Generic Name: Oxytocin

Brand Name: Syntocinon, Oxitone

Drug Classification: Uterine smooth muscle stimulant.

Mechanism of Action: Activates receptors that trigger increase in intracellular calcium

levels in uterine myofibrils; increases prostaglandin production. Stimulates uterine
contractions.

Stock Dosage: 10 units oxytocin at 30gtts per min/ infused at 20–40 milliunits/ min.

Indication: Control of Postpartum Bleeding,

Contraindication: Hypertonic uterine inertia, mechanical obstruction to delivery, failed

trial labor, severe toxemia, predisposition to amniotic fluid embolism, fetal distress &
placenta previa. uterine rupture, h ypersensitivity to oxytocin

Side effects/Adverse Effects: Uterine spasm, very high dose may cause violent
uterine contractions leading to uterine rupture, tissue damage & asphyxia of the fetus.
tachycardia, premature ventricular contractions, hypotension, nausea, vomiting,
hypertonicity may occur with tearing of uterus, increased bleeding, abruptio placentae

Nursing Intervention: Maintain careful I&O Check for blood loss.

Monitor B/P, pulse, respirations, fetal heart rate, intrauterine pressure

Notify physician of contractions that last longer than 1 min, occur more frequently than
every 2 min, or stop.

Stop infusion to prevent fetal anoxia, turn patient on her side, and notify physician if
contractions are prolonged

Check fundus frequently during the first few postpartum hours and several times daily
thereafter.

Keep patient and significant others informed about labor progress.

Educate client and significant other about the purpose and anticipated effect of oxytocin
Generic Name: Progesterone

Brand Name: Utrogestan

Drug Classification: Oestrogens, Progesterones & Related Synthetic Drugs

Mechanism of Action: Progesterone (Utrogestan), which includes micronized

progesterone, greatly raises plasma progesterone levels after oral administration .

Stock Dosage: 100 mg, 200 mg Oral; Vaginal route

Indication: Disorders associated with a progesterone deficit: pre-menstrual syndrome,

menstrual irregularity, benign breast disease, pre-menopause. Treatment of the
menopause, menace of abortion or prevention of recurrent spontaneous abortions due
to luteal phase defect and menace of preterm delivery.

Contraindications: Known hypersensitivity to the active substance or to any of the

excipients. Significant changes in liver function.

Side effects/adverse reactions: Drowsiness, transient dizziness, altered menstrual

cycles, amenorrhea, intermenstrual bleeding, headaches, cholestatic jaundice, pruritus,
gastrointestinal disorders

Nursing Interventions: Obtain baseline weight, serum glucose level, Blood pressure.

Obtain history of thromboembolism.

Check weight daily; report weekly gain over 5 pounds

Assess skin for rash, urticaria.

Encourage client to immediately report development of chest pain, sudden shortness of

breath, sudden decrease in vision, migraine headache and pain

Check vital signs periodically

Note progesterone therapy on pathology specimens.

Encourage client and family to report abnormal vaginal bleeding, other related
symptoms.

Educate client and family to stop taking medication, contact physician at once if
pregnancy suspected

Generic Name: Misoprostol

Brand Name: Cytotec

Drug Classification: Gastrointestinal Agents, Other; Prostaglandins, Endocrine

Mechanism of Action: Misoprostol is a synthetic E1 analog prostaglandin. It protects

the GI mucosa by inhibiting basal, stimulated and nocturnal acid secretion and reducing
the number of gastric secretions and increasing bicarbonate and mucus secretion. It
also causes contractions of the smooth muscle fibers of the myometrium and relaxation
of the cervix uterus.

Stock Dosage: 100 mcg, 200 mcg tablets

Indication: Cytotec is indicated for reducing the risk of NSAID-induced gastric ulcers in
patients at high risk of gastric ulcer complications, concomitant debilitating disease, and
the risk of developing gastric ulcers, such as those with a history of ulcers.

Contraindications: History of allergies to prostaglandins; pregnancy (category X),

lactation

Side effects/adverse reactions: Severe ongoing stomach discomfort or diarrhea,

feeling very thirsty or hot, unable to urinate, heavy sweating, and hot, dry skin diarrhea,
stomach pain, nausea, upset stomach, gas, vaginal bleeding or spotting, heavy
menstrual flow, and menstrual cramps

Nursing Interventions:

Avoid using concurrent magnesium-containing antacids because of increased incidence

of diarrhea.
Report postmenopausal bleeding to physician; it may be drug related.

Avoid pregnancy during misoprostol therapy; use an effective contraception method

while taking drug.

Drug has abortifacient property. Contact physician and immediately discontinue drug if
you become pregnant.

Do not breast feed while taking this drug.

