Drugcards

Generic Name:
Acetaminophen
Trade Name: Tylenol Pregnancy category: Category C
Drug Family: Nonopioid Analgesic/antipyretic
Action: thought to produce analgesia by elevation of the pain threshold and antipyresis through action on the hypothalamic heatregulating center. Inhibits the 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. Common Usage of Drug: Given as a pain reliever or to manage a fever. Usual adult dosage/route: 650 to 1000 mg (regular strength: 325mg/cap; extra strength: 500mg/cap) Q 4-6 hours Usual pediatric dosage/route: PO (Neonates): 1015 mg/kg/dose q 68 hr as needed. Rect (Neonates): 1015 mg/kg/dose q 68 hr as needed.. Side effects: may include nausea/vomiting, insomnia, itching, agitation. Contraindications: Use in pregnancy only if truly needed. Drug Interactions: may increase risk of bleeding when taken with warfarin. Nursing Implications: Can cause liver damage in large doses. No more than 3000 mg in 24 hours.Be aware that many other medications include acetaminophen, including some narcotic combinations and some cold medications. Not as effective for cramping/perineal pain/incisional pain as NSAIDs or narcotics. Atelectasis can occur, take with full glass of water.
Deglin, J.H., Vallerand, A.H. (2013). Davis drug guide for nurses (13th ed.). Philadelphia, PA: F.A. Davis Company. Micromedex, ARMC Pharmacy, WebMD
Generic Name:
Butorphanol
Trade names: Stadol Pregnancy Category: C
Drug Family: opioid analgesic
Action: binds to opiate receptors in the CNS, alters perception of and response to painful stimuli, produces generalized CNS depression. Common Use of drug: pain relief Reason Patient is receiving Drug: Usual adult dosage and route: IM 2 mg q 3-4 hrs PRN. IV: 1mg q 3-4 hrs PRN. Side effects: confusion, dysphoria, hallucinations, sedation, floating feeling, headache, unusual dreams. Contraindications: do not use with for lactating patients. Drug interactions: may decrease effects of concurrently administered opioids. Nursing Implications: Assess pain before and 30-60 mins after administration IM and 5 mins after IV. Rapid admin may cause respiratory distress. Antidote - narcan
Generic Name:
Nalbuphine hydrochloride
Trade names: Nubain Pregnancy Category: C
Drug Family: opioid analgesic
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,may result in opioid withdrawal in physically dependent patients. Common Use of drug: treats itching and pain Reason Patient is receiving Drug:
Usual adult dosage and route: For itching, 0.1-0.2mg IV q 2 hrs PRN; for pain, typically 10 mg IV q 3-6 hrs PRN. Not typically used in this manner for post-partum patients, but is common for antepartal use, particularly labor pain Side effects: sedation, diaphoresis, nausea/vomiting, vertigo, headache (more common at higher dose levels) Contraindications: Hypersensitivity to nalbuphine or bisulfites; Patients physically dependent on opioids and who have not been detoxified (may precipitate withdrawal). Drug interactions: Use with extreme caution in patients receiving MAO inhibitors (may result in unpredictable, severe reactions initial dose of nalbuphine to 25% of usual dose). Additive CNS depression with alcohol , antihistamines , and sedative/hypnotics . May precipitate withdrawal in patients who are physically dependent on opioid agonists . Avoid concurrent use with other opioid analgesic agonists (may diminish analgesic effect). Nursing Implications: use filter needle to draw up medication; instruct patient to call for assist OOB if dizzy, lightheaded.
Generic Name: acetaminophen/oxycodone hydrochloride Drug Family: opioid analgesic, antitussive
Trade names: Percocet Pregnancy category: B
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression Common Use of drug: given as a pain reliever for moderate or severe pain Reason Patient is receiving Drug: Usual adult dosage and route: Typically ordered as 1-2 q 4hrs. PRN post c-section or PPS or 1 q 4hrs PRN post-vaginal delivery Side effects: drowsiness, nausea, constipation, itching or dizziness Contraindications: OB: Avoid chronic use; weigh maternal benefit against fetal risks. Lactation Drug interactions: Use with caution in patients receiving MAO inhibitors Nursing Implications: Assess pain 1 hr after administration. A repeat dose can be safely administered at the time of the peak if previous dose is ineffective and side effects are minimal.
Generic Name:
Acetaminophen/hydrocodone bitartrate
Trade names: Lortab
Drug Family: antipyretics, nonopoid analgesics Action: Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS. Common Use of drug: a narcotic given as a pain reliever for moderate to severe pain Reason Patient is receiving Drug: Usual adult dosage and route: typically ordered as 1-2 q 4 hrs PRN post c-section or PPS or 1 q 4hrs PRN post vaginal delivery Side effects: drowsiness, nausea, constipation, itching or dizziness Contraindications: OB: Lactation: Avoid chronic use; Hypersensitivity to hydrocodon; Drug interactions: Use with extreme caution in patients receiving MAO inhibitors (may produce severe, unpredictable reactions do not use within 14 days of each other). Administration of partial antagonist opioids (buprenorphine, butorphanol, nalbuphine, or pentazocine) may analgesia or precipitate opioid withdrawal in physically dependent patients. Nursing Implications: each pill contains 500mg of acetaminophen, not safe to use more than 3000 mg of acetaminophen in 24 hours. Be aware of spacing meds; can give w/ food to decrease nausea; okay to use for patient allergic/sensitive to codeine (is a synthetic form); Lortab is same as Lortab 5, also available as Lortab 10; may cause respiratory depression.
Generic Name:
Meperidine hydrochloride
Trade names: Demerol Pregnancy category:C
Drug Family: Sedative, Opioid analgesic
Action: Binds to various opioid receptors, producing analgesia and sedation (opioid agonist) Common Use of drug: Moderate or severe pain . Anesthesia adjunct. Analgesic during labor. Preoperative sedation. Reason Patient is receiving Drug: Usual adult dosage and route: analgesia, obstetric [50-100 mg SC/IM q1-3h] Usual pediatric dosage and route: PO: IM: SC: Analgesia11.5 mg/kg q 34 hr (should not exceed 100 mg/dose). Preoperative sedation12 mg/kg 3090 min before anesthesia (not to exceed adult dose). IV: Continuous infusion0.51 mg/kg loading dose followed by 0.3 mg/kg/hr, titrate to effect up to 0.5 0.7 mg/kg/hr. Side effects: sweating, nausea/vomiting, dizziness, lightheaded, constipation, confusion, drowsiness Contraindications: OB: Chronic use may pose risk to the fetus including possible addiction Lactation: Excreted in breast milk and can cause respiratory depression in the infant. Caution in: OB: Use during labor and delivery can cause respiratory depression in the newborn Pedi: Syrup contains benzyl alcohol, which can cause "gasping syndrome" in neonates. Children have risk of seiz ures due to accumulation of normeperidine Drug interactions: Do not use in patients receiving MAO inhibitors or procarbazine (may cause fatal reactioncontraindicated within 14 days of MAO inhibitor therapy). St. Johns wort may inc. serious side effects
Nursing Implications: Monitor vitals 1h after PO,IM,SC ,5 after IV may need to hold PCA if hypotensive, assess pain, bowel function, monitor for CNS stimulation (seizures) PEDI: more susceptible to side effects and may experience respiratory complications, restlessness, and excitability Antidote: NARCAN
Generic Name:Tylenol 300mg + codeine 30mg Drug Family: opiod analgesic combination
Trade names: Tylenol #3 Pregnancy category:C
Action: Acetaminophen is an antipyretic and analgesic due to inhibition of prostaglandin synthesis in the CNS. Codeine is an analgesic and antitussive due to binding to opiate receptors. Common Use of drug: Pain relief Reason Patient is receiving Drug:
Usual adult dosage and route: Acetaminophen: Peds: > 12 yrs: and Adults: 325-650 mg Q4-6H PRN (max. 3g/day) Codeine: Adults: 15-60mg/dose Q4-6H (max. 360 mg/day) Side effects: Hepatotoxicity, resp depression, atelectasis, hypertension, hypotension, hypokalemia, confusion, sedation Contraindications: OB: Use in pregnancy only if clearly needed (for IV), respiratory depression may occur in the newborn Lactation: Use cautiously (for IV) Pedi: Children <2 yr (safety and effectiveness not established) Drug interactions: Chronic high-dose acetaminophen (>2 g/day) may risk of bleeding with warfarin (INR should no t exceed 4). Concurrent use of isoniazid, rifampin, rifabutin, phenytoin, barbiturates, and carbamazepine may the risk of acetaminophen induced liver damage (limit self-medication); these agents will also therapeutic effect s of acetaminophen. Concurre nt use of NSAIDs may the risk of adverse renal effects (avoid chronic concurrent use).Propranolol metabolism and may effects. Nursing Implications: Assess overall health status and alcohol usage before administering acetaminophen. Patients who are malnourished or chronically abuse alcohol are at higher risk of developing hepatotoxicity with chronic use of usual doses of this drug. Assess amount, frequency, and type of drugs taken in patients self-medicating, especially with OTC drugs. Prolonged use of
acetaminophen increases the risk of adverse renal effects. For short-term use, combined doses of acetaminophen and salicylates should not exceed the recommended dose of either drug given alone. Pain: Assess type, location, and intensity prior to and 30 60 min following administration. Fever: Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise).
Generic Name:
Morphine sulfate Schedule II
Trade names: Duramorph Pregnancy catagory:C
Drug Family: Opioid Analgesic
