OB, Peds + Critical Care Medications

oxytocin

hormone, induction of labor, PPH

oxytocin considerations

monitor contractions, monitor fetus, monitor BP HR glucose and K

prostaglandins→ E1 and E2

ripen the cervix

misoprostol

prostaglandin E1, induction of labor, elective pregnancy termination

dinoprostone

prostaglandin E2

induction of labor, elective termination of pregnancy

nitrous oxide

tasteless odorless gas, inhale approx 30 seconds before onset of contraction, reduce anxiety

regional anesthesia→ epidural

can drop blood pressure quickly, closely monitor, sometimes a catheter is placed

regional anesthesia→ spinal block

for planned C-section, removes pain from lower body for 1-2 hr, lowers BP, monitor FHR

<12 months old→ med admin

IM vastus lateralis

SC fatty tissue over anterolateral thigh

12 months -2 years→ med admin

IM vastus lateralis

SC fatty tissue over upper outer area of triceps

>3 years old→ med admin

IM deltoid

SC fatty tissue over upper outer area of triceps

ASA (Reye syndrome), ibuprofen before 6 months (immature liver), Tetracycline (tooth discoloration), Oseltamivir (may cause hallucinations)

avoid all these meds in peds!!!

indomethacin or ibuprofen, surgically close

PDA treatment

prostaglands in peds

meds administered to keep PDA open in certain heart defects

ASD

close spontaneously

surgical closure

CHF management→ diuretics, ACEs, beta blockers

nutrition

surgical closure

VSD

CHF management→ digoxin, diuretics, ACEs, beta blockers

nutrition

surgery at 3-6 months

atrioventricular canal defect

comfort and calm, knee to chest, O2 and morphine

tetralogy of fallot→ tet spells

prostaglandins, surgical repair

tricuspid atresia

prostaglandins, surgery

CoA

prostaglandins, balloon atrial septostomy, surgical repair, bacterial endocarditis prophylaxis for life

TGA

prostaglandins, correct acidemia, inotropes, surgery

HLHS

inotropes

increase force of myocardial contractility

vasopressors

cause vasoconstriction to increase BP

epinephrine

shock, cardiac arrest, asystole

norepinephrine

shock, hypotension

dopamine

shock, hypotension, trauma