PP meds

Morphine Sulfate (Duramorph)

• Action: Binds to opioid receptors; alters perception and response to pain.

• Indication: Moderate to severe postpartum pain.

• Side Effects: Respiratory depression, sedation, nausea, constipation.

• Patient Teaching: Avoid driving; monitor for drowsiness and slow breathing; use stool softeners.

• IM Site: Deltoid, ventrogluteal, or vastus lateralis.

• Pregnancy Category: C

• Lactation: Passes into breast milk—use with caution.

Percocet (Oxycodone + Acetaminophen)

• Action: Opioid agonist + non-opioid analgesic.

• Indication: Moderate postpartum pain.

• Side Effects: Drowsiness, nausea, constipation, respiratory depression.

• Patient Teaching: Avoid alcohol; monitor total acetaminophen intake (<4g/day).

• IM Site: Oral only.

• Pregnancy Category: C

• Lactation: May cause infant sedation—use caution.

Oxycodone

• Action: Binds to opioid receptors for pain relief.

• Indication: Moderate–severe pain.

• Side Effects: Sedation, nausea, constipation, respiratory depression.

• Patient Teaching: Avoid driving; take with food; increase fluids/fiber.

• IM Site: Oral preferred (IM rare).

• Pregnancy Category: B/C (varies by formulation)

• Lactation: Excreted in milk—use lowest effective dose.

Ibuprofen (Motrin)

• Action: Inhibits prostaglandin synthesis; decreases pain and inflammation.

• Indication: Uterine cramping, mild to moderate pain.

• Side Effects: GI upset, bleeding, kidney effects.

• Patient Teaching: Take with food; avoid other NSAIDs.

• IM Site: Oral or IV (not IM).

• Pregnancy Category: B (D in 3rd trimester)

• Lactation: Safe.

Acetaminophen (Tylenol)

• Action: Inhibits CNS prostaglandin synthesis.

• Indication: Mild pain, fever.

• Side Effects: Hepatotoxicity with high doses.

• Patient Teaching: Limit total daily dose to ≤4g; check combo meds.

• IM Site: Oral.

• Pregnancy Category: B

• Lactation: Safe.

Docusate (Colace, Surfak)

• Action: Draws water into stool to soften it.

• Indication: Prevent constipation, especially from opioids.

• Side Effects: Mild cramping, diarrhea.

• Patient Teaching: Increase water and fiber intake.

• IM Site: Oral only.

• Pregnancy Category: C

• Lactation: Safe.

“Triples” Antibiotics (Ampicillin, Gentamicin, Clindamycin)

• Action: Broad-spectrum antibacterial agents.

• Indication: Postpartum infections (e.g., endometritis).

• Side Effects: GI upset, rash, nephrotoxicity (gentamicin).

• Patient Teaching: Complete full course; report rash or diarrhea.

• IM Site: Ventrogluteal (ampicillin, clindamycin).

• Pregnancy Category: Ampicillin – B; Gentamicin – D; Clindamycin – B

• Lactation: Generally safe; monitor infant for GI upset.

Dermaplast Spray (Benzocaine)

• Action: Local anesthetic that numbs tissue.

• Indication: Perineal or episiotomy discomfort.

• Side Effects: Local irritation, allergic reaction (rare).

• Patient Teaching: External use only; apply after voiding.

• IM Site: Topical.

• Pregnancy Category: C

• Lactation: Safe topical use.

Lanolin Ointment

• Action: Moisturizes and soothes cracked nipples.

• Indication: Nipple soreness from breastfeeding.

• Side Effects: Mild local irritation.

• Patient Teaching: Apply after nursing; safe for infant ingestion.

• IM Site: Topical.

• Pregnancy Category: A

• Lactation: Safe.

Rubella Vaccine (MMR)

• Action: Live attenuated vaccine induces antibody formation.

• Indication: For non-immune postpartum women.

• Side Effects: Mild fever, rash, lymphadenopathy.

• Patient Teaching: Avoid pregnancy for 1 month; safe while breastfeeding.

• IM Site: Deltoid.

• Pregnancy Category: X (live vaccine)

• Lactation: Safe postpartum.

Medroxyprogesterone Acetate (Depo-Provera)

• Action: Suppresses ovulation via pituitary inhibition.

• Indication: Postpartum contraception.

• Side Effects: Weight gain, irregular bleeding, delayed fertility.