Action: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Common Use of drug: pain reliever Reason Patient is receiving Drug: Usual adult dosage and route: PO: moderate to severe pain in opioid-naive pts30 mg q34h initially IM, IV, SubQ: 410 mg q 34 hr, for severe pain more smaller doses may be given q3 4h. Epidural: Intermittent5 mg/day; if relief is not obtained at 60 min, 12 mg increments may be made; total dose not to exceed 10 mg/day; Single-dose extended-releaseC section: 10 mg. Usual pediatric dosage and route: Side effects: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, blurred vision, RESPIRATORY DEPRESSION, hypotension, bradycardia, constipation, nausea, vomiting, urinary retention, flushing, itching, sweating, dependence, tolerance Contraindications: OB: Lactation: Avoid chronic use; has been used during labor but may cause respiratory depression in the newborn; Drug interactions: Use with extreme caution in patients receiving MAO inhibitors within 14 days prior (may result in unpredictable, severe reactions initial dose of morphine to 25% of usual dose). Administration of partial -antagonist opioid analgesics may
precipitate opioid withdrawal in physically dependent patients. Buprenorphine, nalbuphine, butorphanol, or pentazocine may analgesia. Cimetidine metabolism and may effects. Epidural test dose of lidocaine/epinephrine may alter release of liposomal injection. Use of liposomal injection after bupivacaine may levels of morphine ( dosing interval between 2 drugs to >30 mi n). Nursing Implications: monitor for respiratory depression - continuous pulse oximetry, q2 resp/conciousness checks required if given Duramorph; monitor urinary output o Duramorph patients, monitor BP, may need to hold if hypotensive; instruct patient to call for assist OOB if dizzy/ woozy.
Generic Name:
Naproxen sodium
Trade names: Anaprox DS
Drug Family: nonopioid analgesics noantipyreticsnsteroidal anti inflammatory agents Pregancy catagory: B 1st trimester Action: Inhibits prostaglandin synthesis, reducing pain, fever, inflammation Common Use of drug: anti-inflammatory given as a pain reliever for mild to moderate pain; very effective for cramping, soreness Reason Patient is receiving Drug: Usual adult dosage and route: PO 1 tab q 8hrs PRN, sometimes ordered as a standing med post c-section. Usual pediatric dosage and route: Side effects: stomach pain/nausea, constipation, headache Contraindications: do not use with other NSAIDs Drug interactions:Drug-Drug: concurrent use with aspirin decreases levels and may decrease effectiveness.Increase risk of bleeding with anticoagulants. Nursing Implications: take with full glass of water; give with food to avoid stomach upset; can cause increased risk of bleeding, use caution; may not be able to take if allergic/sensitive to other NSAIDs; may be more effective when given on a regular basis vs. occasional dosing; do not use with other NSAIDs
Generic Name:
ibuprofen
Trade names: Motrin Pregnancy catagory: B 1st trimester
Drug Family: analgesic
Action: Inhibits prostaglandin synthesis, reducing pain, fever, inflammation Common Use of drug: anti-inflammatory given as a pain reliever for mild to moderate pain and/or as an anti-inflammatory postoperatively. Reason Patient is receiving Drug: Usual adult dosage and route: PO. Typically ordered as 800mg q 8 hrs PRN, sometimes ordered as a standing med post c-section. Usual pediatric dosage and route: Side effects: stomach pain/nausea, flatulence, rash, dizziness. Contraindications: OB: Not recommended for pregnant patients; has been associated with persistent pulmonaryhypertension in infants Lactation: Has been used safely Pedi: Safety not established for infants <6 mo Drug interactions: May limit the cardioprotective effects of low-dose aspirin, Concurrent use with aspirin may effectiveness of ibuprofen, adverse GI side effects with aspirin, oral potassium and other NSAIDs, corticosteroids, or alcohol, chronic use with acetaminophen may risk of adverse renal reactions,May effectiveness of diuretics or antihypertensives, May hypoglycemic effects of insulin or oral hypoglycemic agents, May slightly serum digoxin levels, risk of toxicity from methotrexate,Pro benecid risk of toxicity from ibuprofen, risk of bleeding with cefotetan, cefoperazone, valproic acid, thrombolytics, warfarin, and drugs
affecting platelet function including clopidogrel, ticlopidine, abciximab, eptifibatide. Drug-Natural Products: bleeding risk with , arnica, chamomile, feverfew, garlic, ginger, ginkgo, Panax ginseng, and others Nursing Implications: Give with food to avoid stomach upset; can cause increased risk of bleeding, may be more effective when give on a regular basis vs. occasional dosing; do not use with other NSAIDs.
Generic Name:
ketorolac
Trade names: Toradol
Drug Family:nonsteroidal anti inflammatory agents, nonopioid analgesics Pregnancy catagory: Category C (oral, nasal spray [<30 wk gestation]) Category D (nasal spray [30 wk gestation) Action: Inhibits prostaglandin synthesis, producing peripherally mediated analgesia. Common Use of drug: anti-infammatory given as a pain reliever for mild to moderate pain and/or as an anti-inflammatory postoperatively. Reason Patient is receiving Drug: Usual adult dosage and route: after surgery, typically 30mg IV in recovery, then to 15 to 30mg IV q 6 hrs for 3 doses (may be ordered PRN), then 10 mg PO q 6hrs or standing order; after vaginal delivery, typically 10mg q 6hrs PRN. Usual pediatric dosage and route: Side effects: stomach upset/pain, headache, dizziness, somnolence Contraindications: OB: Chronic use in 3rd trimester may cause constriction of ductus arteriosus. May inhibit labor and maternal bleeding at delivery. Lactation: Lactation. Drug interactions: Probenecid levels and the risk of adverse reactions; concurrent use is contraindicated. risk of bleeding when used with pentoxifylline; concurrent use is contraindicated. Concurrent use with aspirin may effectiveness. May serum lit hium levels and risk of toxicity.
Nursing Implications: IV solution can be highly irritating to vein, dilute with NS and push slowly to avoid burning; can cause increase in bleeding, consult MD if patient has PPH or has increased bleeding; for PO take with food or a full glass of water to avoid stomach upset; may not be able to take if allergic/sensitive to other NSAIDs; may be more effective when given on regular basis vs. occasional dosing; do not use with other NSAIDs.
Generic Name: Ampicillin sodium Drug Family: anti-infectives, aminopenicillins
Trade names: Ampicillin Pregnancy category: B
Action: Bactericidal action; spectrum is broader than penicillin. Active against: Streptococci, nonpenicillinase-producing staphylococci, Listeria, Pneumococci, Enterococci, Haemophilus influenzae, Escherichia coli, Enterobacter, Klebsiella, Proteus mirabilis, Neisseria meningitidis, N. gonorrhoeae, Shigella, Salmonella. Common Use of drug: treatment of genitourinary infection (post-op infection, chorioamnionitis) Reason Patient is receiving Drug: Usual adult dosage and route: typically IV. 2gram IVPB, followed by 1gram IVPB q 6 hrs. Usual pediatric dosage and route: Side effects: rash, diarrhea, nausea/vomiting Contraindications: Hypersensitivity to penicillins. Lactation: Distributed into breast milk. Can cause rash, diarrhea, and sensitization in the infant. Drug interactions: Probenecid renal excretion and blood levels of ampicillintherapy may be combined for this purpose. risk of with concurrent allopurinol therapy. Nursing Implications: give over 10-15 minutes
Generic Name: Clindamycin Drug Family: anti-infective Action: bactericidal, inhibits protein synthesis at the level of 50s ribosome
Trade names: Cleocin Pregnancy catagory: B
Common Use of drug: treatment of bacterial infection, pelvic inflammatory disease Reason Patient is receiving Drug: Usual adult dosage and route:PO: (Adults) Most infections150450 mg q 6 hr. P. carinii pneumonia12001800 mg/day in divided doses with 1530 mg Primaquine/day (unlabeled). CNS toxoplasmosis12002400 mg/day in divided doses with pyrimethamine 50100 mg/day (unlabeled); Bacterial endocarditis prophylaxis600 mg 1 hr before procedure. IV: (Adults) Most infections 300 600 mg q 68 hr or 900 mg q 8 hr (up to 4.8 g/day IV has been used; single IM doses of >600 mg are not recommended). P. carinii pneumonia24002700 mg/day in divided doses with Primaquine (unlabeled). Toxoplasmosis12004800 mg/day in divided doses with pyrimethamine. Bacterial endocarditis prophylaxis600 mg 30 min before procedure. Vag: (Adults and Adolescents): Cleocin, Clindamax1 applicatorful (5 g) at bedtime for 3 or 7 days (7 days in pregnant patients); Clindesse one applicatorful (5 g) single dose; or 1 suppository (100 mg) at bedtime for 3 nights.Topical: (Adults and Adolescents): Solution 1% solution/suspension applied twice daily (range 14 times daily). Foam, gel1% foam or gel applied once daily Usual pediatric dosage and route:(Children >1 mo): 10 30 mg/kg/day divided q 68 hr; maximum dose 1.8 g/day. Bacterial endocarditis prophylaxis20 mg/kg 1 hr before procedure.IM: IV: (Children >1 mo): 25 40 mg/kg/day divided q 68 hr; maximum dose: 4.8 g/day. Bacterial endocarditis prophylaxis20 mg/kg 30 min before procedure; maximum dose: 600 mg.IM: IV: (Infants <1 mo and <2 kg): 5 mg/kg q 812 hr 2 kg2030 mg/kg/day divided q 68 hr
Side effects: rash, abdominal pain, nausea, diarrhea, headache Contraindications: Use Cautiously in: OB: Safety not established for systemic and topical; approved for vaginal use in 3rd trimester of pregnancy. Lactation: Has been used safely but appears in breast milk and exposes infant to drug and its side effects.
Drug interactions: Kaolin/pectin may GI absorption. Topical: Concurrent use with irritants, abrasives, or desquamating agents may result in additive irritation. Nursing Implications: give over 30 mins. Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy. Obtain specimens for culture and sensitivity prior to initiating therapy. First dose may be given before receiving results. Monitor bowel elimination. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. This may begin up to several weeks following the cessation of therapy. Assess patient for hypersensitivity (skin rash, urticaria).
Generic Name:
Gentamycin
Trade names: Garmycin, G-Mycin, Jenamicin Pregnancy category:C
