DRUGS FREQUENTLY USED IN MATERNITY

NURSING
1. DEMEROL – HIGH ALERT MEDICATION. Also known as MEPERIDINE. Classification: (Therapeutic) opioid
analgesics, (Pharmacologic) opioid analgesic. Schedule II. Pregnancy Category C. Indications: Moderate
to severe pain, anesthesia adjunct., Analgesic during labor, preoperative sedation. Action: Binds to
opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing
generalized CNS depression. (Therapeutic effects) Decrease in severity of pain. Adverse Reactions/Side
Effects: Seizures, confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache,
unusual dreams, blurred vision, diplopia, miosis, resp. depression, hypotension, bradycardia, constipation,
nausea, vomiting, urinary retention, flushing, sweating, physical dependence, psychological dependence,
tolerance. ASSESSMENT: Assess type, location, and intensity of pain prior to and 1 hour following
administration, assess BP, HR, and respirations before and periodically during administration, assess
bowel function routinely, prolonged use may lead to physical and psychological tolerance, monitor
patients on chronic or high-dose therapy for CNS stimulation. May increase amylase and lipase
concentrations. HIGH ALERT: ACCIDENTAL OVERDOSE OF OPIOID ANALGESICS HAS RESULTED IN
FATALITIES. CLARIFY ORDER BEFORE ADMINISTRATION.
2. NUBAIN – HIGH ALERT MEDICATION. Also called Nalbuphine. Classification: (Therapeutic) opioid
analgesic, (Pharmacologic) opioid agonist/analgesics. Pregnancy Category: C. Indications: Moderate to
severe pain, Also provides analgesia during labor, sedation before surgery, supplement to balanced
anesthesia. Action: Bind to opiate receptors in the CNS, alters the perception of and response to painful
stimuli while producing generalized CNS depression, in addition, has partial antagonist properties, which
may result in opioid withdrawal in physically dependent patients. (Therapeutic Effects) Decreased Pain. A:
Well absorbed after IM and subcut administration. D: Probably crosses the placenta and enters the breast
milk. M and E: Mostly metabolized by the liver and eliminated in the feces via biliary excretion. Minimal
amounts excreted unchanged by the kidneys. ADVERSE REACTIONS/SIDE EFFECTS: dizziness, headache,
sedation, confusion, dysphoria, euphoria, floating feeling, hallucinations, unusual dreams, blurred vision,
diplopia, miosis, resp. depression, hypertension, orthostatic hypotension, palpitations, dry mouth, nausea,
vomiting, constipation, ileus, urinary emergency, clammy feeling, sweating, physical dependence,
tolerance. ASSESSMENT: assess type, location, and intensity of pain before and 1 hour after
administration, assess BP, HR, and respirations before and periodically during administration, assess
previous analgesic history, may cause amylase and lipase concentrations to increase. HIGH ALERT:
ACCIDENTAL OVERDOSE OF OPIOID ANALGESICS HAS RESULTED IN FATALITIES. CHECK ORDERS BEFORE
ADMINISTRATION.
3. NARCAN – (Naloxone) Classification: (Therapeutic) antidote for opioids, (Pharmacologic) opioid
antagonist. Pregnancy Category: B. INDICATIONS: Reversal of CNS depression and respiratory depression
because of suspected opioid overdose. ACTION: Competitively blocks the effects of opioids, including CNS
and respiratory depression, without production agonist effects. (Therapeutic effect) Reversal of signs of
opioid excess. A: Well absorbed after IM or subcut administration. D: rapidly distributed to tissues,
crosses the placenta. M and E: Metabolized by the liver. ADVERSE REACTIONS/SIDE EFFECTS:
hypertension, hypotension, ventricular fibrillation, ventricular tachycardia, nausea, vomiting.
ASSESSMENT: Monitor RR, rhythm, and depth, pulse, ECG, BP and LOC frequently for 3-4 hours after the
expected peak of blood concentrations, dilute and administer carefully, assess patient for level of pain
after administration, assess patient for S/S of opioid withdrawal.
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