OB MEDS

1. Prenatal Vitamins

Classification: Vitamin/mineral supplement. Dose: 1 tablet. Route: PO. Frequency: Daily. OB use: Supports maternal nutrition and fetal growth; commonly provides folic acid and iron.

2. Docusate Sodium (Colace)

Classification: Stool softener. Dose: 100 mg. Route: PO. Frequency: 1–2 times daily. OB use: Prevents/treats constipation, especially postpartum or with opioid use.

3. Penicillin G

Classification: Penicillin antibiotic. Dose: 5 million units IV loading dose, then 2.5–3 million units. Route: IV. Frequency: Every 4 hours after loading dose. OB use: GBS prophylaxis during labor.

4. Cefazolin (Ancef)

Classification: First-generation cephalosporin antibiotic. Dose: 2 g initially, then 1 g. Route: IV. Frequency: Every 8 hours after initial dose. OB use: Antibiotic prophylaxis, including for patients with certain penicillin allergies.

5. Ondansetron (Zofran)

Classification: Antiemetic; 5-HT3 receptor antagonist. Dose: 4–8 mg. Route: IV or PO. Frequency: Every 8 hours as needed. OB use: Treats nausea and vomiting.

6. Betamethasone

Classification: Corticosteroid. Dose: 12 mg. Route: IM. Frequency: Every 24 hours × 2 doses. OB use: Accelerates fetal lung maturity when preterm birth is anticipated.

7. Indomethacin

Classification: NSAID; prostaglandin synthesis inhibitor. Dose: 50 mg loading dose, then 25–50 mg. Route: PO. Frequency: Every 6 hours. OB use: Tocolytic used to decrease uterine contractions in preterm labor.

8. Terbutaline

Classification: Beta-2 adrenergic agonist; tocolytic. Dose: 0.25 mg. Route: SQ. Frequency: May repeat once in 15–30 minutes if ordered. OB use: Temporarily decreases uterine contractions.

9. Procardia (Nifedipine) – Preterm Labor

Classification: Calcium channel blocker; tocolytic. Dose: 10–20 mg. Route: PO. Frequency: Per ordered/protocol dosing. OB use: Decreases uterine contractions in preterm labor.

10. Magnesium Sulfate – Preterm Labor

Classification: Electrolyte/mineral; CNS depressant. Dose: 4–6 g loading dose, then 1–2 g/hr. Route: IV. Frequency: Continuous infusion after loading dose. OB use: May be used for fetal neuroprotection when very preterm birth is anticipated; also requires careful maternal monitoring.

11. Magnesium Sulfate – Fetal Neuroprotection

Classification: Electrolyte/mineral. Dose: 4 g loading dose, then commonly 1 g/hr. Route: IV. Frequency: Continuous infusion. OB use: Fetal neuroprotection when very preterm delivery is anticipated.

12. Procardia (Nifedipine) – Hypertension

Classification: Calcium channel blocker/antihypertensive. Dose: 10–20 mg. Route: PO. Frequency: Per ordered/protocol dosing. OB use: Lowers maternal blood pressure.

13. Labetalol

Classification: Alpha-1 and beta-adrenergic blocker; antihypertensive. Dose: 20 mg initially. Route: IV. Frequency: Additional doses per protocol/order. OB use: Rapid treatment of severe hypertension in pregnancy.

14. Hydralazine

Classification: Direct vasodilator; antihypertensive. Dose: 5–10 mg. Route: IV. Frequency: Per protocol/order. OB use: Treats acute severe maternal hypertension.

15. Magnesium Sulfate – Hypertension/Preeclampsia

Classification: Anticonvulsant/electrolyte. Dose: 4–6 g loading dose, then 1–2 g/hr. Route: IV. Frequency: Continuous infusion. OB use: Prevents and treats seizures associated with severe preeclampsia/eclampsia.

16. Diazepam (Valium)

Classification: Benzodiazepine; anticonvulsant. Dose: 5–10 mg. Route: IV. Frequency: Per order/protocol. OB use: May be used for seizure control when indicated.

17. Misoprostol (Cytotec) – Induction

Classification: Prostaglandin E1 analog. Dose: 25 mcg. Route: Vaginal. Frequency: Every 3–6 hours per protocol. OB use: Cervical ripening and induction of labor.

18. Dinoprostone (Cervidil)

Classification: Prostaglandin E2. Dose: 10 mg vaginal insert. Route: Vaginal. Frequency: Inserted for cervical ripening; duration per product/protocol. OB use: Cervical ripening before labor induction.

19. Oxytocin (Pitocin) – Induction/Augmentation

Classification: Oxytocic hormone. Dose: Commonly started at 0.5–2 mU/min and titrated. Route: IV infusion. Frequency: Continuous/titrated. OB use: Induces or augments labor by increasing uterine contractions.

20. Fentanyl

Classification: Opioid analgesic. Dose: 25–100 mcg. Route: IV/IM. Frequency: Per order/protocol. OB use: Provides systemic pain relief during labor.