Drug Family: anti-infectives Action: Inhibits protein synthesis in bacteria. Bactericidal action. Common Use of drug: treatment of genitourinary infection Reason Patient is receiving Drug:
Usual adult dosage and route: IV, patient specific based on weight and creatine clearance, typically 80-150mg IVPB q 8 hrs (after loading dose). Usually given over 1 hour but may be ordered to give over 1.5 to 2 hours. Usual pediatric dosage and route: Side effects: usually dose related - redman syndrome Contraindications: Pedi: May cause fatal respiratory depression in children <2 yr. Use Cautiously in: Pedi: For children >2 yr, use lowest effective dose, avoid concurrent respiratory depressants. OB: Has been used safely during labor; avoid chronic use during pregnancy. Lactation: Safety not established; may cause drowsiness in infant;Geri: Appears on Beers list. Sensitive to anticholinergic effects and have risk for side effects. Drug interactions: Concurrent use with MAO inhibitors may result in sedation and anticholinergic side effects Nursing Implications: can cause ototoxicity, nephrotoxicity; assure patient stays adequately hydrated during treatment; monitor trough/peak per pharmacy order, follow pharmacy guidelines for administration.
Generic Name:Penicillin Drug Family:anti-infective
Trade names: Penicillin Pregnancy category: B
Action: Binds to bacteria cell wall and results in cell death Common Use of drug: treatment of a wide variety of infections. Reason Patient is receiving Drug: Usual adult dosage and route:250 mg = 400,000 units PO: (Adults and Children 12 yr): Most infections125500 mg q 68 hr. Rheumatic fever prevention125250 mg q 12h Usual pediatric dosage and route:PO: (Children <12 yr): Lyme disease 50 mg/kg/day in 4 divided doses (unlabeled); prevention of Streptococcus pneumoniae sepsis in children with sickle cell disease 125 mg twice daily. Side effects: SEIZURES, diarrhea, epigastric distress, nausea, vomiting, pseudomembranous colitis, interstitial nephritis, rash, urticaria, eosinophilia, leukopenia, pain at IM site, phlebitis at IV site Contraindications: OB: Although safety not established, has been used safely. Lactation: Safety not established Drug interactions: Penicillin may effectiveness of oral contraceptive agents. Nursing Implications: Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy. Obtain a history to determine previous use of and reactions to penicillins, cephalosporins, or other beta-lactam
antibiotics. Persons with a negative history of penicillin sensitivity may still have an allergic response. Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results. Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify physician or other health care professional immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.
Generic Name: Erythromycin Trade names: erythromycin (topical):Akne-Mycin,Erygel erythromycin base: E-Mycin,Eryc,Ery-Tab,PCE Drug Family: anti-infective Action: Suppresses protein synthesis at the level of the 50S bacterial ribosome Common Use of drug: treatment of various infections; syphilis or gonorrhea. Reason Patient is receiving Drug: Usual adult dosage and route:2% ointment, gel, or solution bid Usual pediatric dosage and route: Side effects: seizures (rare),ototoxicity, TORSADE DE POINTES, VENTRICULAR ARRHYTHMIAS, QT interval prolongation, PSEUDOMEMBRANOUS COLITIS, nausea, vomiting, abdominal pain, cramping, diarrhea, hepatitis, infantile hypertrophic pyloric stenosis, pancreatitis (rare), interstitial nephritis, rash, phlebitis at IV site,allergic reactions, superinfection Contraindications: OB: May be used in pregnancy to treat chlamydial infections or syphilis. Myasthenia gravis (may worsen symptoms) Drug interactions: Concurrent use with pimozide may levels and the risk for serious arrhythmias (concurrent use contraindicated); similar effects may occur with diltiazem, verapamil, ketoconazole, itraconazole, nefazodone, and protease inhibitors; avoid
pregnancy category:B
concurrent use. May levels of ergotamine and dihydroergotamine and risk for acute ergot toxicity; concurrent use contraindicated. May verapamil levels and the risk for hypotension, bradycardia, and lactic acidosis. blood levels and effects of sildenaf il, tadalafil and vardenafil ; use lower doses. Concurrent rifabutin or rifampin may effect of erythromycin and risk of adverse GI reactions. May levels of lovastatin, and simvastatin and the risk of myopathy/rhabdomyolysis. May serum digoxin levels. Theophylline may blood levels. May colchicine levels and the risk for toxicity; use lower starting and maximum dose of colchicine. May theophylline levels and the risk for toxicity; theophylline dose. May warfarin levels and the risk for bleeding.
Nursing Implications: Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy. Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results. Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
Generic Name:
Witch hazel pads
Trade names: Tucks pads Pregnancy category:C
Drug Family:Topical Astringent Action: Relieves pain of lacerations/hemorrhoids
Common Use of drug: soothe and decrease itching/irritation of perineal tears, episiotomies, or hemorrhoids Reason Patient is receiving Drug: Usual adult dosage and route: use pads continuously or PRN Usual pediatric dosage and route: Side effects:Rash, irritation, burning. Cold sensation when used initially Contraindications:Avoid if allergic to any of its components Drug interactions: No significant drug interaction known Nursing Implications: may be left in bathroom for patient to self-administer; may use over ice pack to prevent sticking to perineal area.
Generic Name:
Benzocaine topical
Trade names: Americaine ointment Pregnancy category:C
Drug Family:Anesthetic (topical/local) Action: Inhibit initiation and conduction of sensory nerve impulses
Common Use of drug: 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. Reason Patient is receiving Drug: Usual adult dosage and route: Topical/Mucosal: (Adults and Children) Apply cream, ointment, topical solutions, or dental/oral products as needed. Lozenges may be used hourly (not to exceed 12 lozenges/day). Rectal products may be used twice daily. Side effects: Topical use: burning, edema, irritation, stinging, tenderness, urticaria Contraindications: Hypersensitivity. Cross-sensitivity may occur among related agents (amide typesdibucaine; ester types benzocaine, tetracaine).Hypersensitivity to any components of preparations including stabilizers, colorants, or bases. Active, untreated infection of affected area. Not to be used in the eye. Some products contain alcohol and should be avoided in patients with known alcohol intolerance. Pedi: Topical benzocaine products should not be used in children <2 yr. Drug interactions: Toxicity of ester-type agents may be increased by concurrent use of cholinesterase inhibitors
Nursing Implications: Assess type, location, and intensity of pain before and a few minutes after administration of anesthetic. Assess integrity of involved skin and mucous membranes before and periodically throughout course of therapy. Notify health care professional if signs of infection or irritation develop.
Generic Name:
Lansinoh
Trade names: Lanolin pregnancy category:C
Drug Family: emollient
Action: Draws water into the outer layer of the skin while forming an oily layer that traps the moisture, helps slough off dead skin, keeps skin hydrated and protected Common Use of drug: used to soften and protect nipples of breast feeding mothers. Reason Patient is receiving Drug: Usual adult dosage and route: Apply topically to skin prn Usual pediatric dosage and route: Side effects: Burning, stinging, redness, or irritation Contraindications:Hypersensitivity Drug interactions: Nursing Implications: Some products need to be shaken before use. Apply to the skin only. Avoid sensitive areas such as your eyes, inside your mouth/nose, and the vaginal/groin area,
Generic Name:
Hydrocortisone acetate/ pramoxine hydrochloride
Trade names: Epifoam pregnancy category:C
Drug Family:combination topical corticosteroid and local anesthetic
Action: works by reducing skin inflammation, decreases pain in the affected area Common Use of drug: decrease pain and swelling of perineal tears, incisions. Reason Patient is receiving Drug: Usual adult dosage and route: amount sufficient to cover affected area, 3 times/day. Topical application Usual pediatric dosage and route: Side effects:Severe allergic reactions; acne-like rash; excessive hair growth; inflamed hair follicles; inflammation around the mouth; muscle weakness; rectal pain, burning, cracking, itching, bleeding, peeling, or irritation not present before using Epifoam Foam; thinning, softening, or discoloration of the skin; unusual weight gain, especially in the face. Contraindications:allergic to any ingredient in Epifoam Foam. Drug interactions:corticosteroids/immunosuppressants Nursing Implications: instruct patient that causes numbing effect; may be used in conjunction with Tucks pads/ice.
Generic Name:
Vitamin K, Phytonadione
Trade names: Vitamin K,Mephyton
Drug Family: fat soluble vitamin, electrolyte replacement, antidote Action: Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, and X. Therapeutic Effect(s): Prevention of bleeding due to hypoprothrombinemia. Common Use of drug: used in the baby to promote clotting; given with in the first hour after birth Reason Patient is receiving Drug: Usual adult dosage and route: Usual pediatric dosage and route:PO: (Children >1 mo): 2.5 5 mg/day. IM: Neonates 0.51 mg, within 1 hr of birth, may repeat in 68 hr if needed. May be repeated in 2 3 wk if mother received previous anticonvulsant/anticoagulant/anti-infective/antitubercular therapy. 15 mg may be given IM to mother 1224 hr before delivery. Treatment of Hemorrhagic Disease of Newborn: IM: SC: Neonates 12 mg/day Side effects:GI: gastric upset, unusual taste Derm: flushing, rash, urticaria Hemat: hemolytic anemia Local: erythema, pain at injection site, swelling Misc: allergic reactions, hyperbilirubinemia (large doses in very premature infants), kernicterus Contraindications:Hypersensitivity or intolerance to benzyl alcohol (injection only). Use Cautiously in: Impaired liver function. Exercise Extreme Caution in: Severe life-threatening reactions have occurred following IV administration, use other routes unless risk is justified. Drug interactions:Large doses of salicylates or broad-spectrum anti-infectives may vitamin K requirements, Bile acid sequestrants, mineral oil, and sucralfate may vitamin K absorption from the GI tract.
