Drugs Used for Pregnant

Women During Antenatal,

Labor and Postnatal Peroid
Submitted by: Mohd Saif Khan
Submitted to: Mr. Misbah Moin Sir
BSc. Nursing 4th Semester
Calcium Gluconate
 Calcium Gluconate

• Calcium gluconate is a calcium salt, used as a medicine to manage

hypocalcemia, cardiotoxicity due to hyperkalemia and hypermagnesemia.
• In pregnancy, it is used as a antidote of magnesium sulfate.
• In case of hypermagnesemia, which occur as a toxicity of magnesium
sulfate given during the prevention and treatment of eclampsia.
• It work as a antagonism of magnesium site of action.
 Indications

• Toxicity of magnesium sulfate

• Hypocalcemia
• Hyperkalemia
• Hypermagnesemia
 Available Form

• Each ampule contain 100 mg/mL of calcium of Calcium gluconate

• 1 mL of 10% calcium gluconate contains 9.3 mg of elemental calcium
• Available in 1 mL ampule and 10 mlL vial.
 Dosage

• In case of cardiac arrest, calcium gluconate 10% 15-30 ml. IV over 2-3 min.
• In case of toxicity of MgSO, (treatment of eclampsia), calcium gluconate
10% 10 mL IV over 2-3 min.
• In case of hypermagnesemia due to renal impairment, calcium gluconate 1-
2 g (10-20 mL) over 5-10 min.
 Contraindications Side Effects

• Syncope
• Hypercalcemia
• Bradycardia
• Hypersensitivity
• Paresthesia
• Sarcoidosis
• Extravasation
• Hypophosphatemia
• Necrosis
 Toxicity

• Extravasation injury can cause necrosis

• Fatigue
• ECG changes with short QT interval
• Muscle weakness
• Polydipsia
 Nursing Responsibilities

• Check for hypersensitivity and other contraindication

• Monitor serum calcium level before administering and during infusion every
1-4 hourly.
• Monitor IV site closely to avoid extravasation
• Check the ECG for any changes.
ERGOMETRINE
 Ergot Derivatives

• These alkaloids are produced by fungus, which affects the cereal crops:
• Ergotoxine- Has an alpha adrenergic blocking activity and an
antihypertensive, and cerebral vasodilator
• Ergotamine, dihydroergotamine-used in acute attack of migraine
• Bromocriptine-is a dopaminergic agonists, used for Parkinsonism
• Ergometrine-is an oxytocic, used to prevent postpartum hemorrhage
 Ergometrine and its Analogue

• Ergometrine and its derivatives are more potent and has a selective action
on uterus
• Small doses: Rhythmic uterine contraction and relaxation
• Larger doses: Substantial, prolonged contractions
 Mechanism Of Action
• Ergot alkaloids significantly increase the motor activity of the uterus
• It affects primarily uterine smooth muscles producing sustained
contractions and thereby shortens the third stage of labor.
• Stimulant action: Involves serotonergic, alpha-adrenergic receptor Uterine
sensitivity changes during pregnancy (possibly due to progressively
increasing numbers of a1 receptors.
• After small doses contractions are increased in force or frequency, or both,
but are followed by a normal degree of relaxation.
• As the dose is increased, contractions become more forceful and prolonged,
resting tonus is markedly increased, and sustained contracture can result.
 Indications
• Atonic postpartum hemorrhage
• Inevitable abortion
• Expulsion of hydatidiform mole pregnancy
• Medical termination of pregnancy
• AMTSL (Active Management of Third Stage Labor) in case of excessive
bleeding
 Contraindications

• Hypersensitivity
• Heart disease
• Severe pre-eclampsia and eclampsia
• Caution in patients with hypertension, vascular disease, presence of sepsis-
may cause gangrene, liver and kidney disease
 Side Effects

• Increase in BP
• Hour glass contraction of uterus
• Nausea and vomiting
• Uterine cramping
• Decreased milk production
 Pharmacokinetics

• Rapidly and completely absorbed orally

• Onset of action-oral (15 minutes), IV (almost immediate)
• Metabolized in liver
• Excreted in urine
• Plasma t½ is 1-2 hours
• Duration of action-3-4 hours
 Nursing Responsibilities and Patient Education

• Closely monitor lochia and BP after administration

• Explain indication for administration to client
• Prepare clients for route of administration and possible side effects, such as
cramping
• Instruct client to report excessive blood loss
• Instruct client not to smoke.