• Patient Teaching: Repeat every 3 months; use backup method for 7 days after first dose.

• IM Site: Deltoid or gluteal.

• Pregnancy Category: X

• Lactation: Safe after 6 weeks postpartum.

Hepatitis B Vaccine (newborn)

• Action: Stimulates antibodies to Hepatitis B virus.

• Indication: Prevent Hepatitis B infection.

• Side Effects: Soreness, mild fever.

• Patient Teaching: Given in 3-dose series (birth, 1–2 mo, 6 mo).

• IM Site: Vastus lateralis (newborn).

• Pregnancy Category: C

• Lactation: Safe (non-live).

EMLA Cream (Lidocaine + Prilocaine)

• Action: Local anesthetic blocks nerve impulses.

• Indication: Numbs skin before procedures (e.g., heel stick, vaccination).

• Side Effects: Redness, blanching.

• Patient Teaching: Apply 30–60 minutes before procedure.

• IM Site: Topical.

• Pregnancy Category: B

• Lactation: Safe.

Ferrous Sulfate

• Action: Replaces iron stores for hemoglobin production.

• Indication: Iron-deficiency anemia postpartum.

• Side Effects: Constipation, dark stools, GI upset.

• Patient Teaching: Take with vitamin C; avoid milk; increase fluids/fiber.

• IM Site: Z-track (ventrogluteal) if IM.

• Pregnancy Category: A

• Lactation: Safe.

Kefzol (Cefazolin)

• Action: Cephalosporin antibiotic; inhibits bacterial cell wall synthesis.

• Indication: C-section prophylaxis, postpartum infection.

• Side Effects: Rash, diarrhea, allergic reaction.

• Patient Teaching: Report allergy; complete dose.

• IM Site: Ventrogluteal.

• Pregnancy Category: B

• Lactation: Safe.

TDaP (Tetanus, Diphtheria, Pertussis) Vaccine

• Action: Stimulates antibody formation.

• Indication: Maternal booster, infant protection.

• Side Effects: Soreness, mild fever.

• Patient Teaching: Expect local soreness; keep vaccine record.

• IM Site: Deltoid.

• Pregnancy Category: C

• Lactation: Safe.

Prenatal Vitamin

• Action: Provides essential vitamins and minerals.

• Indication: Nutritional support postpartum and during lactation.

• Side Effects: Nausea, constipation.

• Patient Teaching: Take with food; don’t double dose.

• IM Site: Oral only.

• Pregnancy Category: A

• Lactation: Safe.

RhoGAM / Rhophylac

• Action: Prevents Rh sensitization in Rh-negative mothers.

• Indication: Rh-negative mother with Rh-positive infant.

• Side Effects: Soreness, mild fever.

• Patient Teaching: Given within 72 hr postpartum; confirm blood types.

• IM Site: Deltoid or gluteal.

• Pregnancy Category: C

• Lactation: Safe.

Tucks (Witch Hazel Pads)

• Action: Astringent; reduces perineal swelling and discomfort.

• Indication: Perineal discomfort, hemorrhoids.

• Side Effects: Local irritation.

• Patient Teaching: External use only; apply after voiding or sitz bath.

• IM Site: Topical.

• Pregnancy Category: C

• Lactation: Safe.

Flu Vaccine (Fluzone)

• Action: Promotes antibody formation to influenza virus.

• Indication: Flu prevention postpartum.

• Side Effects: Local soreness, mild fever.

• Patient Teaching: Annual vaccination; safe while breastfeeding.

• IM Site: Deltoid.

• Pregnancy Category: B

• Lactation: Safe.

Toradol (Ketorolac)

• Action: NSAID; inhibits prostaglandins for pain relief.

• Indication: Moderate postpartum pain (short-term).

• Side Effects: GI upset, bleeding, renal impairment.

• Patient Teaching: Use ≤5 days; avoid with other NSAIDs.

• IM Site: Vastus lateralis or gluteal (deep IM).

• Pregnancy Category: C (D in 3rd trimester)

• Lactation: Generally safe short-term.

Pneumovax Vaccine

• Action: Stimulates antibodies to Streptococcus pneumoniae.

• Indication: Prevent pneumococcal infection (high-risk patients).

• Side Effects: Soreness, mild fever.

• Patient Teaching: Safe while breastfeeding; booster as directed.

• IM Site: Deltoid.

• Pregnancy Category: C

• Lactation: Safe.