OB Medication List
Antepartal
Prenatal
1. Prenatal Vitamins – recommended; some contain
both Fe and Ca (Fe might not be readily absorbed)
2. Folic acid – A – crucial to prevent neural tube
defects (400 mcg if healthy; 4 mg if Hx of neural
defects)
3. Calcium – C – supplements needed only if dietary
intake is insufficient
4. Iron – 30 mg (325 mg if iron sulfate) 1st trimester;
best absorbed with Vit C; on empty stomach, do not
take with Calcium ( absorption); dark green leafy
veggies
Contraction Suppressants
1. Brethine (terbutaline sulfate) – B – used for
preterm labor. Relaxes smooth muscle, inhibits
uterine activity + bronchodilation. SubQ q4h no longer
than 24h.
2. MgSO4 (magnesium sulfate) – CNS depressant,
prophyaxix of seizures in preeclampsia. A/C – IV
loading dose 4-6 g over 15-30 min, maintenance 1-2
g/h. therapeutic range blood 4-7.5 ml/dl. Lamicel –
contains MgSO4, synthetic cervical dilator.
Tocolitics can induce pulmonary edema (alpa2agonists) – watch for dyspnea, crackles + limit fluids.
Ectopic pregnancy treatment
1. Methotrexate – X – cancer drug; attacks
quickly growing cells => embryo is dissolved by the
body within 2-4 weeks
Labor and Delivery
Narcotic Analgesics
1. Demerol (meperidine) – C – not used anymore,
stays in baby system for 3 days.
2. Stadol (butorphanol tartrate) - C – agonistantagonist; not that severe to cause RR depression in
mom and newborn; not for Hx of opioid addiction –
antagonist part causes withdrawal syndrome.
3. Nubain (nalbuphine) – C – agonist-antagonist;
Antagonist for magnesium sulfate
good pain relief; not that severe to cause RR
Calcium gluconate – + antidote
depression in mom and newborn; not for Hx of opioid
addiction – antagonist part causes withdrawal
Steroids
1. Betamethasone – C – corticosteroid. IM. Helps syndrome.
mature fetal lungs when given 12.5 mg stat for abruptio 4. Duramorph (morphine sulfate) – C – IV, IM, SC
placentae. 2 doses 24h apart.
2. Dexamethasone – C - IM. Helps mature fetal lungs Narcotic Antagonist
Narcan (naloxone) -B – pain quickly returns
when given 6 mg, 4 doses 12 h apart.
after administration; contraindicated for opioiddependent women because may precipitate withdrawal
Anti-Infectives-prophylaxis
symptoms.
1. Ampicillin - B
2. Gentamicin - C
Inducer / Enhancer
1. Prostaglandin gel or suppository – C - ripens
Anti-hypertensive
cervix – Dinoprostone (Prepidil)
1. Propranolol - C
2. Pitocin (oxytocin) - ? – mix 30 units in 500 mL of
2. Labetolol – C
3. Nifedipine – C – PO; Ca channel blocker; LR
relaxes smooth muscles, incl uterus; watch 3. Cytotec (misoprostol) – X – prostaglandin; ripens
cervix.
for maternal hypotension.
4. Cervidil (dinoprostone) – C prostaglandin; ripens
4. Hydralazine – C
vervix; vaginal insert – posterior fornix; remain in bed
5. Methyldopa – B
for 2h; caution with asthma!
Don’t give ACEs to pregnant!
Prevention or stopping hemorrhage
1. Methergine/ Methylergometrine – C - Analgesic
and Uterotonic; Can treat severe bleeding from the
uterus after childbirth. Not good for HTN
2. Hemabate/ carboprost tromethamine – C synthetic prostaglandin with oxytocic properties;
reduces PP bleeding. Not good for asthma. N&V,
diarrhea, hyperthermia.
3. Pitocin (oxytocin) – ? - IV/IM after placenta
expulsion to contract the uterus; anti-diuretic effect.
