Drugs used in pregnancy,

labour, post partum and

newborn.
Presented by
Madhu.B
Lecturer
Department of OBG
Sarvodaya college of nursing
Bangalore
 NIFEDIPINE
Preparations
Capsule-10mg,20mg
Tablet-20mg,30mg,60mg,90mg

Action
Thought to inhibit calcium ion reflex across
cardiac and smooth muscle cells, decreasing
contractility and oxygen demand and also dilates
arteries and arterioles.
 Indications
1. Hypertension
2. Classic chronic stable angina pectoris.

Contraindications
3. Heart failure
4. Hypotension
5. Severe GI narrowing

Adverse effects
6. Dizziness
7. Syncope
8. Heart failure
9. Muscle cramps
10.Peripheral edema
 Dosage and route of administrations
 5-20mg OD orally.

Nursing considerations
1. Monitor BP & HR regularly
2.Advise patient to avoid taking this drug with
grapefruit juice.
3. Watch for symptoms for heart failure.
4.Advise patient if chest pain worsen
immediately report to doctor.
 METHYLDOPA
Preparations
 Tablet-250mg,500mg

 Inj-50mg/ml

Action
Inhibit the central vasomotor centre, decreasing
sympathetic outflow to the heart, kidney and
peripheral vasculature.
 Indications
1. Hypertension
2. Hypertensive crisis

Contraindications
3. Hepatic disease or liver cirrhosis
4. Lactating mother

Adverse effects
5. Decrease mental acuity
6. Sedation
7. Headache or depression
8. Bradycardia
9. Hepatic necrosis
10.Hepatitis
 Dosage and routes of administration
 250mg BD or TDS max 2g daily titrated by BP

Nursing considerations
1. Monitor BP regularly.
2. Monitor patient coomb’s test result.
3. Report for involuntary movements.
4.Tell patient to check weight daily and notify if he gains
2 or more pounds in a week
 Hydralazine Hydrochloride
Preparation
 Inj-20mg/ml in 1ml vial

Tablet-10mg,25g,50mg,100mg

Action
Direct acting peripheral vasodilator that relexes arteriolar
smooth muscle.

Indications
1. Hypertension
2. Severe essential hypertension
contraindications
1. Coronary artery disease
2. Rheumatic heart disease
3. Stroke
4. Severe renal impairment

Adverse effects
5. Neutropenia
6.Leukopenia
3.Thrombocytopenia
4. Orthostatic
hypotension
 Dosage and route of administration
 25mg tablet BD and if necessary may increase to 50mg
BD
 5mg diluted in 10ml of NS slow IV at 15-20minutes
interval.

Nursing considerations
1. Monitor patient BP, pulse rate, body weight
frequently.
2.Monitor patient for muscle and joint pain, fever or
throat pain.
3.Advised patient to take drug after food to increase
absorption
 DIURETICS
Diuretics are used in the following conditions
during pregnancy:

1. PIH with massive edema

2. Eclampsia with pulmonary edem a
3. Severe anemia in pregnancy with heart
failure
4. Prior to blood transfusion in severe
anemia
5.As an adjunct to certain antihypertensive
 FUROSEMIDE (LASIX)
Preparation
 Inj-10mg/ml

Tablets-20mg,40mg,80mg,500mg

Action
Inhibits sodium and chloride reabsorption at proximal
and distal tubules and loop of Henle.

Indications
1. Acute pulmonary edema
2. Edema
 Contraindications
1. Anuria
2. Hepatic cirrhosis
3. Allergic to sulfonamides

Adverse effects
4. Maternal: Weakness, fatigue, muscle cramps, hypokalemia
5.Fetal: May occur due to decreased leading to fetal compromise,
hyponatremia.

Dosage and routes of administration

 4 0 mg tablet, daily following breakfast.
 In acute conditions, the drug is administered parenterally in
doses of 40-120 mg daily.
 Nursing
considerations
1.Monitor weight, BP and pulse rate routinely
for long term use.
2. Monitor patient I/O chart.
3.Watch the signs for hypokalemia such as
muscle weakness and cramps.
4. Monitor uric acid if patient is having
gout.
5.Advise the patient to take drug in the morning
after food.
6.Advised patient to avoid direct sunlight to
prevent photosensitivity reactions.
 TOCOLYTIC AGENTS
These drugs can inhibit uterine contractions &
used to prolonged the pregnancy. In women
who develop premature uterine contractions, in
addition to putting them to absolute bed rest &
sedating, Tocolytic drugs are administered in
an attempt to inhibit uterine contraction.
Here are the drugs used are:-
1. Isoxsuprine Hydrochloride
2. Ritrodrine hydrochloride
 Isoxsuprine hydrochloride
(Duvadilan)
Preparation
 Tablet -10mg

 Inj-10mg/ml

Action
Acts directly on vascular smooth muscle, causes cardiac
stimulation & uterine relaxation And thus causing relaxing the veins
and arteries and making them wider to increase the blood flow to
certain parts of the body.

Indication
1. Prevent Preterm labour
2. Inhibit uterine contractions.
 Contraindications
1. Hypersensitivity
2. Postpartum

Adverse effects
3. Hypotension
4. Tachycardia
5. Nausea or vomiting
6. Pulmonary edema
7. Cardiac arrhythmias
8. Hyperglycemia or hypokalemia
 Dosage & routes of administration
 Initial: IV drip 100 mg in 5% dextrose @Rate0.2ug/minute.

 To continue at least 2 hours after the contractions cease

 Maintenance: IM 10mg 6 hourly for 24 hrs or tab 10mg 6-
8hrly.

Nursing considerations
1. Assess patient BP, pulse during treatment
2.Take BP lying & standing as orthostatic hypotension is
common
3.Monitor for Intensity & length of uterine contractions and
FHS.
4.Advise patient to make position changes slowly as
fainting may occur.
 Ritodrine hydrochloride (yutopar)
Preparation
 Inj-5ml amp-10mg/ml=50mg per amp.

 Tablet-10mg

Action
Acts directly on vascular smooth muscle, causes cardiac stimulation &
uterine relaxant.

Indications
Prevent preterm labour

Contraindications
1. Hypersensitivity
2. Eclampsia
3. Hypertension
4. Dysrhythmias
 Adverse effects
1. Hyperglycemia
2. Headache
3. Restlessness or sweating
4. Chills and drowsiness
5. Nausea or vomiting
6. Altered maternal & fetal heart tone & palpitations.

Dosage and routes of administration

 Initial: IV drip 100 mg in 5% dextrose @ 0.1 mg/minute gradually
increased by 0.05mg/min ,To continue for at least 2 hrs after
contractions cease.
 Maintenance -Tab 10mg 6-8 hourly PO 10 mg given half hour
before termination of iv, then 10 mg q2 hr x 24 hrs, then 10-20 mg
q4th, not to exceed 120 mg/day
 Nursing
considerations
1.Assess Maternal & fetal heart tones during infusion
and also Intensity & length of uterine contractions
2.Monitor Fluid intake to prevent fluid overload,
discontinue if this occurs.
3.Administer only clear solutions after dilution 150 mg
in 500 ml D5W or NS, give at 0.3 mg/ml By Using
infusion pumps/monitor carefully
4.Positioning of patient in left lateral recumbent
position to decrease hypotension & increase renal
blood flow.
5. Advise patient to remain in bed during infusion.