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Approved medication list for obstetrical patients
APPROVED MEDICATION LIST FOR OBSTETRICAL PATIENTS
The following list of medications are approved by Dr. Martinez M.D., and Jennifer Stauss, CNP. These are all over the counter medications, and it is very important that you read the labels carefully, and take the medication as directed on the label. All over the counter medications will have a warning not to take the medication if pregnant or lactating. We have provided this list of medications that are SAFE to use in pregnancy. However, it is your choice whether or not to use these medications. Gastrointestinal Upset
• Mylanta Antacid Liquid INDICATIONS: Relieves heartburn, acid indigestion, sour stomach, associated symptoms of gas and upset stomach, and overindulgence in food and drink. INGREDIENTS: Active Ingredients:Per 5 mL Teaspoonful: Aluminum Hydroxide 200 mg; Magnesium Hydroxide 200 mg; Simethicone 20 mg. DIRECTIONS: Shake well. Take 2-4 teaspoonfuls between meals, at bedtime or as directed by a physician. Do not take more than 24 teaspoonfuls in a 24-hour period, or use the maximum dosage for more than 2 weeks. WARNINGS: Ask a doctor before use if you have kidney disease.
• Tums Chewable Tablets INDICATIONS: Antacid Uses: It is for the relief of acid indigestion, heartburn, sour stomach and upset stomach associated with these symptoms. Calcium Supplement Uses: It is provides a daily source of extra calcium. INGREDIENTS: Active Ingredients:Calcium Carbonate USP grade (1000 mg) DIRECTIONS: Antacid: Chew 2-3 tablets as symptoms occur. Repeat hourly if symptoms return • Phazyme or Gax-X INDICATIONS: Relieves bloating, pressure or fullness commonly referred to as gas. INGREDIENTS: Active Ingredients:Per Tablet: Simethicone 125 mg. DIRECTIONS: Chew or swallow 1 or 2 tablets thoroughly as needed after a meal. Do not exceed 4 tablets per day SEVERE GI UPSET Zantac or Pepcid AC. These medications are histamine blockers and work by decreasing the amount of acid the stomach produces. Both medications are in the FDA pregnancy category B. This means that it is unlikely to harm your unborn baby. Your may take these medications as directed on the label. Please notify us at your next appointment if you are taking these medications regularly. • Zantac 150 Tabs Max Strength INDICATIONS: MAXIMUM STRENGTH Zantac 150 reduces the production of stomach acid. This is what makes MAXIMUM STRENGTH Zantac 150 different from antacids, which neutralize the acid already in your stomach. Antacids do not reduce the production of acid. INGREDIENTS: Active Ingredients:Ranitidine 150 mg. DIRECTIONS: adults and children 12 years and over, to relieve symptoms,swallow 1 tablet with a glass of water, to prevent symptoms, swallow 1 tablet with a glass of water 30 to 60 minutes before eating food or drinking beverages that cause heartburn, can be used up to twice daily(do not take more than 2 tablets in 24 hours). WARNINGS:Do not useif you are allergic to ranitidine or other acid reducers, if you are trouble or pain swallowing food,vomting with bloody for black stools. These may be signs of a serious condition. See your doctor, with other acid reducers, if you have kidney disease. • Pepcid Ac INDICATIONS: Prevents heartburn associated with acid indigestion and sour stomach brought on by eating or drinking certain food and beverages. INGREDIENTS: Active Ingredients: In Each Gelcap: Famotidine 10 mg (Acid Reducer). DIRECTIONS: Adults and children 12 years and over: To relieve symptoms, swallow 1 gelcap with a glass of water. To prevent symptoms, swallow 1 gelcap with a glass of water at any time from 15 to 60 minutes before eating food or drinking beverages that cause heartburn. Do not use more than 2 gelcaps in 24 hours NAUSEA AND VOMITING
Over the counter Emetrol, ginger lozenges, (can be purchased at health food stores) Sea Bands, Accupuncture, combination of Sominex and Vitamin B6. If vomiting is severe (more than 3 times a day) contact the office. • Emetrol Liquid Cherry INDICATIONS: For relief of nausea due to upset stomach from intestinal flu, stomach flu, and food or drink indiscretions. INGREDIENTS: Active Ingredient: Each 5ml teaspoonful contains: Dextrose (1.87 g), Levulose (fructose) (1.87 g), Phosphoric Acid (21.5 mg) DIRECTIONS: Administer dosage below every 15 minutes or until distress subsides: Adults---One or two tablespoons. • Sea Band Motion Sickness Bands INDICATIONS: The Sea-Band has been clinically tested against nausea and vomiting in travel, pregnancy, anaesthesia, chemotherapy and all conditions which induce