OB/GYN

  • Methylergonovine
  • Misoprostol
  • RhoGAM

Methylergonovine

  • 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
Video Credit: Osmosis

*Deep Dive: Methergine (Drugs.com)



Misoprostol

  • 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
Video Credit: PharmacyD by Asim

*Deep Dive: Misoprostol (NCBI)



RhoGAM

  • 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
Video Credit: RegisterdNurseRN

*Deep Dive: Rhogam Redux (Taming The SRU)


Brandon Simpson, PA-S2
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