21. Nitrous Oxide

Classification: Inhaled analgesic/anesthetic gas. Dose: 50% nitrous oxide/50% oxygen. Route: Inhalation. Frequency: As needed during contractions. OB use: Reduces labor pain and anxiety.

22. Ketorolac (Toradol)

Classification: NSAID. Dose: 15–30 mg. Route: IV/IM. Frequency: Every 6 hours as needed. OB use: Treats moderate postpartum pain without opioid effects.

23. Ibuprofen

Classification: NSAID. Dose: 600–800 mg. Route: PO. Frequency: Every 6–8 hours as needed. OB use: Treats postpartum uterine cramping and pain.

24. Acetaminophen ES

Classification: Non-opioid analgesic/antipyretic. Dose: 650–1,000 mg. Route: PO. Frequency: Every 4–6 hours as needed. OB use: Treats mild pain and fever.

25. Hydrocodone/Acetaminophen (Norco)

Classification: Opioid + non-opioid analgesic. Dose: 5/325–10/325 mg. Route: PO. Frequency: Every 4–6 hours as needed. OB use: Treats moderate-to-severe postpartum pain.

26. Oxycodone

Classification: Opioid analgesic. Dose: 5–10 mg. Route: PO. Frequency: Every 4–6 hours as needed. OB use: Treats moderate-to-severe postpartum pain.

27. Ketamine

Classification: Dissociative anesthetic/analgesic. Dose: 0.2–0.5 mg/kg. Route: IV. Frequency: Per anesthesia/protocol. OB use: Provides analgesia/anesthesia when specifically indicated.

28. Delsym (Dextromethorphan)

Classification: Antitussive. Dose: 30 mg. Route: PO. Frequency: Every 12 hours. OB use: May be used as directed when cough treatment is needed; know its interaction with serotonergic medications and CNS depressants.

29. Oxytocin (Pitocin) – Postpartum

Classification: Oxytocic hormone. Dose: Commonly 10 units IM or IV infusion. Route: IM or IV. Frequency: Per postpartum protocol/order. OB use: Promotes uterine contraction and prevents/treats postpartum hemorrhage due to uterine atony.

30. Misoprostol – Postpartum Hemorrhage

Classification: Prostaglandin E1 analog; uterotonic. Dose: 800–1,000 mcg. Route: Rectal. Frequency: Usually one dose; repeat only if ordered. OB use: Promotes uterine contraction to control postpartum bleeding.

31. Methylergonovine (Methergine)

Classification: Ergot alkaloid; uterotonic. Dose: 0.2 mg. Route: IM. Frequency: Every 2–4 hours as needed. OB use: Causes strong uterine contraction to control postpartum hemorrhage. IMPORTANT: Avoid with hypertension/preeclampsia.

32. Carboprost Tromethamine (Hemabate)

Classification: Prostaglandin F2-alpha analog; uterotonic. Dose: 250 mcg. Route: IM or intramyometrial. Frequency: Every 15–90 minutes as needed. OB use: Treats postpartum hemorrhage from uterine atony. IMPORTANT: Avoid/caution with asthma.

33. Tranexamic Acid (TXA)

Classification: Antifibrinolytic. Dose: 1 g. Route: IV. Frequency: Usually given once over 10 minutes; additional dose may be ordered. OB use: Helps control postpartum hemorrhage by preventing breakdown of blood clots.

34. Erythromycin Ophthalmic Ointment

Classification: Macrolide antibiotic. Dose: 1 cm ribbon. Route: Ophthalmic. Frequency: Once after birth. OB use: Prevents neonatal ophthalmia caused by certain bacteria.

35. Hepatitis B Vaccine

Classification: Vaccine. Dose: 0.5 mL. Route: IM. Frequency: Birth dose followed by vaccine series. OB use: Provides newborn protection against hepatitis B infection.

36. Phytonadione (Vitamin K) – Newborn

Classification: Vitamin K preparation. Dose: 0.5–1 mg. Route: IM. Frequency: Once after birth. OB use: Prevents vitamin K deficiency bleeding in the newborn.

37. RhoGAM (Rh Immune Globulin)

Classification: Immune globulin. Dose: 300 mcg. Route: IM. Frequency: Commonly given around 28 weeks and within 72 hours after delivery when indicated. OB use: Prevents Rh sensitization in an Rh-negative mother.

38. Tdap

Classification: Vaccine; tetanus, diphtheria, pertussis. Dose: 0.5 mL. Route: IM. Frequency: Once during each pregnancy, ideally 27–36 weeks, if indicated. OB use: Helps protect mother and newborn from pertussis.

39. Varicella Vaccine

Classification: Live attenuated vaccine. Dose: 0.5 mL. Route: SQ. Frequency: 2-dose series when indicated. OB use: Provides immunity to varicella. IMPORTANT: Live vaccine is contraindicated during pregnancy.

40. Rubella Vaccine (MMR)

Classification: Live attenuated vaccine. Dose: 0.5 mL. Route: SQ. Frequency: Usually given postpartum if nonimmune. OB use: Provides rubella immunity for future pregnancies. IMPORTANT: Live vaccine is contraindicated during pregnancy.