Nursing Implications:Do not confuse Mephyton (phytonadione) with methadone. The parenteral route is preferred for phytonadione therapy but, because of severe, potentially fatal hypersensitivity reactions, IV vitamin K is not recommended. Administration of whole blood or plasma may also be required in severe bleeding because of the delayed onset of this medication. Phytonadione is an antidote for warfarin overdose but does not counteract the anticoagulant activity of heparin.
Generic Name:
Erythromycin Ophthalmic Ointment
Trade names: Romycin,Ilotycin Pregnancy category: B
Drug Family: anti-infective, anti-fungal,anti-viral
Action:Suppresses protein synthesis at the level of the 50S bacterial ribosome. Common Use of drug: applied to babys eyes to prevent conjunctivitis. Reason Patient is receiving Drug: Usual adult dosage and route: Usual pediatric dosage and route: Infants: Prophylaxis of ophthalmia neonatorumthin strip in each eye as a single dose. Apply a 1 to 2 cm ribbon of ointment to the lower conjunctival sac of each eye; the medicine may also ne used in drop form. Side effects: May cause chemical conjunctivitis that lasts 24-48 hours; vision my be temporarily blurred. Contraindications:Small amounts may be absorbed and result in hypersensitivity reactions. Drug interactions: Nursing Implications: Law states that drops must be administered.
Generic Name:
Hepatitis B vaccine
Trade names: HepB, Engerix-B Recombivax HB pregnancy category:C
Drug Family:Passive immunizing agent
Action: A solvent/detergent-treated sterile solution of purified gamma globulin containing anti-HBs. Prepared from plasma donated by healthy, screened donors with high titers of anti-HBs. Mechanism of action is unknown. Common Use of drug: Reason Patient is receiving Drug: Usual adult dosage and route: Usual pediatric dosage and route: 0.5 mL IM at 0, 1 2, and 618 mo; if mother's HBsAg status is unknown, administer hepatitis B vaccine within 12 hr of birth. Dose is same for patients age 019 yr. Infants born to HBsAg-positive mothers: Administer 0.5 mL of hepatitis B immune globulin IM and 1st dose of hepatitis B vaccine within 12 hr of birth; give 2nd and 3rd doses of hepatitis B vaccine at 1 mo and 6 mo, respectively. Side effects:Local soreness. Contraindications:History of anaphylactic or severe systemic reactions to human globulins. Hypersensitivity to yeast. Drug interactions:
Nursing Implications: IM: Administer hepatitis B immune globulin (HBIG) in adults and children into the deltoid muscle or anterolateral thigh. The gluteal site should be used only in adults with injections of large volumes or when large volumes are divided into multiple doses. Do not administer IV.
Generic Name:
oxytocin
Trade names: Pitocin pregnancy category: X
Drug Family:Hormone, oxytocics
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. Common Use of drug: used to induce labor Reason Patient is receiving Drug: Usual adult dosage and route: Induction/Stimulation of Labor IV: (Adults) 0.52 milliunits/min; by 12 milliunits/min q 1560 min until pattern established (usually 56 milliunits/min; maximum 20 milliunits/min), then dose. Postpartum Hemorrhage: IV: (Adults) 10 units infused at 2040 milliunits/min. IM: (Adults) 10 units after delivery of placenta. Incomplete/Inevitable Abortion: IV: (Adults) 10 units at a rate of 20 40 milliunits/min Usual pediatric dosage and route: Side effects:Maternal adverse reactions are noted for IV use only CNS: maternal: COMA, SEIZURESfetal: INTRACRANIAL HEMORRHAGE Resp: fetal: ASPHYXIA, hypoxia CV: maternal: hypotensionfetal: arrhythmias F and E: maternal: hypochloremia, hyponatremia, water intoxication Misc: maternal: uterine motility, painful contractions, abruptio placentae, uterine bloo d flow, hypersensitivity Contraindications:Hypersensitivity, Anticipated nonvaginal delivery. Use Cautiously in: OB: First and second stages of labor; slow infusion over 24 hr has caused water intoxication with seizure and coma or maternal death due to oxytocin's antidiuretic effect.
Drug interactions.Concurrent use with cyclopropane anesthesia may result in excessive hypotension. Nursing Implications:Do not administer oxytocin simultaneously by more than one route. IV Administration pH: 3.0 5.0. Continuous InfusionRotate infusion container to ensure thorough mixing. Store solution in refrigerator, but do not freeze. Infuse via infusion pump for accurate dose. Oxytocin should be connected via Y-site injection to an IV of 0.9% NaCl for use during adverse reactions. Magnesium sulfate should be available if needed for relaxation of the myometrium. Induction of Labor: Diluent: Dilute 1 mL (10 units) in 1 L of compatible infusion fluid (0.9% NaCl, D5W, or LR). Concentration 10 milliunits/mL. Rate: Begin infusion at 0.52 milliunits/min (0.050.2 mL); increase in increments of 12 milliunits/min at 1530-min intervals until contractions simulate normal labor. Postpartum Bleeding: Diluent: For control of postpartum bleeding, dilute 1 4 mL (1040 units) in 1 L of compatible infusion fluid. Concentration 10 40 milliunits/mL. Rate: Begin infusion at a rate of 20 40 milliunits/min to control uterine atony. Adjust rate as indicated. Incomplete or Inevitable Abortion: Diluent: For incomplete or inevitable abortion, dilute 1 mL (10 units) in 500 mL of 0.9% NaCl or D5W. Concentration 20 milliunits/mL. Rate: Infuse at a rate of 20 40 milliunits/m
Generic Name: Methylergonovine Drug Family: Ther. Class.: oxytocic Pharm. Class:Ergot alkaloids
Trade names: Methergine Pregnancy category: C
Action: Directly stimulates uterine and vascular smooth muscle. Therapeutic Effect(s):Uterine contraction. Common Use of drug: Preventing and treating bleeding after delivery of a baby. Reason Patient is receiving Drug: Usual adult dosage and route:PO: (Adults) 200400 mcg (0.40.6 mg) q 612 hr for 27 days. IM: IV: (Adults) 200 mcg (0.2 mg) q 24 hr for up to 5 doses. Usual pediatric dosage and route: Side effects:CNS: dizziness, headache EENT: tinnitus Resp: dyspnea CV: HYPERTENSION, arrhythmias, chest pain, palpitations GI: nausea, vomiting GU: cramps Derm: diaphoresis Misc: allergic reactions Contraindications:Hypersensitivity; OB: Should not be used to induce labor. Use Cautiously in: Hypertensive or eclamptic patients (more susceptible to hypertensive and arrhythmogenic side effects); Severe hepatic or renal disease; Sepsis. Exercise Extreme Caution in: OB: Third stage of labor Drug interactions::Excessive vasoconstriction may result when used with heavy cigarette smoking (nicotine) or other vasopressors, such as dopamine
Nursing Implications: IV administration is used for emergencies only. Oral and IM routes are preferred. Administer at a rate of 0.2 mg over at least 1 min. Use only solution that is clear and colorless and that contains no precipitate
Generic Name:
Karboprost
Trade names: Hemabate Pregnancy category:C
Drug Family:Abortifacients
Action: Causes uterine contractions by directing stimulating the myometrium. Common Use of drug:Expulsion of fetus. Control of postpartum bleeding. Reason Patient is receiving Drug: Usual adult dosage and route:Abortifacient: IM 250 mcg every 1.5 - 3.5 hrs depending on response; may increase to 500 mcg if several doses of 250 mcg produce inadequate response. (not to exceed 2 days of continuous therapy or total dose of 12 mg. Uterine Bleeding: IM 250 mcg; may be repeated every 15-90 min (total dose not to exceed 2 mg Usual pediatric dosage and route: Side effects:dizziness, headache, wheezing, diarrhea, nausea, vomiting, abdominal pain, cramps, UTERINE RUPTURE, flushing, fever, chills, shivering Contraindications:Hypersensitivity. Acute PID. Active pelvic, renal, or hepatic disease. Drug interactions:Augments the effects of other oxytocic agents. Nursing Implications: Avoid contact with skin. Thoroughly wash skin immediately after spillage. Opioid analgesic may be given for uterine cramping. Store in refrigerator. IM: Administer deep IM. Rotate sites.
Generic Name:Misoprostol
Trade names: Cytotec
Drug Family:Ther. Class. antiulcer agents, cytoprotective agents. Pharm, Class. prostaglandins Pregnancy category; X Action: Acts as a prostaglandin analogue, decreases gastric acid secretion (antisecretory effect) and increasing the production of protective mucus (cytoprotective effect). Causes uterine contractions. Common Use of drug: Prevention of gastric ulceration from NSAIDs. With mifepristone terminates pregnancy of less than 49 days. Reason Patient is receiving Drug: Usual adult dosage and route: PO: (Adults) Antiulcer 200 mcg 4 times daily with or after meals and at bedtime, or 400 mcg twice daily, with the last dose at bedtime. If intolerance occurs, dose may be to 100 mcg 4 times daily. Termination of pregnancy400 mcg single dose 2 days after mifepristone if abortion has not occurred. Intravaginally: (Adults) 25 mcg (1/4 of 100 mcg tablet); may repeat q 36 hr, if needed Usual pediatric dosage and route: Side effects:CNS: headache GI: abdominal pain, diarrhea, constipation, dyspepsia, flatulence, nausea, vomiting GU: miscarriage, menstrual disorders Contraindications:Hypersensitivity to prostaglandins OB: Should not be used to prevent NSAID-induced gastric injury due to potential for fetal harm or death Lactation: May cause severe diarrhea in the nursing infant. Use Cautiously in: OB: Patients with childbearing potential should be counseled to avoid pregnancy during misoprostol therapy for prevention of NSAID-induced gastric
