals are given for c section) For Neonates IV, IM, ET. Standard dosage is 0.01mg/kg Contraindications: Don’t give to women of baby’s with known dependency to narcotics. Side Effects:

Maternal/Fetal Risk:
Nursing implications: The half life is shorter then Demerol so you need to have it on hand because resp depression might return. Can cause withdrawals in women who have a dependency on narcotics. After giving direct IV maternal vial signs should be checked q5 minutes until resp depression is stabilized and then q30 minutes. Nalbuphine Hydrochloride (Nubain)

Class: Synthetic opioid agonist-antagnoist narcotic analgesic Ob Use: Moderate to severe pain equal to the effects of morphine Route: IM/SQ/IV adults 10-20mg q3-6 hours.
Contraindications: hypersenstiviy to allergy of this drug.
Side Effects: sedation, clammy, sweaty skin, dry mouth, bitter taste, N/V, dizziness, vertigo, nervousness, restlessness, depression, crying, euphoria… Maternal/Fetal Risk:
Nursing implications: assess for allergy for narcotics on admission. Inform pt of potential side effects, check pain scale, if they are allergic to sulfate it may cause allergy, can give naloxone (Narcan) or diphenhydramine per dr orders. Asses resp rate before and after giving (if less then 12 breaths per minutes) assess urinary output and bladder distension. Help pt to walk, don’t drink on this drug, can cause withdawls if you discontinue abruptly. Naloxone (Narcan)

Class: opioid antagonist
Ob Use: used to reverse the mild resp depression caused by butorphanol (Standol, nalbuphine (Nubain) and meperidine hydrochloride (Demerol), sedation, and hypotension following small doses of opiates. NOTE: this is the drug of choice when the cause of resp depression is unknown./Given to the laboring mother or newborn. Route: To mother: may be injected undiluted at a rate of 04.mg over 15sec into the tubing of a running IV. Also can be diluted in 5% dextrose (more often...
tracking img