OB/GYN

Rapid Review

• Mechanism of Action: Uterotonic agent; increases uterine contraction force and frequency to decrease post-partum hemorrhage and aid in passage of retained products after abortion/miscarriage.
• Indications: Postpartum hemorrhage, 
• Contraindications: Allergy to class/drug, pregnancy, hypertension
• Dosage: 0.2 mg IV/IM q 2-4 hours (max five doses)
• Onset: Immediate (IV); 2-5 minutes (IM)
• Duration: 45 minutes (IV); 3 hours (IM)
• Adverse Reactions: Seizures, bradycardia, hypertension, stroke
• Special Considerations: None

Pearls

Deep Dive

• Methergine (Drugs.com)

Rapid Review

• Mechanism of Action: Prostaglandin; binds to myometrial cells and causes strong myometrial contractions. 
• Indications: Induction of labor, treatment of post-partum hemorrhage, medical management of miscarriage, medical abortion.
• Contraindications: Allergy to drug/class
• Dosage: 800 mcg PO or 1,000 mcg rectally
• Onset: 8 minutes
• Duration: 2 hours
• Adverse Reactions: Anaphylaxis, uterine rupture, diarrhea, headache.
• Special Considerations: None

Pearls

Deep Dive

• Misoprostol (NCBI)

Rapid Review

• Mechanism of Action: Immunoglobulin; prevents isoimmunization by suppressing immune response by Rh negative individuals against Rh positive blood cells. 
• Indications: Risk of maternal/fetal hemorrhage, ectopic pregnancy, miscarriage
• Contraindications: Allergy to drug, prior sensitization of mother, known Rh-negative father, known Rh-negative fetus.
• Dosage: 50-300mcg (IM)
• Onset: Peak plasma time of 5-10 days (IM)
• Duration: 12 weeks
• Adverse Reactions: Nausea, vomiting, diarrhea, general ill feeling
• Special Considerations: N/A

Pearls

Deep Dive

• Rhogam Redux (Taming The SRU)