Common medications seen during OBGYN posting
Supp voltaren 100mg BD
IV pitocin 40u in 1pint NS/6-8h
IV ampicillin 500mg QID
(prom: ampicillin 1g stat and 500mg QID@12hrs post prom)
s/c heparin 5000u BD 6hr after op
IV cefuroxime 750mg TDS
IV flagyl 500mg TDS
IV transxenamic acid 1g TDS
Pain management
C. Celebrex 200mg BD
T. Pcm 1g QID
IV tramal 50mg start
Pre-operation meds
IV ampicillin 1g stat to OT
IV maxolon 10mg stat to OT
IV ranitidine 50mg stat to ot
Mist sodium citrate 30cc stat to ot
Iv cefuroxime 1.5g start to OT (on request)
Post natal
I'm symtometrine 1ampule (before placenta delivery)
Iv pitocin 40u/6hrs
T pcm 1g PRN
PPROM :
T. EES 400mg BD x10/7
If mum rhesus negative :IM volgram/rhogam at 28w and 34w
For PROM
>18h? - IV Benzylpenicillim 3g stat & 1.5g 4hourly
or
IV Ampicillin 1g stat(some gave 2g stat based on the duration of leaking)
Preterm tocolysis
- nifedipine 20mg stat & 10mg x3 with 15 mins interval & 10mg TDS x 48h.
+ MgSO4 bolus & infusion (depends on hours) for neuroprotection
Bricanyl 0.25mg during hyperstimulation/asthma
Pt allergic to penicillin alternatives
- IV clindamycin 900mg TDS
- IV cephazolin 1g TDS x 2/7 & tab EES 1g stat, then change to tab cephalexin 500mg QID x 5/7
- IV cephazolin 2g loading dose, then IV cephazolin 1g TDS
PPH
IV pitocin 10u/40u /80u (max)
IV pitocin 5u/10u bolus
IM hemabate 1ampule stat
IM symtometrine 1 ampule stat
If you are unsure if the meds are safe for pregnant ladies, best to check about the medications category or consult your seniors / MO / registrar / specialist.
- atenolol: causes fetal growth restriction
- ACEI, ARB, Thiazide diuretics: a/w fetal anomaly
References:
1. http://pharmwarthegame.blogspot.com/2019/02/teratogenic-drugs-mnemonic.html
2. https://www.moh.gov.my/moh/resources/Penerbitan/CPG/CPG_Management_of_Hypertension_4th_Edition.pdf
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