Pharmacology and Medications Flashcards

A midwife is managing a postpartum hemorrhage unresponsive to oxytocin. Which second-line uterotonic is appropriate, but is CONTRAINDICATED in clients with hypertension?

Answer: Methylergonovine (Methergine) 0.2 mg IM

Methylergonovine (Methergine) causes vasoconstriction and is contraindicated in hypertensive clients as it can precipitate severe hypertension and stroke.

A client in preterm labor at 32 weeks is given betamethasone. What is the primary therapeutic goal of this medication?

Answer: Accelerate fetal lung maturation by stimulating surfactant production

Antenatal corticosteroids like betamethasone stimulate fetal type II pneumocyte maturation, increasing surfactant production and reducing the risk of neonatal respiratory distress syndrome.

What is the recommended dose and route for misoprostol when used to treat postpartum hemorrhage after oxytocin failure?

Answer: 600–800 mcg rectally or sublingually

For postpartum hemorrhage treatment, misoprostol 600–800 mcg is given rectally or sublingually when IV access is unavailable or oxytocin has failed.

A client at 36 weeks is prescribed nifedipine for tocolysis. Which side effect should the midwife anticipate and monitor?

Answer: Maternal hypotension and reflex tachycardia

Nifedipine, a calcium channel blocker, causes peripheral vasodilation leading to maternal hypotension and compensatory reflex tachycardia.

Iron supplementation is recommended during pregnancy. Which statement about iron absorption is correct?

Answer: Vitamin C (ascorbic acid) co-administration enhances iron absorption

Ascorbic acid (Vitamin C) reduces ferric to ferrous iron in the gut and forms a soluble chelate, significantly enhancing non-heme iron absorption.

Which medication used for nausea and vomiting of pregnancy (NVP) is classified as a combination antihistamine/Vitamin B6 product?

Answer: Doxylamine-pyridoxine (Diclegis/Bonjesta)

Doxylamine succinate/pyridoxine HCl (Diclegis) is the only FDA-approved medication specifically indicated for NVP, combining an antihistamine with Vitamin B6.

A midwife administers carboprost (Hemabate) for uterine atony. Which condition is an absolute contraindication for this prostaglandin F2α analog?

Answer: Asthma

Carboprost (Hemabate) is absolutely contraindicated in clients with active asthma because prostaglandin F2α causes bronchospasm and can precipitate a life-threatening asthma attack.