Use Drug Dose – EPA-MW Reasoning
Preterm Nifedipine PO, 20mg 2x doses (30mins apart) Tocolytic to enable time for
labour administered. steroid loading
Max 160mg/day
Third dose requires MO
Betamethasone 1M 11.4mg, Single dose Steroid loading
2nd dose MO – 24hrs later or 12hrs if birth Monitor BSL
imminent.
MgSo4 IV Neuroprotection for fetus
*Not EPA-MW (calming effect)
Benzylpenicillin 3g loading dose Prophylactic for GBS
1.8g 4hrly (MO) Infection is major cause for
PTL
Lincomycin 600mg IV 8hrly Same^ when penicillin allergy
Induction of Cervadil Prostaglandin (slow release) 10mg Ripens cervix
Labour (IOL) *Not EPA-MW
Dinoprostone gel 1-2mg, check 6 hours later Ripen cervix
*Not EPA-MW
Oxytocin infusion 30IU in 500mls 0.9% Saline IV infusion Augments labour
EPA-MW states: 10units/dose with
Max 20-30 for IV infusion
Tocolytic Terbutaline 250micog S/C or in 5mL/5min IV push Uterine hypertonic w/
(with fetal *Not EPA-MW tachysystole.
compromise) Salbutamol 100micog IV, slow push Uterine hypertonic w/
tachysystole.
*Not EPA-MW
GTN Spray 400micog Uterine hypertonic w/
tachysystole.
*Not EPA-MW
Infiltration of 1% Lignocaine 200micog (20mL) Local anaesthetic for suturing
perineum
PPH Ergometrine IM/IV 250micog / dose. Contraction of uterine smooth
Max 500micog, over 1-2mins muscle to reduce bleeding
Syntometrine 500micog Ergometrine + 5IU Oxytocin. 3rd stage active management
(Oxytocin/Ergometrine) IM, single dose ONLY
Misoprostol PR 800-1000 micog Increases uterine tone
Max 1000micog
Oxytocin 5IU IV / 12 mins or 10IU IM Contraction of uterine smooth
muscle to reduce bleeding
Carboprost 250micog IM or 500micog intramyometrial Uterine atony unresponsive to
*Not EPA-MW other drugs
Hypertensive Nifedipine PO 19-20mg, repeat 45mins. Lower BP (wouldn’t use in
crisis emergency – time to take
Only use in rural/isolated settings for effect)
emergency as it is in EPA-MW
Labetalol 20mg IV bolus, repeat 40-80mg IV every Lower BP
10mins
Hydralazine 5-10mg IV, repeat same every 20mins. Lower BP
Preterm Nifedipine PO, 20mg 2x doses (30mins apart) Tocolytic to enable time for
labour administered. steroid loading
Max 160mg/day
Third dose requires MO
Betamethasone 1M 11.4mg, Single dose Steroid loading
2nd dose MO – 24hrs later or 12hrs if birth Monitor BSL
imminent.
MgSo4 IV Neuroprotection for fetus
*Not EPA-MW (calming effect)
Benzylpenicillin 3g loading dose Prophylactic for GBS
1.8g 4hrly (MO) Infection is major cause for
PTL
Lincomycin 600mg IV 8hrly Same^ when penicillin allergy
Induction of Cervadil Prostaglandin (slow release) 10mg Ripens cervix
Labour (IOL) *Not EPA-MW
Dinoprostone gel 1-2mg, check 6 hours later Ripen cervix
*Not EPA-MW
Oxytocin infusion 30IU in 500mls 0.9% Saline IV infusion Augments labour
EPA-MW states: 10units/dose with
Max 20-30 for IV infusion
Tocolytic Terbutaline 250micog S/C or in 5mL/5min IV push Uterine hypertonic w/
(with fetal *Not EPA-MW tachysystole.
compromise) Salbutamol 100micog IV, slow push Uterine hypertonic w/
tachysystole.
*Not EPA-MW
GTN Spray 400micog Uterine hypertonic w/
tachysystole.
*Not EPA-MW
Infiltration of 1% Lignocaine 200micog (20mL) Local anaesthetic for suturing
perineum
PPH Ergometrine IM/IV 250micog / dose. Contraction of uterine smooth
Max 500micog, over 1-2mins muscle to reduce bleeding
Syntometrine 500micog Ergometrine + 5IU Oxytocin. 3rd stage active management
(Oxytocin/Ergometrine) IM, single dose ONLY
Misoprostol PR 800-1000 micog Increases uterine tone
Max 1000micog
Oxytocin 5IU IV / 12 mins or 10IU IM Contraction of uterine smooth
muscle to reduce bleeding
Carboprost 250micog IM or 500micog intramyometrial Uterine atony unresponsive to
*Not EPA-MW other drugs
Hypertensive Nifedipine PO 19-20mg, repeat 45mins. Lower BP (wouldn’t use in
crisis emergency – time to take
Only use in rural/isolated settings for effect)
emergency as it is in EPA-MW
Labetalol 20mg IV bolus, repeat 40-80mg IV every Lower BP
10mins
Hydralazine 5-10mg IV, repeat same every 20mins. Lower BP