nausea. The Sea-Band is a knitted elasticated wrist band, which operates by applying pressure on the Nei Kuan acupressure point on each wrist by means of a plastic stud. Because the bands do not use drugs, they do not cause any of the side effects associated with anti-nausea drugs and can be worn on each wrist whenever you feel nauseous. They are suitable for adults and children. DIRECTIONS: Simple to use, the Sea-Band does not need specialist handling. Care should be taken however to position the bands according to the instructions provided with the product. They become effective within 5 minutes even if nausea has already started. They can be worn continuously. • Sominex INDICATIONS: Relieves nausea when combined with Vitamin B 6. INGREDIENTS: Active Ingredients: Each tablet contains: Diphenhydramine HCl (25 mg.). DIRECTIONS: Directions: Adults: Take 2 tablets every 8 hours with Vitamin B 6. HEADACHE
• Tylenol 8 Hour Extended Relief Caplets INDICATIONS: Temporarily relieves minor aches and pains due to: muscular aches, backache, headache, toothache, the common cold, menstrual cramps, minor pain of arthritis. INGREDIENTS:Active Ingredients: Per Caplet: Acetaminophen 650 mg. DIRECTIONS: Do not take more than directed (see overdose warning). Adults: Take 2 caplets every 8 hours with water. Swallow whole-do not crush, chew or dissolve. Do not take more than 6 caplets in 24 hours. Do not use for more than 10 days • Tylenol Extra Strength Tablets, Pain Reliever & Fever Reducer INDICATIONS: For the temporary relief of minor aches and pains associated with headache, muscular aches, backache, minor arthritis pain, common cold, toothache, menstrual cramps. For the reduction of fever. INGREDIENTS: Active Ingredients:Per Tablet: Acetaminophen 500 mg. DIRECTIONS: Adults and children 12 years of age and older: Take 2 tablets every 4 to 6 hours as needed. Do not take more than 8 tablets in 24 hours WARNINGS: Alcohol Warning: If you drink 3 or more alcoholic beverages every day, ask your doctor whether you should take TYLENOL or other pain relievers. Chronic heavy alcohol users may be at increased risk of liver damage when taking more than the recommended dose (overdose) of TYLENOL. Do Not Use: with any other product containing acetaminophen. For more than 10 days for pain unless directed by a doctor. For more than 3 days for fever unless directed by a doctor. Stop Using and Ask a Doctor If: symptoms do not improve, new symptoms occur, pain or fever persists or gets worse, redness or swelling is present. Do not exceed recommended dose. NASAL CONGESTION
Saline nose spray, Sudafed, Actifed, Benadryl, humidifier. You may also use Afrin Nasal Spray. Do not use more than 3 days in a row, to prevent rebound stuffiness. Nasal stuffiness is normal in pregnancy. • Sudafed/Actifed INDICATIONS: For the temporary relief of nasal congestion due to the common cold, hay fever or other upper respiratory allergies, and nasal congestion associated with sinusitis. Promotes nasal and/or sinus drainage; temporarily relieves sinus congestion and pressure. Temporarily restores freer breathing through the nose. DIRECTIONS: Pseudoephedrine Hydrochloride (60mg), Take every 4 to 6 hours and do not take more than 4 doses in 24 hours PRECAUTION: Do not use this product if you are now taking a prescription monoamine oxidase inhibitor (MAOI (certain drugs for depression, psychiatric or emotional conditions, or Parkinson's disease), or for 2 weeks after stopping the MAOI drug. • Benadryl Allergy Relief INDICATIONS: Temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: runny nose, sneezing, itchy, watery eyes, and itching of the nose or throat. Temporarily relieves these symptoms due to the common cold: runny nose and sneezing. 24 Ultratab Tablets - Small Tablet size. Easy to Swallow. INGREDIENTS: Active Ingredients:in each tablet: Diphenhydramine HCl (25 mg - Antihistamine). DIRECTIONS: Take every 4 to 6 hours. Do not take more than 6 doses in 24 hours. Adults and children 12 years of age and over: 25mg to 50mg (1 to 2 tablets) • Afrin Nasal Spray Original - 15Ml INDICATIONS: For temporary relief of nasal congestion due to colds, hay fever or other upper respiratory allergies, or associated with sinusitis. Shrinks swollen nasal membranes so you can breathe more freely. Active Ingredients:Oxymetazoline HCl (0.05). Adults and children 6 to under 12 years of age: 2 or 3 sprays in each nostril not more often than every 10 to 12 hours. Do not exceed 2 doses in any 24 hour period. INSOMNIA Insomnia is a normal finding in pregnancy. Sominex, Benadryl, or Tylenol PM taking at bedtime are safe in pregnancy.