4.
Cytotec (Misoprostol) – X – vaginal tablet;
prostaglandin; causes the cervix to soften and the
uterus to contract to allow the pregnancy to be expelled
from the uterus. Used for cervical ripening for induction
of labor. Rectally to stop PP hemorrhage.
2. Erythromycin ophthalmic ointment – for
prophylaxis of gonorrhea.
3. Hepatitis B vaccine
4. Hepatitis B Immunoglobulin
Astringents
1. Witch hazel – promotes perineal comfort
(lacerations, episiotomy, hemorrhoids) topically; good
for rinsing mouth if excessive salivation.
2. Tucks
Anticholinergics
1. Atropine sulfate – C – pre-op for the reduction of
salivary and bronchial secretions
2. Robinul (glycopyrrolate) – B – lowers the amount
of acid in stomach
Surgery
Antiemetic
1. Reglan (Metoclopramide) – B – OK in small doses;
often given also for hyperemesis gravidarum
(antiemetic + stimulates motility)
2. Zofran – B – often given also for hyperemesis
Topical Agents
gravidarum
1. Dermoplast/Benzocaine – pain and itch relief
3. Phenergan - C – causes drowsiness (rarely given
2. Americaine spray/ Benzocaine
3. Epifoam/ Hydrocortisone / Pramoxine - Steroid and for hyperemesis gravidarum); can decrease effect of
opioids.
Topical anesthetic
Stool Softeners/Laxatives
Antacids
1. Colace – C – reco’d to promote elimination + fluids
1. Protonix - B
+ fiber
2. Bicitra - C
2. Miralax – C – reco’d to promote elimination + fluids
3. Tums – ( ? 1st trimester)
+ fiber
Analgesia / Pain – Cramping Management
Gynecological/Reproductive
1. Ibuprofen – B (D in 3rd trimester) – causes fetal
impairment
Prostaglandin Inhibitors
2. Norco / hydrocodone+acetaminophen – C –
1. Motrin – B (D in 3rd trimester) – ibuprofen;
usually after C-section.
3. Toradol (ketorolac) – C – NSAID, moderate to NSAID
severe pain, usually for after surgery.
2. Naprosyn B (D in 3rd trimester) – naproxen,
NSAID
Other
1. RhoGAM – C – IM; for Rh- moms to prevent
Anti-infectives
forming antibodies against Rh+ fetus, suppresses
1. Rocephin - B
immune system; during pregnancy PRN; after birth
2. Doxycycline - D
72h (direct and indirect Coombs should be “-”)
3. Penicillin - B
2. Rubella vaccine – LIVE, X during pregnancy. No
4. Amoxicillin - B
pregnancy 1 month after administration. Doesn’t get
5. Macrobid - B
into milk.
6. Flagyl (metronidazole) - B
3. Tdap vaccine – SAFE, recommended during
7. Bicillin – B
pregnancy (27-36 weeks) to facilitate mom-baby
8. Azithromycin - B
antibodies transfer
4. MMR vaccine (measles, mumps, rubella) Anti-fungals
LIVE, X during pregnancy
1. Nystatin - B
5. Influenza vaccine - SAFE, recommended
2. Diflucan - C
6. Gardasil vaccine – NOT recommended during
pregnancy (not enough data)
Anti-viral
1. Acyclovir - B
Newborn
2. Valacyclovir - B
3. Famcyclovir - B
1. Vitamin K – OM soon after birth
Safety in Pregnancy
Category
X
Category
A
B
C
D
Definition
Safety established using human
studies
Presumed safety based on
animal studies
Uncertain safety, no human
studies and animal studies
show an adverse effect
Unsafe – evidence of risk that
+
?
Definition
may in certain clinical
circumstances be justifiable
Highly unsafe – risk of use
outweighs
any
possible
benefit
Generally accepted as safe
Safety unknown or controversial
– generally regarded as
unsafe
Revised L. Cavazos8/202