N395 Maternity Meds- Labor/ Surgical Pain

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N395 Maternity Spring 2017
Kate Parvey
Flashcards by Kate Parvey, updated more than 1 year ago
Kate Parvey
Created by Kate Parvey over 7 years ago
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Duramorph/ Morphine Route & Dose SC, IV, IM, Epidural, Intrathecal INITIAL DOSE: 2 mg to 10 mg/70 kg weight. Epidural Initial injection of 5 mg in the lumbar region for pain relief for up to 24 hours. If NOT adequate pain relief within one hour, incremental doses of 1 to 2 mg at intervals sufficient to assess effectiveness may be given. No more than 10 mg/24 hour should be administered.
Duramorph/ Morphine Class & Action NARCOTIC ANALGESIC Given in the Epidural Systemic narcotic analgesic for extended pain relief w/o loss of motor, sensory or sympathetic function. Preferred opiate to use while breastfeeding due to poor oral bioavailability. Also used to treat Drug Withdrawal Syndrome in Newborn Infant.
Duramorph/ Morphine Side Effects & LR/PR SE: Sedation, constipation LR/PR: L3/C Preferred opiate while breastfeeding due to poor oral bioavailability.
Naloxone/ Narcan Route & Dose SC or IM 0.4 mg SC/IM Q2-3min PRN
Naloxone / Narcan Class & Action NARCOTIC ANTAGONIST Opioid overdose Occupies opiate receptor sites; displaces opioids already at opiate receptor sites
Naloxone / Narcan Side Effects & LR/PR SE: Tachycardia, HTN, hypotension, nausea, vomiting, tremor, withdrawal symptoms, diaphoresis, pulmonary edema, dyspnea LR/PR: L3/C AAP: Should not be administered to infants of narcotic-dependent mothers; rapid withdrawal symptoms.
Fentanyl (discontinued) / Sublimaze/ Duragesic Route & Dose IV 100 mg (2-20 ug/kg) IV: Administer by slow IV push over 3-5 minutes or by continuous infusion; larger bolus doses (>5 mcg/kg) should be given slow IV push over 5-10 minutes. Muscular rigidity may occur with rapid IV administration.
Fentanyl (discontinued) / Sublimaze/ Duragesic Class & Action POTENT NARCOTIC ANALGESIC ;OPIOID For Labor Pain Fentanyl binds with stereospecific receptors at many sites within the CNS, increases pain threshold, alters pain reception, inhibits ascending pain pathways.
Fentanyl (discontinued) / Sublimaze/ Duragesic Side Effects & LR/PR SE: Apnea, respiratory depression, muscle rigidity, hypotension, bradycardia Physical and psychological dependence with prolonged use. LR/PR: L2/C Note: neonates who receive a total fentanyl dose >1.6mg/kg or continuous infusion duration >5 days are more likely to develop narcotic withdrawal symptoms.
Ketoralac/ Toradol (discontinued) / Acular Route & Dose PO, IM, IV PO: 10 mg Q6 hours IV/IM: 30 mg Q6h; Max: 120 mg/day
Ketoralac/ Toradol (discontinued) / Acular Class & Action NSAID used for its analgesic activity Postpartum Pain Blocks Cyclooxygenase (COX) enzymes that are needed to produce prostaglandin.
Ketoralac/ Toradol (discontinued) / Acular Side Effects & LR/PR SE: Headache, nausea, abdominal pain, dyspepsia, dizziness, somnolence, constipation, diarrhea, edema, rash LR/PR: L2/C; D in 3rd trimester
Nitrous Oxide / Nitronox Route & Dose Intermittent inhalation via face mask 50% oxygen and 50% N20 Self-administered by the mother ONLY.
Nitrous Oxide / Nitronox Class & Action ANALGESIA For Labor Pain Endogenous opioid release occurs with associated analgesia, and N-methyl-Daspartate receptor inhibition reduces hyperalgesia. N2O, when used at concentrations of < 50% and as a sole agent, is defined by ASA criteria as analgesia minimal sedation. High concentrations for prolonged periods may be harmful.
Nitrous Oxide / Nitronox Side Effects & LR/PR SE: Nausea and vertigo, euphoria LRPR: L3/C
Nubain (discontinued) / Nalbuphine Route & Dose IM/ IV/SC Non-opioidtolerant patients: 10-20 mg/70kg Q3-6hr PRN; *not to exceed 20 mg As Anesthesia Supplement 0.3-3 mg/kg IV over 10-15 minutes, then 0.25-0.5 mg/kg PRN Opioid-dependent patients: Administer ¼ dose, and observe for withdrawal signs Not to exceed 160 mg/day
Nubain (discontinued) / Nalbuphine Class & Action POTENT NARCOTIC ANALGESIC For Labor Pain Opioid agonist/antagonist; inhibits ascending pain pathways Both an antagonist and agonist of opiate receptors and should not be mixed with other opiates: interference with analgesia.
Nubain (discontinued) / Nalbuphine Side Effects & LR/ PR SE: Hypotension, sedation, withdrawal syndrome, respiratory depression in mother and baby LR/PR: L2/ B
Bupivicaine On-Q Pump Route & Dose Via Catheter at wound site Dose rate variable : 1-7 mL/hr and 2-14 mL/hr A portable device ON-Q pump continuously infuses the local anesthetic through 2 small catheters inserted at wound site. *To be given only by or under the direct supervision of a doctor.
Bupivicaine On-Q Pump Class & Action LOCAL ANESTHETIC (caine drug) prevents pain by blocking signals at nerve endings
Bupivicaine On-Q Pump Side Effects & LR/PR SE: Sedation, bradycardia, respiratory depression. LR/PR: L2/C
Ropivacaine On-Q Pump Route & Dose Via Catheters at wound site Dose Rate Variable: 1-7 mL/hr and 2-14 mL/ hr A portable device ON-Q pump continuously infuses the local anesthetic through 2 small catheters inserted at the wound site.
Ropivacaine On-Q Pump Class & Action Amide LOCAL ANESTHETIC Blocks the generation and conduction of nerve 8 impulses, by increasing the threshold for electrical excitation in the nerve
Ropivacaine On-Q Pump Side Effects & LR/PR SE: Sedation, bradycardia, respiratory depression. LR/PR: L2/B
Stadol (discontinued) / Butorphanol Route & Dose IM / IV Initial dose: 1 or 2 mg once. May be repeated in 4 hours if necessary
Stadol (discontinued) / Butorphanol Class & Action Potent NARCOTIC ANALGESIC; OPIOID agonist/antagonist For Labor Pain Inhibits ascending pain pathways, thus altering response to pain Alternative analgesia should be used if delivery is expected to occur within 4 hours.
Stadol (discontinued) / Butorphanol Side Effects & LR/PR SE: Sedation, respiratory depression LR/PR: L2/C
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