Friday, July 2, 2021

Common meds used in OBGYN

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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