injury. Pregnancy status should be determined before initiating therapy. When used for cervical ripening (unlabeled use) may cause uterine rupture (risk factors are late trimester pregnancy, previous caesarian section or uterine surgery or 5 previous preg nancies Drug interactions:Increased risk of diarrhea with magnesium-containing antacids. Nursing Implications: Do not confuse Cytotec (misoprostol) with Mifeprex (mifepristone). Misoprostol therapy should be started at the onset of treatment with NSAIDs. PO: Administer medication with meals and at bedtime to reduce severity of diarrhea. Antacids may be administered before or after misoprostol for relief of pain. Avoid those containing magnesium, because of increased diarrhea with misoprostol.
Generic Name: Prostin suppository Prostin E Vaginal Suppository Drug Family:cervical ripening agent
Trade names: Cervidil Vaginal Insert,Prepidil Endocervical Gel,
Pregnancy category:c
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. Common Use of drug:Initiation of labor. Expulsion of fetus. Reason Patient is receiving Drug: Usual adult dosage and route: Cervical Ripening: Vag: (Adults, Cervical): Endocervical gel 0.5 mg; if response is unfavorable, may repeat in 6 hr (not to exceed 1.5 mg/24 hr). Vaginal insert: one 10-mg insert. Abortifacient: Vag: (Adults) One 20-mg suppository, repeat q 35 hr (not to exceed 240 mg total or longer than 48 hr). Usual pediatric dosage and route: Side effects:Endocervical Gel, Vaginal Insert: GU: uterine contractile abnormalities, warm feeling in vagina MS: back pain Misc: AMNIOTIC FLUID EMBOLISM, fever Suppository: CNS: headache, drowsiness, syncope Resp: coughing, dyspnea, wheezing CV: hypotension, hypertension GI: diarrhea, nausea, vomiting GU: UTERINE RUPTURE, urinary tract infection, uterine hyperstimulation, vaginal/uterine pain Misc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS, chills, fever
Contraindications:Hypersensitivity to prostaglandins or additives in the gel or suppository. The gel/insert should be avoided in situations in which prolonged uterine contractions should be avoided, including Presence of acute pelvic inflammatory disease or ruptured membranes Concurrent oxytocic therapy (wait for 30 min after removing insert before using oxytocin).Use Cautiously in: Uterine scarring, Asthma, Hypotension, Cardiac disease, Adrenal disorders, Anemia, Jaundice, Diabetes mellitus, Epilepsy, Glaucoma, Pulmonary, renal, or hepatic disease, Multiparity (up to 5 previous term pregnancies), Women >30 yr, those with complications during pregnancy, and those with a gestational age >40 wk ( risk of di sseminated intravascular coagulation) Drug interactions:Augments the effects of other oxytocics. Nursing Implications: Warm the suppository to room temperature just before use. Wear gloves when handling unwrapped suppository to prevent absorption through skin. Patient should remain supine for 10 min after insertion of suppository; then she may be ambulatory. Vaginal Insert: Place vaginal insert transversely in the posterior vaginal fornix immediately after removing from foil package. Warming of insert and sterile conditions are not required. Use vaginal insert only with a retrieval system. Use minimal amount of water-soluble lubricant during insertion; avoid excess because it may hamper release of dinoprostone from insert. Patient should remain supine for 2 hr after insertion, then may ambulate. Vaginal insert delivers dinoprostone 0.3 mg/hr over 12 hr. Remove insert at the onset of active labor, before amniotomy, or after 12 hr. Oxytocin should not be used during or less than 30 min after removal of insert.
Generic Name:Betamethasone Drug Family:corticosteroids
Trade names: Celestone Pregnancy category:C
Action: Suppression of inflammation and modification of the normal immune response.Replacement therapy in adrenal insufficiency. Common Use of drug: Suppression of inflammation, Prevention of respiratory distress syndrome in newborn Reason Patient is receiving Drug: Usual adult dosage and route:IM: (Adults) 0.5 9 mg/day as betamethasone sodium phosphate/acetate suspension in 1 2 divided doses. Usual pediatric dosage and route:Prevention of respiratory distress syndrome in newborn 12 mg daily for 23 days before delivery(unlabeled).IM: Children Adrenocortical insufficiency17.5 mcg/kg (500 mcg/m2)/day in 3 divided doses every 3rd day or 5.88.75 mcg/kg (166250 mcg/m2)/day as a single dose. Side effects:Adverse reactions/side effects are much more common with high-dose/long-term therapyCNS: depression, euphoria, headache, intracranial pressure (children only), personality changes, psychoses, restlessnessEENT: cataracts, intraocular pressureCV: hypertensionGI: PEPTIC ULCERATION, anorexia, nausea, vomitingDerm: acne, wound healing, ecchymoses, fragility, hirsutism, petechiaeEndo: adrenal suppression, hyperglycemiaF and E: fluid retention (long-term high doses), hypokalemia, hypokalemic alkalosisHemat: THROMBOEMBOLISM, thrombophlebitisMetabolic: weight gain, weight lossMS:
muscle wasting, osteoporosis, avascular necrosis of joints, muscle painMisc: cushingoid appearance (moon face, buffalo hump), susceptibility to infection Contraindications:Active untreated infections (may be used in patients being treated for tuberculous meningitis)Traumatic brain injury (high doses may mortality)Lactation: Avoid chronic useSome products contai n bisulfites and should be avoided in patients with known hypersensitivity.Use Cautiously in: Chronic treatment (will lead to adrenal suppression; use lowest possible dose for shortest period of time)HypothyroidismCirrhosisUlcerative colitisStress (surgery, infections); supplemental doses may be neededPotential infections may mask signs (fever, inflammation)OB: Safety not establishedPedi: Chronic use will result in growth; use lowest possible dose for shortest period of time Drug interactions:Hypokalemia may risk of digitalis glycoside toxicity.Phenytoin,phenobarbital, and rifampin stimulate metabolism; may effectiveness. Oral contraceptives may block metabolism. risk of adverse GI effects with NSAIDs (including aspirin). Nursing Implications: If dose is ordered daily or every other day, administer in the morning to coincide with the body's normal secretion of cortisol.
Generic Name: magnesium sulfate Drug Family:Mineral and electrolyte replacements/supplements
Trade names: Magnesium sulfate pregnancy category: A
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. Common Use of drug: used to treat preeclampsia in laboring women. May also delay labor in the case of premature labor, to delay preterm birth Reason Patient is receiving Drug: Usual adult dosage and route:Seizures/HypertensionIM: IV: (Adults) 1 g q 6 hr for 4 doses as needed.Eclampsia/Pre-EclampsiaIV: IM: (Adults) 45 g by IV infusion, concurrently with up to 5 g IM in each buttock; then 4 5 g IM q 4 hr or 4 g by IV infusion followed by 12 g/hr continuous infusion (not to exceed 40 g/day or 20 g/48 hr in the presence of severe renal insufficiency). Usual pediatric dosage and route:.IM: IV: (Children > 1 mo): 25 50 mg/kg/dose q 46 hr for 34 doses, maximum single dose: 2 g.IV: Neonates 2550 mg/kg/dose q 812 hr for 23 doses. Torsade de PointesIV: (Infants and Children): 2550 mg/kg/dose, maximum dose: 2 g Side effects:CNS: drowsinessResp: respiratory rateCV: arrhythmias, bradycardia, hypotensionGI: diarrheaMS: muscle weaknessDerm: flushing, sweatingMetabolic: hypothermia
Contraindications:HypermagnesemiaHypocalcemiaAnuriaHeart blockOB: Unless used for preterm labor, avoid continuous use during active labor or within 2 hr of delivery due to potential for magnesium toxicity in newborn.Use Cautiously in: Any degree of renal insufficiencyGeri: May require dosage due to age -related in renal function. Drug interactions:Drug-DrugMay potentiate calcium channel blockers and neuromuscular blocking agents. Nursing Implications: High Alert: Accidental overdosage of IV magnesium has resulted in serious patient harm and death. Have second practitioner independently double check original order, dose calculations, and infusion pump settings. .Rate: Infuse over 2-4 hr. Do not exceed a rate of 1 mEq/kg/hr (125 mg/kg/hr). When rapid infusions are needed (severe asthma or torsade de pointes) may infuse over 1020 min.
Generic Name:
promethazine
Trade names: Phenergan pregnancy category:C
Drug Family: anti-emeti, antihistamines, sedative/hypnotics
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. Common Use of drug: treats nausea and vomiting Reason Patient is receiving Drug: Usual adult dosage and route: IV, 6.25 mg q 4-6 hrs PRN. Usual pediatric dosage and route: Side effects: sedation, respiratory depression; side effets often dose-related, an cause hallucinations, leg twitching/jumpiness, other symptoms when given in higher doses IV Contraindications: do not use with Duramorph Drug interactions:Drug-DrugConcurrent use with MAO inhibitors may result in sedation and anticholinergic side effects.
Nursing Implications: very irritation to vein, dilute heavily with NS and push very slowly IV; watch for respiratory depression, particularly when given with other sedatives; must have anesthesia clearance if patient has been given Duramorph; instruct patient to call for assist as needed OOB if dizzy/light-headed.
Generic Name:
ondansetron hydrochloride
Trade names: Zofran Pregnancy category:B
Drug Family: anti-emetic
Action: Blocks the effects of serotonin at 5-HT3receptor sites (selective antagonist) located in vagal nerve terminals and the chemoreceptor trigger zone in the CNS.Therapeutic Effect(s): Decreased incidence and severity of nausea and vomiting following chemotherapy or surgery. Common Use of drug: treats nausea and vomiting Reason Patient is receiving Drug: Usual adult dosage and route: typically 4mg q 4-6 hrs PRN, IV Usual pediatric dosage and route: Side effects: constipation, diarrhea, headache Contraindications: Drug interactions: Nursing Implications: can be given undiluted, push over 2-5 mins; larger doses must be given as IVPB, call pharm to mix; should be first choice if ordered for patients on PCA or with Duramorph as is not sedating.
