Mont. Admin. r. 24.111.616
Drug | Indication | Dose- in conformance ACOG guidelines | Route of Administration | Duration of Treatment |
Oxygen | Maternal/Fetal Distress Neonatal Resuscitation | 10-12 L/min. 10 L/min. 10-12 L/min. 10 L/min. | Bag and mask Mask Bag and mask Mask | Until maternal/fetal stabilization is achieved or transfer to hospital is complete Until stabilization is achieved or transfer to a hospital is complete |
Oxytocin (Pitocin) | Postpartum hemorrhage only | 10 Units/ml | Intramuscularly only | 1-2 doses Transport to hospital required if more than two doses are administered |
Lidocaine HCl 1% 2% | Local anesthetic for use during postpartum repair of lacerations or episiotomy | 20 cc 10 cc | Percutaneous infiltration only | Completion of repair |
Penicillin G (Recommended) | Group B Strep Prophylaxis | 5 million units initial dose, then 2.5 million units every 4 hours until birth | IV in [GREATER THAN OR EQUAL TO] 100 ml LR, NS or D5LR | Birth of baby |
Methegrine (Methylergonovine | Postpartum hemorrhage only | 0.2mg/ml | Intramuscularly only 1 dose | Transport to hospital required if single dose does not stop hemorrhage |
Ampicillin Sodium (Alternative) | Group B Strep Prophylaxis | 2 grams initial dose, then 1 gram every 4 hours until birth | IV in [GREATER THAN OR EQUAL TO]100 ml NS or LR | Birth of baby |
Cefazolin Sodium (drug of choice for penicillin allergy with low risk for anaphylaxis) | Group B Strep Prophylaxis | 2 grams initial dose, then 1 gram every 8 hours | IV in [GREATER THAN OR EQUAL TO] 100 ml LR, NS or D5LR | Birth of Baby |
Clindamycin Phosphate (drug of choice for penicillin allergy with high risk for anaphylaxis) | Group B Strep Prophylaxis | 900 mg every 8 hours | IV in [GREATER THAN OR EQUAL TO]100 ml NS (not LR) | Birth of Baby |
Epinephrine HCl 1:1000 | Treatment or post-exposure prevention of severe allergic reactions | 0.3 ml | Subcutaneously or intramuscularly | Every 20 minutes or until emergency medical services arrive Administer first dose then immediately request emergency services |
Lactated Ringer's (LR) 5% Dextrose in Lactated Ringer's solution (D5LR) 0.9% Sodium Chloride (NS) Sterile Water | To achieve maternal stabilization Reconstitution of antibiotic powder | I - 2 liter bags First liter run in at a wide-open rate, the second liter titrated to client's condition As directed | Intravenously As directed | Until maternal stabilization is achieved or transfer to a hospital is complete Birth of Baby |
Cytotec (Misoprostol) | Postpartum hemorrhage only | Up to 800 mcg | Rectally is the preferred method Orally is allowed | 1-2 doses Transport to hospital required if more than one dose is administered |
Rho(d) Immune Globulin | Prevention of Rho (d) sensitization in Rho (d) negative women | 300 mcg | Intramuscularly | Single dose at any gestation for Rho (d) negative, antibody negative women within 72 hours of spontaneous bleeding or abdominal trauma. Single dose at 26-28 weeks gestation for Rho (d) negative, antibody negative women Single dose for Rho (d) negative, antibody negative women within 72 hours of delivery of Rho (d) positive infant, or infant with unknown blood type |
Phytonadione | Prophylaxis for Vitamin K Deficiency Bleeding | 1 dose | ||
0.5% Erythromycin Ophthalmic Ointment | Prophylaxis of Neonatal Ophthalmia | 1 cm ribbon in each eye | Topical | 1 dose |
Tranexamic acid | Postpartum Hemorrhage | 1000 mg over 10 minutes given within 3 hours of birth | Intravenous | Initiate transfer after administering first dose. If bleeding continues after 30 minutes or stops and restarts within 24 hours after the first dose, a second dose of 1000mg may be given. |
Terbutaline | Stop or prevent premature labor | As per direct order of a licensed physician | As per direct order of a licensed physician | As per direct order of a licensed physician |
Mont. Admin. r. 24.111.616
AUTH: 37-1-131, 37-27-302, MCA; IMP: 37-1-131, 37-27-302, MCA