Educate client about the medication about its benefits and its side effects.

Generic Name: Amyl Nitrate

Brand Name: Amyl Nitrate

Drug Classification: Cardiovascular agent; Nitrate vasodilator; Antidote

Mechanism of Action: Short-acting vasodilator and smooth muscle relaxant with action
similar to that of nitroglycerin. Action in the treatment of cyanide poisoning based on the
ability of amyl nitrite to convert hemoglobin to methemoglobin, which forms a non -toxic
complex with cyanide ion.

Stock Dosage: 0.3 mL ampules

Indication: Acute Relief of Angina and Cyanide Poisoning

Contraindications: Hypersensitivity to nitrites or nitrates; cerebral hemorrhage, head

trauma; hypotension; glaucoma; severe anemia; hyperthyroidism; recen t MI; acute
alcoholism. Safety during pregnancy (category C) and lactation is not established.

Side effects/adverse reactions: Dizziness, facial flushing, hypotension, tachycardia,

vasodilation, headache restlessness, syncope, shock, nausea, vomiting, orth ostatic
hypotension, Hemolytic anemia, methemoglobulinemia (high dose), rash, weakness

Nursing Interventions: Monitor for S&S of syncope, due to a sudden drop in systolic
BP, which sometimes follows drug inhalation, particularly in older adults.
Monitor vital signs until stable. Rapid pulse, which usually lasts for a brief period, is an
expected response to the fall in BP produced by the drug.

Chart length of time required for pain to subside after administration of drug.

Note that tolerance may develop with repeated use over prolonged periods.

Educate family and client to go to the emergency room immediately or consult physician
if no relief from angina is experienced after 3 doses 5 min apart.

Educate family and client to not breast feed while taking this drug without consulting
physician.

Generic Name: Dexamethasone

Brand Name: Oradexon, Decilone

Drug Classification: Corticosteroid hormone, Category: C

Mechanism of Action: Removes neutrophil migration, reduces the development of

inflammatory mediators, reverses increased capillary permeability. Reduces
inflammation. Removes the normal immune response.

Stock Dosage: 0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, 6 mg tablets

Indication: Inflammatory joint diseases, shock, diabetic macular oedema, macular

oedema secondary to retinal vein occlusion, uveitis, inflammatory eye disorders, anti -
inflammatory or immunosuppressive

Contraindications: Systemic fungal infection, acute infections, active or resting

tuberculosis, vaccinia, varicella, administration of live virus vaccines (to patient, family
members), latent or active amebiasis. Primary open-angle glaucoma, eye infections,
superficial ocular herpes simplex, keratitis and tuberculosis of eye. Safe use during
pregnancy (category C), lactation, or in children is not established.
Side effects/adverse reactions: Menstrual irregularities, hyperglycemia; cushingoid
state; growth suppression in children; hirsutism, euphoria, insomnia, convulsions,
increased ICP, vertigo, headache, psychic disturbances

Nursing Interventions: Monitor and report signs and symptoms of Cushing's syndrome
or other systemic adverse effects.

Monitor neonates born to a mother who has been receiving a corticosteroid during
pregnancy for symptoms of hypoadrenocorticism.

Check vital signs at least twice daily

Monitor for signs and symptoms of a hypersensitivity reaction.

Question for hypersensitivity to any corticosteroids.

Educate client and family to not change dose/schedule or stop taking drug.

Encourage client and family report fever, sore throat, mu scle aches, sudden weight
gain, edema, exposure to measles/chickenpox.

Educate client to avoid alcohol, limit caffeine.

Generic Name: Magnesium Sulfate

Brand Name: Epsom salt

Drug Classification: Electrolytes, anticonvulsants, other antihypertensives, laxatives,

purgatives, other dermatologicals

Mechanism of Action: Magnesium sulfate increases peristaltic activity by inducing

osmotic fluid accumulation, resulting in intestinal evacuation. Magnesium sulfate
reduces the levels of acetylcholine in motor nerve terminals. It also works on
myocardium by decreasing the rate of SA node pulse formation and prolonging the
conduction time.

Stock Dosage: 0.8 mEq/mL, 1 mEq/mL, 4 mEq/mL injection

Indication: Reduction of cerebral oedema, Eclampsia, Muscle stimulating effects of
barium poisoning, Constipation

Contraindications: Appendicitis, symptoms of appendicitis, ileostomy, intestinal

obstruction, severe renal impairment

Side effects/adverse reactions: Chalky taste, diarrhea, laxative effect, nausea,

vomiting, stomach cramps, prolonged use or large doses in renal impairment may
cause hypermagnesemia

Nursing Interventions: Assess sensitivity to magnesium.

Assess GI pain

Assess for weight loss, nausea, vomiting, history of recent abdominal surgery

Assess renal function, serum magnesium.