Generic Name: Meruvax Drug Family: Viral Vaccine Action: Live, attenuated virus stimulates active immunity Common Use of drug: Reason Patient is receiving Drug:
Trade names: Rubella vaccine Pregnancy category: C
Usual adult dosage and route:The dose for any age is 0.5 mL administered subcutaneously, preferably into the outer aspect of the upper arm Usual pediatric dosage and route: Side effects:Pain/redness/swelling at the injection site may occur. Other side effects may include fever, irritability, mild swollen glands (lymph nodes), measles-like rash, hives, tiredness, sore throat, dizziness, headache, nausea, vomiting, diarrhea, and body aches. These rubella-like symptoms may occur 11 to 20 days after vaccination and are usually mild Contraindications:Allergy to egg, gelatin, or neomycin; active infection; severe immunosuppression (in the absence of severe immunosuppression, HIV is not a contraindication); pregnancy. Drug interactions:Drug-Drug. 160 known drugs that interact with the Rubella Virus Vaccine
Nursing Implications: Measles, mumps, and rubella vaccine and diphtheria toxoid, tetanus toxoid, and pertussis vaccine may be given concomitantly. Do not administer FluMist concurrently with other vaccines, or in patients who have received a live virus vaccine within 1 mo or an inactivated vaccine within 2 wk of vaccination. Administer each immunization by appropriate route: Subcut: rubella.
Generic Name: Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine absorbed (generic) Trade names: TdAP , Adacel, Boostrix Drug Family:immunization Pregnancy category:C
Action:Diphtheria and tetanus toxoids induce antibodies against toxins made by Corynebacterium diphtheriae and Clostridium tetani . Pertussis vaccine protects against Bordetella pertussis Common Use of drug: Reason Patient is receiving Drug: Usual adult dosage and route: 0.5 mL IM single dose Usual pediatric dosage and route: Side effects:Fatigue, headache, gastrointestinal symptoms, pain at injection site Contraindications:Previous reactions to DTaP; progressive neurological disease; recent (within 7 days) CNS pathology. Drug interactions:Anticoagulants Administer DTaP/Tdap with caution to patients on anticoagulant therapy. Immunosuppressants (eg, alkylating agents, antimetabolites, corticosteroids [in greater than physiologic doses], cytotoxic agents, irradiation) May reduce efficacy of the vaccine Nursing Implications: Single dose should be given to replace one of the 10 yr Td boosters in adults (1964 yr) who did not previously receive a dose of Tdap or if their vaccine status is unknown. Single dose should also be given as soon as feasible to all
postpartum women, close contacts of infants <12 mo, and healthcare workers wi th direct patient contact. Rotate vial or syringe in palm to bring contents to room temperature before administering; administer immediately.
Generic Name:
simethicone
Trade names: Mylicon
Drug Family:antiflatulant, Action: Causes the coalescence of gas bubbles.Does not prevent the formation of gas. Common Use of drug: relief of gas and bloating. Reason Patient is receiving Drug: Usual adult dosage and route: PO: (Adults) 40 125 mg qid, after meals and at bedtime (up to 500 mg/day) Usual pediatric dosage and route: .PO: (Children 2 12 yr): 40 mg 4 times daily.PO: (Children <2 yr): 20 mg 4 times daily (up to 240 mg/day). Side effects: may include diarrhea, nausea, or vomiting Contraindications: Not recommended for infant colic.Use Cautiously in: Abdominal pain of unknown cause, especially when accompanied by fever OB: Lactation: Has been used safely. Drug interactions: Nursing Implications: may be more effective when given as a standing med vs. PRN
Generic Name:Rho (D) Immune Globulin Drug Family:Vaccines/immunizing agents
Trade names: Rogam
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. Common Use of drug: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. Reason Patient is receiving Drug: Usual adult dosage and route: Following Delivery:IM: (Adults) HyperRHO S/D Full Dose, RhoGAM 1 vial standard dose (300 mcg) within 72 hr of delivery.Before Delivery: IM: (Adults) HyperRHO S/D Full Dose, RhoGAM1 vial standard dose (300 mcg) at 2628 wk.Termination of Pregnancy (<13 wk Gestation): IM: (Adults) HyperRHO S/D Mini-Dose, MICRhoGAM1 vial of microdose (50 mcg) within 72 hr.Termination of Pregnancy (>13 wk Gestation): IM: (Adults) RhoGAM1 vial standard dose (300 mcg) within 72 hr.Large Fetal-Maternal Hemorrhage (>15 mL): IM: (Adults) RhoGAM 20 mcg/mL of Rho(D)-positive fetal RBCs.Transfusion Accident: IM: (Adults) HyperRHO S/D Full Dose, RhoGAM (Volume of Rh-positive blood administered Hct of donor blood)/15 = number of vials of standar Usual pediatric dosage and route: Side effects: CNS: dizziness, headache CV: hypertension, hypotension Derm: rash GI: diarrhea, nausea, vomiting GU: acute renal failure Hemat: ITP: DISSEMINATED INTRAVASCULAR COAGULATION, INTRAVASCULAR HEMOLYSIS, anemia
MS: arthralgia, myalgia Local: pain at injection site Misc: fever Contraindications: Prior hypersensitivity reaction to human immune globulin. Rh o(D)- or Du-positive patients. Drug interactions: May antibody response to some live-virus vaccines (measles, mumps, rubella). Nursing Implications: IV: Assess vital signs periodically during therapy in patients receiving IV Rh o(D) immune globulin. ITP: Monitor patient for signs and symptoms of intravascular hemolysis (IVH) (back pain, shaking chills, fever, hemoglobinuria), anemia, and renal insufficiency. If transfusions are required, use Rh o(D)-negative packed red blood cells to prevent exacerbation of IVH.
Generic Name:
Iron
Trade names: Ferrous Suflate
Drug Family: antianemics Action: An essential mineral found in hemoglobin, myoglobin, and many enzymes.Enters the bloodstream and is transported to the organs of the reticuloendothelial system (liver, spleen, bone marrow) where it becomes part of iron stores. Common Use of drug: iron supplement whe patient is anemic; commonly given as supplement post-delivery. Reason Patient is receiving Drug: Usual adult dosage and route: PO, 325mg q day or BID Side effects: may cause nausea, constipation or dark stools. Contraindications: Anemia not due to iron deficiencyHemochromatosisHemosiderosisHypersensitivity to iron products.Use Cautiously in: Peptic ulcer diseaseUlcerative colitis or regional enteritis (condition may be aggravated)AlcoholismSevere hepatic impairmentSevere renal impairment. Drug interactions: absorption of tetracyclines, fluoroquinolones bisphosphonates, levothyroxine, mycofenolate mofetil, and penicillamine (simultaneous administration should be avoided).Concurrent administration of proton pump inhibitors, histamine H2 antagonists, and cholestyramine may absorption of iron.Doses of ascorbic acid 200 mg may absorption of iron by up to 30%.Chloramphenicol and vitamin E may hematologic response to iron therapy.D rug-Food: Iron absorption is 3350% by concurrent administration of food. Nursing Implications: give with food to reduce nausea; patient may desire to take once-daily dose in PM to reduce nausea; can be given with orange juice to increase absorption
Generic Name:
Brethine/Terbutaline
Trade names: Bricanyl
Drug Family:Bronchodilators, adrenergics 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. Common Use of drug:Bronchodilation. Reason Patient is receiving Drug: Usual adult dosage and route: PO: (Adults and Children >15 yr): Bronchodilation 2.55 mg 3 times daily, given q 6 hr (not to exceed 15 mg/24 hr).(Adults) Tocolysis2.510 mcg/min infusion; by 5 mcg/min q 10 min until contractions stop (not to ex ceed 30 mcg/min). After contractions have stopped for 30 min, infusion rate to lowest effective amount and maintain for 48 hr (unlabeled). Usual pediatric dosage and route: PO:(Children <12 yr): Bronchodilation 0.05 mg/kg 3 times daily; may gradually (not to exceed 0.15 mg/kg 34 times daily or 5 mg/24 hr. .SC: (Children <12 yr): Bronchodilation 0.0050.01 mg/kg; may repeat in 1520 min Side effects:CNS: nervousness, restlessness, tremor, headache, insomniaResp: pulmonary edemaCV: angina, arrhythmias, hypertension, myocardial ischemia, tachycardiaGI: nausea, vomitingEndo: hyperglycemiaF and E: hypokalemia
Contraindications:Hypersensitivity to adrenergic amines.Use Cautiously in: Cardiac diseaseHypertensionHyperthyroidismDiabetesGlaucomaGeri: More suscep tible to adverse reactions; may require dose Excessive use may lead to tolerance and paradoxical bronchospasm (inhaler)OB: Lactation: Pregnancy (near term) and lactation Drug interactions:use with other adrenergics (sympathomimetic) will have additive adrenergic side effects.Use with MAO inhibitors may lead to hypertensive crisis.Beta blockers may negate therapeutic effect.Drug-Natural Products: Use with caffeine-containing herbs (cola nut, guarana, mate, tea, coffee) stimulant effect
Nursing Implications:Do not confuse Brethine (terbutaline) with Methergine (methylergonovine).PO: Administer with meals to minimize gastric irritation.Tablet may be crushed and mixed with food or fluids for patients with difficulty swallowing.SC: Administer subcut injections in lateral deltoid area. Do not use solution if discolored
Generic Name: Drug Family: vitamins
Trade names:Prenatal Vitamins
Action: Necessary for normal growth and development. Many act as coenzymes or catalysts in numerous metabolic processes. Common Use of drug: boost nutrition for pregnant, lactation, or post-partum patients. Reason Patient is receiving Drug: Usual adult dosage and route: PO, once daily Usual pediatric dosage and route: N/A Side effects: nausea, bad taste in mouth, headache Contraindications: Hypersensitivity to preservatives, colorants, additives; intolerance to alcohol; use cautiously in pts w/ anemia of undetermined cause Drug interactions:Large amts of Vit B may interfere w/ beneficial effect of levodopa Nursing Implications: give with food to decrease nausea; give with full glass of water; patient may desire to take at bedtime to decrease nausea; chewable vitamins are an option if patient has difficulty swallowing.
