MATERNITY PHARMACOLOGY, MNB FINAL EXAM, MNB QUIZ
2, MNB EXAM 1 QUESTIONS AND ANSWERS
Ibuprofen - CORRECT ANSWER✅✅✅-motrin
-NSAID given for pain management post-partum
-best to take with food
Acetaminophen - CORRECT ANSWER✅✅✅-can be given for pain management postpartum or IV
intrapartum
-do not exceed 4000mg in 24 hrs
-toxicity can be managed with acetylcysteine
Morphine - CORRECT ANSWER✅✅✅-used to assist in sleep during labor and managing pain in labor
(not usually the drug of choice given effects of drug on fetal respirations), as well as pain during
pregnancy (as in pyelonephritis)
-can be used through an epidural or IV
-must be given in small doses to limit effects on fetus
-can lead to N/V, dizziness, respiratory depression, decrease in FHR variability
-decreases uterine contractions
-give naloxone as antidote if needed
Stadol - CORRECT ANSWER✅✅✅-usually given in first stage of labor IV in small doses
-starts working quickly and helps patient sleep
-can lead to respiratory depression
-give naloxone as antidote if needed
Toradol - CORRECT ANSWER✅✅✅-contraindicated because it may adversely affect fetal circulation
and inhibit uterine contractions, but postpartum following C. section
-also contraindicated in breastfeeding
,Dilaudid - CORRECT ANSWER✅✅✅-hydromorphone
-can be used in an epidural with a local anesthetic for pain relief during labor and delivery
-used in VERY small amounts to reduce risk to mother and fetus of respiratory depression
Oxycodone - CORRECT ANSWER✅✅✅-given PO to treat early labor pains or postpartum (especially
following a C/S)
-does cross into breastmilk
Fentanyl - CORRECT ANSWER✅✅✅-works quickly, but effects are not long-lasting
-minimal effects on the fetus
-frequent drug used in epidural pain relief
Epidural anesthesia - CORRECT ANSWER✅✅✅-watch for hypotension
-watch for headache!
-continuous fetal monitoring required
-generally on bedrest
-a local anesthetic is applied before the needle is inserted
-may cause labor to slow down
-typically placed when patient is in active labor
-cannot be used if a patient is on blood thinners or has low platelet counts or if patient is hypovolemic
or has spinal abnormalities
Nitrous oxide - CORRECT ANSWER✅✅✅-non-narcotic pain relief used during labor
-mixed with half oxygen
-self-administered
-can cause nausea, vomiting, dizziness
Penicillin - CORRECT ANSWER✅✅✅-can be given for GBS+ during labor and birth
-IV q 4 hrs (at least 2 doses before birth, if possible)
,-benzathine PCN is the treatment for syphilis
Clindamycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
-given for chorioamnionitis or postpartum endometritis IV
Ampicillin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
-given for chorioamnionitis IV
Erythromycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Cefazolin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Gentamicin - CORRECT ANSWER✅✅✅-given for chorioamnionitis or postpartum endometritis IV
Vancomycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Azithromycin - CORRECT ANSWER✅✅✅-antibiotic treatment for chlamydia and gonorrhea (for the
latter, give ceftriaxone as well)
Magnesium sulfate - CORRECT ANSWER✅✅✅-given to stop preterm labor (and neuroprotection) or
prevent seizures d/t PEC or to stop seizures in eclampsia
-relaxes smooth muscle
-watch out for B(blood pressure low)U(urine output low)R(low respiratory rate)P(absent patellar reflex)
as signs of Mag toxicity
-antidote: calcium gluconate
-monitor vitals hourly and continuous EFM
, -on bedrest and clear liquids
-cannot be used in patients with myasthenia gravis
-helps decrease incidence and severity of CP in preterm birth
-for neuroprotection, administer within 24 hours of birth
Terbutaline - CORRECT ANSWER✅✅✅-tocolytic (anticontraction med to delay labor) to give time to
administer steroids
-given subcutaneously
-may cause racing heart, flushing, tremors, restlessness
Tranexamic Acid - CORRECT ANSWER✅✅✅-used to promote blood clotting in PPH
-cannot be given to patients with a history of seizures
-watch for blood clots
Nifedipine - CORRECT ANSWER✅✅✅-Ca2+ channel blocker (lowers BP), tocolytic
-given to stop preterm contractions to give steroids time to work
-usually administered for 2-7 days
-monitor BP, dizziness, peripheral edema, angina, cough
-30mg load, then 10-20 mg q 4-6 hrs
Pitocin - CORRECT ANSWER✅✅✅-exogenous oxytocin
-given to induce contractions to augment labor and prevent PPH
-titrated by nurse
-watch for tachysystole (too many contractions)
-often stopped in emergent situations (i.e. intrauterine resuscitation)
-cannot be given as an IV bolus
-can be used in TOLAC
Methergine - CORRECT ANSWER✅✅✅-used in postpartum to prevent hemorrhage