Assess for relief of gastric distress.

Monitor renal function

Monitor daily pattern of bowel activity, stool consistency. Maintain adequate fluid intake.

Educate client and family to take at least 2 hours apart from other medication.

Educate client and family not take longer than 2 weeks unless directed by physician

Generic Name: Azithromycin

Brand Name: Zithromax, Zmax

Drug Classification: Macrolide antibiotic

Mechanism of Action: Binds to ribosomal receptor sites in susceptible species,

inhibiting RNA-dependent protein synthesis. Often, bacteriostatic or bactericidal,
depending on the dose of the medication.
Stock Dosage: 250 mg, 500 mg, 600 mg tablets; 100 mg/5 mL, 200 mg/5 mL; 500 mg
injection; 1,000 mg

Indication: Infections caused by susceptible organisms in upper respiratory and lower

respiratory tract, skin & soft tissue infections, acute otitis media.

Contraindications: Hypersensitivity to macrolide antibiotics. History of hepatic

dysfunction/cholestatic jaundice following prior use of antibiotics.

Side effects/adverse reactions: Headache, dizziness, nausea, vomiting, diarrhea,

abdominal pain; hepatotoxicity, mild elevations in liver function tests.

Nursing Interventions: Interview for history of hepatitis, allergies to azithromycin,

erythromycins

Assess for infection

Check for GI discomfort, nausea, vomiting

Monitor daily pattern of bowel activity and stool consistency

Be alert for superinfection: fever, vomiting, diarrhea, anal or genital pruritus, oral
mucosal changes

Encourage client and family continue therapy for full length of treatment.

Educate client and family to avoid concurrent administration of aluminum- or

magnesium-containing antacids.

Educate client and family that direct sunlight exposure should be lessened during the
therapy of this drug.

Encourage client and family to report onset of loose stools or diarrhea.

Generic Name: Ritodine Hydrochloride

Brand Name: Yutopar

Drug Classification: Autonomic nervous system agent; beta-adrenergic agonist; drugs
acting on the uterus

Mechanism of Action: A selective β2-adrenoceptor agonist with its main action on the
uterus, which causes relaxation. Reduces the strength and duration of contractions. Th e
heart rate is also raised when the diastolic pressure is decreased. It may induce
bronchial relaxation, but this is not clinically important in its use.

Stock Dosage: 10 mg/mL, 15 mg/mL, 0.3 mg/mL injection

Indication: Uncomplicated premature labor

Contraindications: Antepartum hemorrhage, eclampsia and severe preeclampsia,

intrauterine fetal death, cardiac disease. Threatened miscarriage, placenta previa and
cord compression.

Side effects/adverse reactions: Tachycardia, palpitation, headache, nervousness,

anxiety, nausea, vomiting, rarely, anaphylaxis, arrhythmia, pulmonary oedema,
hypokalemia.

Nursing Interventions: Monitor continuously for pronounced dose-related adverse

effects to maternal and fetal heart rates and maternal BP while infusion is running.

Be alert to signs and symptoms of pulmonary edema

Encourage client and family report immediately any of the following: palpitations, chest
pain, dizziness, respiratory distress, weakness, tremors, sweating or chills.

Encourage client not breast feed while taking this drug

Educate client about the benefits and possible side effects of the medication.
Generic Name: Terbutaline

Brand Name: Bricanyl

Drug Classification: Beta2 -adrenergic agonist; Bronchodilator, premature labor

inhibitor

Mechanism of Action: Stimulates beta2-adrenergic receptors, resulting in uterine,

bronchial, smooth muscle relaxation. Inhibits the contractions of the uterine. Relieves
bronchospasm, decreases resistance to airways.

Stock Dosage: 2.5 mg, 5 mg tablets; 0.2 mg aerosol; 1 mg/mL injection

Indication: Bronchospasm, Preterm Labor,

Contraindications: Hypersensitivity to terbutaline. Cardiac arrhythmias associated with

tachycardia; tachycardia caused by digoxin toxicity. Prolonged prevention or
management of preterm labor

Side effects/adverse reactions: Too frequent or prolonged use can lead to decreased
drug efficacy and/or extreme, paradoxical bronchoconstriction. Excessive
sympathomimetic stimulation can cause palpitations, extrasystoles, tachycardia, chest
pain, slight increase in blood pressure followed by significant decrease, ch ills,
diaphoresis, whitening of the skin.

Nursing Interventions: Assess baseline maternal pulse, blood pressure, frequency

and duration of contractions, fetal heart rate.

Question history of cardiac arrhythmias, narrow-angle glaucoma, hypertension,

seizures.

Monitor for frequency, duration, strength of contractions.