Generic Name:
docusate sodium
Trade names: Colace
Drug Family:laxatives Action: Promotes incorporation of water into stool, resulting in softer fecal mass.May also promote electrolyte and water secretion into the colonl. Common Use of drug: stool softener Reason Patient is receiving Drug: Usual adult dosage and route: PO, 100mg q day or BID Usual pediatric dosage and route: Side effects: diarrhea, nausea, bitter taste in mouth Contraindications:HypersensitivityAbdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen.Use Cautiously in: Excessive or prolonged use may lead to dependenceShould not be used if prompt results are desiredOB: Lactation: Has been used safely. Drug interactions: none significant Nursing Implications: do not use within 1-2 hours before or after other medications as it can interfere with absorption and effectiveness; instruct patient to drink plenty of water; may take 1-2 days to see effect
Generic Name:MedroxyPROGERTERone Drug Family:Antineoplastics, Contraceptive hormones
Trade names: Depoprovera
Action: A synthetic form of progesteroneactions include secretory changes in the endometrium, increases in basal body temperature, histologic changes in vaginal epithelium, relaxation of uterine smooth muscle, mammary alveolar tissue growth, pituitary inhibition, and withdrawal bleeding in the presence of estrogen Common Use of drug:Decreased endometrial hyperplasia in postmenopausal women receiving concurrent estrogen (combination with estrogen decreases vasomotor symptoms and prevents osteoporosis).Restoration of hormonal balance with control of uterine bleeding.Management of endometrial or renal cancer.Prevention of pregnancy. Reason Patient is receiving Drug: Usual adult dosage and route:.Dysfunctional Uterine Bleeding/Induction of MensesPO: (Adults) 510 mg/day for 510 days, starting on day 16 or day 21 of menstrual cycle.Renal or Endometrial CarcinomaIM: (Adults) 400 1000 mg, may be repeated weekly; if improvement occurs, attempt to decrease dose to 400 mg monthly.Endometriosis-Associated PainSC: (Adults) 104 mg every 1214 wk (3 mo), beginning on day 5 of normal menses (not recommended for more than 2 yr). Usual pediatric dosage and route: Side effects:CNS: depressionEENT: retinal thrombosisCV: PULMONARY EMBOLISM, thromboembolism, thrombophlebitisGI: drug-induced hepatitis, gingival bleedingGU: cervical erosionsDerm: chloasma, melasma, rashesEndo: amenorrhea, breakthrough
bleeding, breast tenderness, changes in menstrual flow, galactorrhea, hyperglycemia, spottingF and E: edemaMetabolic: bone lossMisc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS AND ANGIOEDEMA, weight gain, weight loss Contraindications: HypersensitivityHypersensitivity to parabens (IM suspension only)Missed abortionThromboembolic diseaseCerebrovascular diseaseSevere liver diseaseBreast or genital cancerPorphyriaOB: May risk of fetal genitourinary malformation.Use Cautiously in: History of liver diseaseRenal diseaseCardiovascular diseaseSeizure disordersMental depressionLactation: If used as a contraceptive, wait 6 wk after delivery if breastfeeding. Drug interactions:Drug-DrugMay effectiveness of bromocriptine when used concurrently for galactorrhea/amenorrhea.Aminoglutethimide may oral absorption. Nursing Implications: Do not confuse Depo-Provera with Depo-subQ Provera 104. Do not confuse Provera (medroxyprogesterone) with Proscar (finasteride) or Prozac (fluoxetine).Only the 150 mg/mL vial should be used for contraception.Injectable medroxyprogesterone may lead to bone loss, especially in women younger than 21 yr. Injectable medroxyprogesterone should be used for >2 yr only if other methods of contraception are inadequate. If used long term, women should use supplemental calcium and vitamin D, and monitor bone mineral density.IM: Shake vial vigorously before preparing IM dose. Administer deep IM into gluteal or deltoid muscle. If period between injections is >14 wk, determine thatpatient is not pregnant before administering the drug.In patients with cancer, IM dose may initially be required weekly. Once stabilized, IM dose may be required only monthly.
Generic Name:
Hydroxyzine
Trade names: Atarax
Drug Family:antianxiety agents, antihistamines, sedative/hypnotics Action: Acts as a CNS depressant at the subcortical level of the CNS.Has anticholinergic, antihistaminic, and antiemetic properties.Blocks histamine 1 receptors. Common Use of drug:Sedation.Relief of anxiety.Decreased nausea and vomiting.Decreased allergic symptoms associated with release of histamine, including pruritus. Reason Patient is receiving Drug: Usual adult dosage and route:PO: (Adults) Antianxiety25100 mg 4 times/day, not to exceed 600 mg/day. Preoperative sedation 50100 mg single dose. Antipruritic25 mg 34 times dailyIM: (Adults) Preoperative sedation25100 mg single dose. Antiemetic, adjunct to opioid analgesics25100 mg q 46 hr as needed Usual pediatric dosage and route:.PO: Children 2 mg/kg/day divided q 68 hr. .IM: Children 0.51 mg/kg/dose q 46 hr as needed. Side effects:CNS: drowsiness, agitation, ataxia, dizziness, headache, weaknessResp: wheezingGI: dry mouth, bitter taste, constipation, nauseaGU: urinary retentionDerm: flushingLocal: pain at IM site, abscesses at IM sitesMisc: chest tightness Contraindications:HypersensitivityOB: Potential for congenital defects (oral clefts and hypoplasia of cerebral hemisphereLactation: Safety not established.Use Cautiously in: Severe hepatic dysfunctionOB: Has been used safely during laborPedi: Injection contains benzyl alcohol, which can cause potentially fatal gasping syndrome in neonatesGeri: Appears on Beers list
Drug interactions:Drug-Natural Products: Concomitant use of kava-kava, valerian, or chamomile can increase CNS depression. Nursing Implications: Do not confuse hydroxyzine with hydralazine or Atarax (hydroxyzine) with Ativan (lorazepam).PO: Tablets may be crushed and capsules opened and administered with food or fluids for patients having difficulty swallowing.Shake suspension well before administration.IM: Administer only IM deep into well-developed muscle, preferably with Z-track technique. Injection is extremely painful. Do not use deltoid site. If must be administered to children, midlateral muscles of the thigh are preferred. Significant tissue damage, necrosis, and sloughing may result from subcut or intra-arterial injections. Hemolysis may result from IV injections. Rotate injection sites frequently.
Generic Name:
diphenhydramine
Trade names: Benadryl
Drug Family:antihistamines, antitussives Action: Antagonizes the effects of histamine at H1-receptor sites; does not bind to or inactivate histamine.Significant CNS depressant and anticholinergic properties Common Use of drug: as an antihistamine that relieves itching and allergy symptoms such as a runny nose and sneezing; also a nighttime sleep aid. Reason Patient is receiving Drug: Usual adult dosage and route: PO or IV. Typically ordered 25-50mg PO q 4-6 hrs PRN; 12.5 mg IV q 4-6 hrs. Side effects: sedation/somnolence or paradoxical excitation, dry mucosal membranes, dyskinesia (involuntary movements) Contraindications:HypersensitivityAcute attacks of asthma Lactation, Known alcohol intolerance (some liquid products).Use Cautiously in: Severe liver diseaseAngle-closure glaucomaSeizure disordersProstatic hyperplasiaPeptic ulcerMay cause paradoxical excitation in young childrenHyperthyroidismOB: Safety not establishedGeri: Appears on Beers list. Nursing Implications: use caution if patient is on other sedating medications; can inhibit lactation, so use caution if patient is breastfeeding.
Generic Name:
Ephedrine Hydrochloride
Trade names: Ephedrine
Drug Family:Alpha and Beta Adrenergic agonist, Bronchodilator Action:Both indirect and direct acting sympathomimetic amine thought to act indirectly by releasing tissue stores of norepinephrine and directly by stimulation of alpha, beta1 and beta2 adrenergic receptors. Like epinephrine, contracts dilated arterioles of nasal mucosa, thus reducing engorgement and edema and facilitation ventilation and drainage. Ephedrine relaxes bronchial smoothe muscle, relieving mild bronchospasm, improving air exchange and increasing vital capacity Common Use of drug: Reason Patient is receiving Drug: Usual adult dosage and route:Bronchodilatior, Nasal decongestant: Adult; PO 25-50 mg q 3-4h prn (max 150 mg/24h) Im/IV/SubQ 12.5-25 mg Usual pediatric dosage and route:child: PO Older than 2 y, 2-3 mg/kg/day in 4-6 divided doses; 6-12y, 6.25-12.5 mg q4h (max: 75mg/24h). Side effects: Contraindications: Drug interactions: Nursing Implications:
Generic Name: Drug Family:
naloxone hydrochloride
Trade names: Narcan
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. Common Use of drug: helps reverse the effects of opioids, treats itching. Reason Patient is receiving Drug: Usual adult dosage and route: IV, to treat itching, 0.04 mg IV bolus, followed by IV drip of 0.4mg in 100ml NS, 10ml/hr; to treat respiratory depression, Usual pediatric dosage and route:IM: IV: SC: Neonates 0.01 mg/kg; may repeat q 2 3 min until response obtained. Additional doses may be given q 12 hr if needed Side effects: flushing, sweating, nausea/vomiting, tremor, agitation; more severe effects have been seen in higher doses, typically in patients with previous drug usage and/or other medical conditions. Contraindications:Contraindicated in:Hypersensitivity.Use Cautiously in:Cardiovascular disease,Patients physically dependent on opioids (may precipitate severe withdrawal)OB: May cause acute withdrawal syndrome in mother and fetus if mother is opioid dependent Lactation: Safety not established Pedi: May cause acute withdrawal syndrome in neonates of opioid-dependent mothers. Drug interactions: Nursing Implications: should use caution if patient has suspected history of opioid abuse.

