Flashcards
N395 Maternity Meds- Labor/ Surgical Pain
Cards in this deck (27)
- 1Duramorph/ Morphine Route & DoseSC, 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. - 2Duramorph/ Morphine Class & ActionNARCOTIC 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.
- 3Duramorph/ Morphine Side Effects & LR/PRSE: Sedation, constipation
LR/PR: L3/C
Preferred opiate while breastfeeding due to poor oral bioavailability.
- 4Naloxone/ Narcan Route & DoseSC or IM
0.4 mg SC/IM
Q2-3min PRN
- 5Naloxone / Narcan Class & ActionNARCOTIC ANTAGONIST
Opioid overdose
Occupies opiate receptor sites; displaces opioids already at opiate receptor sites
- 6Naloxone / Narcan Side Effects & LR/PRSE: 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.
- 7Fentanyl (discontinued) / Sublimaze/ Duragesic Route & DoseIV
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.
- 8Fentanyl (discontinued) / Sublimaze/ Duragesic Class & ActionPOTENT 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.
- 9Fentanyl (discontinued) / Sublimaze/ Duragesic Side Effects & LR/PRSE: 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.
- 10Ketoralac/ Toradol (discontinued) / Acular Route & DosePO, IM, IV
PO: 10 mg Q6 hours
IV/IM: 30 mg Q6h;
Max: 120 mg/day
- 11Ketoralac/ Toradol (discontinued) / Acular Class & ActionNSAID
used for its analgesic activity
Postpartum Pain
Blocks Cyclooxygenase (COX) enzymes that are needed to produce prostaglandin.
- 12Ketoralac/ Toradol (discontinued) / Acular Side Effects & LR/PRSE: Headache, nausea, abdominal pain, dyspepsia, dizziness, somnolence, constipation, diarrhea, edema, rash
LR/PR: L2/C; D in 3rd trimester
- 13Nitrous Oxide / Nitronox Route & DoseIntermittent inhalation via face mask
50% oxygen and 50% N20
Self-administered by the mother ONLY.
- 14Nitrous Oxide / Nitronox Class & ActionANALGESIA
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.
- 15Nitrous Oxide / Nitronox Side Effects & LR/PRSE: Nausea and vertigo, euphoria
LRPR: L3/C
- 16Nubain (discontinued) / Nalbuphine Route & DoseIM/ 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
- 17Nubain (discontinued) / Nalbuphine Class & ActionPOTENT 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.
- 18Nubain (discontinued) / Nalbuphine Side Effects & LR/ PRSE: Hypotension, sedation, withdrawal syndrome, respiratory depression in mother and baby
LR/PR: L2/ B
- 19Bupivicaine On-Q Pump Route & DoseVia 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.
- 20Bupivicaine On-Q Pump Class & ActionLOCAL ANESTHETIC (caine drug)
prevents pain by blocking signals at nerve endings
- 21Bupivicaine On-Q Pump Side Effects & LR/PRSE: Sedation, bradycardia, respiratory depression.
LR/PR: L2/C
- 22Ropivacaine On-Q Pump Route & DoseVia 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.
- 23Ropivacaine On-Q Pump Class & ActionAmide LOCAL ANESTHETIC
Blocks the generation and conduction of nerve 8 impulses, by increasing the threshold for electrical excitation in the nerve
- 24Ropivacaine On-Q Pump Side Effects & LR/PRSE: Sedation, bradycardia, respiratory depression.
LR/PR: L2/B
- 25Stadol (discontinued) / Butorphanol Route & DoseIM / IV
Initial dose: 1 or 2 mg once.
May be repeated in 4 hours if necessary
- 26Stadol (discontinued) / Butorphanol Class & ActionPotent 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.
- 27Stadol (discontinued) / Butorphanol Side Effects & LR/PRSE: Sedation, respiratory depression
LR/PR: L2/C