Monitor input and output ratio

Diligently monitor maternal and fetal heart rate.

Encourage client avoid excessive use of caffeine derivatives

Educate client that medication may cause nervousness, anxiety, shakiness.

Encourage client and family to report intermittent palpitations, chest pain, muscle
tremor, dizziness, headache, flushing, trouble breathing.

Encourage client and family not to you over-the-counter drugs without consulting the
doctor.

Generic Name: Anisotropic xerogel of Aquacryl

Brand Name: Dilapan- S

Drug Classification: Hygroscopic cervical dilator

Mechanism of Action: DILAPAN-S is a hydrophilic dilator that raises its volume by

absorbing fluids and gradually dilates the cervix. It also induces the release of
endogenous prostaglandins, contributing to the degradation of collagen fibers.

Stock Dosage: Available in boxes of 10 or 25 dilators and in the following dimensions

Indication: DILAPAN-S is intended for use wherever cervical softening and dilatation is
required, such as cervical maturation prior to labor induction, cervical preparation prior
to pregnancy termination, or other uterine cavity instrumentation, etc.

Contraindications: Presence of clinically apparent genital tract infection

Side effects/adverse reactions: Spontaneous onset of labor, spontaneous rupture of

membranes, cervical laceration, device retraction into the uterus, device expulsion

Nursing Interventions: Encourage client to report any excessive bleeding, pain, or

increase in temperature

Educate client that it is necessary to return for removal of the DILAPAN-S

Educate client that he or she should not attempt to remove DILAPAN-S herself

Educate client to avoid bathing, douching and to refrain from sexual intercourse while
DILAPAN-S is in place.

Monitor client for evidence of any unusual pallor, nausea, vertigo or weakness
REFERENCE/S:

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http://robholland.com/Nursing/Drug_Guide/data/monographframes/A061.html

(amyl nitrite) dosing, indications, interactions, adverse effects, and more. (2019,
September 28). Retrieved March 1, 2021, from
https://reference.medscape.com/drug/amyl-nitrite-342274#4

AZITHROMYCIN. (n.d.). Retrieved March 2, 2021, from

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/A092.ht
ml

Azithromycin: Indication, Dosage, Side Effect, Precaution | MIMS Philippines. (n.d.).

Retrieved March 2, 2021, from
https://www.mims.com/philippines/drug/info/azithromycin?mtype=generic

Bs, R. K. J., & Hodgson, K. (2018). Saunders Nursing Drug Handbook 2019 (1st ed.).
Amsterdam, Netherlands: Elsevier.

Cytotec (Misoprostol): Uses, Dosage, Side Effects, Interactions, Warning. (2020, August
5). Retrieved March 1, 2021, from https://www.rxlist.com/cytotec-
drug.htm#medguide

DEXAMETHASONE. (n.d.). Retrieved March 1, 2021, from

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ml

Dexamethasone: Indication, Dosage, Side Effect, Precaution | MIMS Philippines. (n.d.).

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https://www.mims.com/philippines/drug/info/dexamethasone?mtype=generic
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https://www.mims.com/philippines/drug/info/oxitone

Oxytocin. (n.d.). Retrieved October 28, 2020, from

https://www.mims.com/philippines/drug/info/oxytocin?mtype=generic

OXYTOCIN INJECTION. (n.d.). Retrieved October 28, 2020, from

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/O031.ht
ml

MAGNESIUM SULFATE. (n.d.). Retrieved March 1, 2021, from

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/M007.ht
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Magnesium sulfate: Indication, Dosage, Side Effect, Precaution | MIMS Philippines.

(n.d.). Retrieved March 1, 2021, from
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ic

MISOPROSTOL. (n.d.). Retrieved March 1, 2021, from

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Misoprostol: Indication, Dosage, Side Effect, Precaution | MIMS Philippines. (n.d.).

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RITODRINE HYDROCHLORIDE. (n.d.). Retrieved March 2, 2021, from

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/R024.ht
ml
Ritodrine: Indication, Dosage, Side Effect, Precaution | MIMS Philippines. (n.d.).
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https://www.mims.com/philippines/drug/info/ritodrine?mtype=generic

Utrogestan Full Prescribing Information, Dosage & Side Effects | MIMS Philippines.
(n.d.). Retrieved March 1, 2021, from
https://www.mims.com/philippines/drug/info/utrogestan?type=full

W. (2021, February 16). Dilapan-S®: A unique mechanical cervical dilator for induction
of labour. Retrieved March 2, 2021, from https://www.dilapan.com

Zithromax Dosage & Drug Information | MIMS Philippines. (n.d.). Retrieved March 2,
2021, from https://www.mims.com/philippines/drug/info/zithromax

Tirona, Joshua Roderick B.

BSN II-A