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Generic Name:

Trade Name: Tylenol Pregnancy category: Category C

Drug Family: Nonopioid Analgesic/antipyretic

Trade names: Stadol Pregnancy Category: C

Drug Family: opioid analgesic

Trade names: Nubain Pregnancy Category: C

Drug Family: opioid analgesic

Generic Name: acetaminophen/oxycodone hydrochloride Drug Family: opioid analgesic, antitussive

Trade names: Percocet Pregnancy category: B

Trade names: Lortab

Trade names: Demerol Pregnancy category:C

Drug Family: Sedative, Opioid analgesic

Trade names: Tylenol #3 Pregnancy category:C

Morphine sulfate Schedule II

Trade names: Duramorph Pregnancy catagory:C

Drug Family: Opioid Analgesic

Trade names: Anaprox DS

Trade names: Motrin Pregnancy catagory: B 1st trimester

Drug Family: analgesic

Trade names: Toradol

Generic Name: Ampicillin sodium Drug Family: anti-infectives, aminopenicillins

Trade names: Ampicillin Pregnancy category: B

Trade names: Cleocin Pregnancy catagory: B

Trade names: Garmycin, G-Mycin, Jenamicin Pregnancy category:C

Generic Name:Penicillin Drug Family:anti-infective

Trade names: Penicillin Pregnancy category: B

Witch hazel pads

Trade names: Tucks pads Pregnancy category:C

Drug Family:Topical Astringent Action: Relieves pain of lacerations/hemorrhoids

Trade names: Americaine ointment Pregnancy category:C

Trade names: Lanolin pregnancy category:C

Drug Family: emollient

Hydrocortisone acetate/ pramoxine hydrochloride

Trade names: Epifoam pregnancy category:C

Drug Family:combination topical corticosteroid and local anesthetic

Trade names: Vitamin K,Mephyton

Erythromycin Ophthalmic Ointment

Trade names: Romycin,Ilotycin Pregnancy category: B

Drug Family: anti-infective, anti-fungal,anti-viral

Trade names: HepB, Engerix-B Recombivax HB pregnancy category:C

Drug Family:Passive immunizing agent

Trade names: Pitocin pregnancy category: X

Drug Family:Hormone, oxytocics

Trade names: Methergine Pregnancy category: C

Trade names: Hemabate Pregnancy category:C

Trade names: Cytotec

Trade names: Cervidil Vaginal Insert,Prepidil Endocervical Gel,

Generic Name:Betamethasone Drug Family:corticosteroids

Trade names: Celestone Pregnancy category:C

Generic Name: magnesium sulfate Drug Family:Mineral and electrolyte replacements/supplements

Trade names: Magnesium sulfate pregnancy category: A

Trade names: Phenergan pregnancy category:C

Drug Family: anti-emeti, antihistamines, sedative/hypnotics

Trade names: Zofran Pregnancy category:B

Drug Family: anti-emetic

Trade names: Rubella vaccine Pregnancy category: C

Trade names: Mylicon

Generic Name:Rho (D) Immune Globulin Drug Family:Vaccines/immunizing agents

Trade names: Rogam

Trade names: Ferrous Suflate

Trade names: Bricanyl

Generic Name: Drug Family: vitamins

Trade names:Prenatal Vitamins

Trade names: Colace