2, MNB EXAM 1 QUESTIONS AND ANSWERS
Ibuprofen - CORRECT ANSWER✅✅✅-motrin
-NSAID given for pain management post-partum
-best to take with food
Acetaminophen - CORRECT ANSWER✅✅✅-can be given for pain management postpartum or IV
intrapartum
-do not exceed 4000mg in 24 hrs
-toxicity can be managed with acetylcysteine
Morphine - CORRECT ANSWER✅✅✅-used to assist in sleep during labor and managing pain in labor
(not usually the drug of choice given effects of drug on fetal respirations), as well as pain during
pregnancy (as in pyelonephritis)
-can be used through an epidural or IV
-must be given in small doses to limit effects on fetus
-can lead to N/V, dizziness, respiratory depression, decrease in FHR variability
-decreases uterine contractions
-give naloxone as antidote if needed
Stadol - CORRECT ANSWER✅✅✅-usually given in first stage of labor IV in small doses
-starts working quickly and helps patient sleep
-can lead to respiratory depression
-give naloxone as antidote if needed
Toradol - CORRECT ANSWER✅✅✅-contraindicated because it may adversely affect fetal circulation
and inhibit uterine contractions, but postpartum following C. section
-also contraindicated in breastfeeding
,Dilaudid - CORRECT ANSWER✅✅✅-hydromorphone
-can be used in an epidural with a local anesthetic for pain relief during labor and delivery
-used in VERY small amounts to reduce risk to mother and fetus of respiratory depression
Oxycodone - CORRECT ANSWER✅✅✅-given PO to treat early labor pains or postpartum (especially
following a C/S)
-does cross into breastmilk
Fentanyl - CORRECT ANSWER✅✅✅-works quickly, but effects are not long-lasting
-minimal effects on the fetus
-frequent drug used in epidural pain relief
Epidural anesthesia - CORRECT ANSWER✅✅✅-watch for hypotension
-watch for headache!
-continuous fetal monitoring required
-generally on bedrest
-a local anesthetic is applied before the needle is inserted
-may cause labor to slow down
-typically placed when patient is in active labor
-cannot be used if a patient is on blood thinners or has low platelet counts or if patient is hypovolemic
or has spinal abnormalities
Nitrous oxide - CORRECT ANSWER✅✅✅-non-narcotic pain relief used during labor
-mixed with half oxygen
-self-administered
-can cause nausea, vomiting, dizziness
Penicillin - CORRECT ANSWER✅✅✅-can be given for GBS+ during labor and birth
-IV q 4 hrs (at least 2 doses before birth, if possible)
,-benzathine PCN is the treatment for syphilis
Clindamycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
-given for chorioamnionitis or postpartum endometritis IV
Ampicillin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
-given for chorioamnionitis IV
Erythromycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Cefazolin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Gentamicin - CORRECT ANSWER✅✅✅-given for chorioamnionitis or postpartum endometritis IV
Vancomycin - CORRECT ANSWER✅✅✅-can be given for GBS prophylaxis for preterm birth 48 hrs IV
then 5 days of PO
Azithromycin - CORRECT ANSWER✅✅✅-antibiotic treatment for chlamydia and gonorrhea (for the
latter, give ceftriaxone as well)
Magnesium sulfate - CORRECT ANSWER✅✅✅-given to stop preterm labor (and neuroprotection) or
prevent seizures d/t PEC or to stop seizures in eclampsia
-relaxes smooth muscle
-watch out for B(blood pressure low)U(urine output low)R(low respiratory rate)P(absent patellar reflex)
as signs of Mag toxicity
-antidote: calcium gluconate
-monitor vitals hourly and continuous EFM
, -on bedrest and clear liquids
-cannot be used in patients with myasthenia gravis
-helps decrease incidence and severity of CP in preterm birth
-for neuroprotection, administer within 24 hours of birth
Terbutaline - CORRECT ANSWER✅✅✅-tocolytic (anticontraction med to delay labor) to give time to
administer steroids
-given subcutaneously
-may cause racing heart, flushing, tremors, restlessness
Tranexamic Acid - CORRECT ANSWER✅✅✅-used to promote blood clotting in PPH
-cannot be given to patients with a history of seizures
-watch for blood clots
Nifedipine - CORRECT ANSWER✅✅✅-Ca2+ channel blocker (lowers BP), tocolytic
-given to stop preterm contractions to give steroids time to work
-usually administered for 2-7 days
-monitor BP, dizziness, peripheral edema, angina, cough
-30mg load, then 10-20 mg q 4-6 hrs
Pitocin - CORRECT ANSWER✅✅✅-exogenous oxytocin
-given to induce contractions to augment labor and prevent PPH
-titrated by nurse
-watch for tachysystole (too many contractions)
-often stopped in emergent situations (i.e. intrauterine resuscitation)
-cannot be given as an IV bolus
-can be used in TOLAC
Methergine - CORRECT ANSWER✅✅✅-used in postpartum to prevent hemorrhage