• Sominex/Benadryl/Tylenol PM (Tylenol PM has acetomenophen—see Tylenol above) INDICATIONS: Helps to reduce difficulty falling asleep. INGREDIENTS: Active Ingredients: Each tablet contains: Diphenhydramine HCl (25 mg.). DIRECTIONS: Directions: Adults and children 12 years of age and over: Take 2 tablets at bedtime if needed, or as directed by a doctor. For best results, take recommended dose. This will provide approximately six to eight hours of restful sleep. UPPER RESPIRATORY SYMPTOMS Please be aware that different cold remedies often use similar medications. Please read the labels in order to assure that you are not taking multiple doses of the same medications. Cloraseptic throat spray, any throat lozenges, and Vicks Vapor Rub may be used for symptomatic relief. • Actifed Cold & Allergy Tablets INDICATIONS: Temporarily relieves these symptoms of hay fever or other upper respiratory allergies:runny nose, sneezing, itchy, watery eyes, and itching of the nose or throat. Temporarily relieves nasal congestion due to the common cold. INGREDIENTS:Active Ingredients: Pseudoephedrine Hydrochloride (60mg), Triprolidine Hydrochloride (2.5mg). DIRECTIONS: Take every 4 to 6 hours and do not take more than 4 doses in 24 hours. Adults and children 12 years of age and over: 1 tablet. WARNINGS: Do not use if you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric, or emotional conditions, or Parkinson's disease), or for 2 weeks after sopping the MAOI drug
• Actifed Maximum Strength Cold & Sinus Capsules INDICATIONS: Temporarily relieves sinus congestion and pressure. Temporarily relieves these symptoms of hay fever: itchy, watery eyes, sneezing, itching of the nose or throat and runny nose. Temporarily relives these symptoms due to the common cold: nasal congestion, headache, fever, and minor aches and pains. INGREDIENTS:Active Ingredients:Each caplet contains: Acetaminophen (500 mg), Chlorpheniramine Maleate (2 mg), Pseudoephedrine HCI (30 mg). DIRECTIONS: Adults and children 12 years of age and over: 2 caplets. Dosage may be repeated every 6 hours while symptoms persist, not to exceed 8 caplets in 24 hours
• Robitussin Expectorant Syrup INDICATIONS: Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. Active Ingredients: Each teaspoonful (5ml) contains: Guaifenesin, USP 100mg (Expectorant). DIRECTIONS: Do not take more than 6 doses in any 24-your period. Adults and children 12 years and over: 2-4 teaspoonfuls every 4 hours.
• Robitussin Pe Syrup INDICATIONS: Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. Temporarily relieves nasal congestion due to a cold. INGREDIENTS: Active Ingredients:Per Teaspoonful (5 mL): Guaifenesin USP 100 mg; Pseudoephedrine HCl USP 30 mg. DIRECTIONS: Do not take more than 4 doses in any 24-hour period. Adults and children 12 years and over: 2 teaspoonfuls every 4 hours.
• Alka-Seltzer Plus Cold & Sinus Medicine, Non-Drowsy Effervescent Tablets INDICATIONS: Provides temporarily relief of these symptoms like headache, nasal congestion, and sinus pain and pressure. INGREDIENTS: Active Ingredients:in each tablet: Acetaminophen 250mg (Pain reliever/fever reducer), Phenylephrine Hydrochloride 5 mg (Nasal decongestant). DIRECTIONS:Adults and children 12 years and over: take 2 tablets fully dissolved in 4 oz of water every 4 hours. Do not exceed 8 tablets in 24 hours • Tylenol Flu Maximum Strength, Non-Drowsy INDICATIONS: Temporarily relieves these cold and flu symptoms: Minor aches and pains,Headaches,Sore throat,Nasal congestion,Coughs,For the reduction of fever. INGREDIENTS: Active Ingredients:Acetaminophen (500 mg; Pain Reliever/Fever Reducer), Dextromethorphan HBr (15 mg; Cough Suppressant), Pseudoephedrine HCI (30 mg; Nasal Decongestant). DIRECTIONS: Adults and children 12 years of age and older: Take 2 gelcaps every 6 hours. Do not take more than 8 gelcaps in 24 hours WARNINGS: Sore throat warning: If sore throat is sever, persists for more than 2 days, is accompanied or followed by fever, headache, rash, nausea or vomiting, consult a doctor promptly. • Tylenol Flu Maximum Strength Night INDICATIONS: Temporarily relieves these cold and flu symptoms Minor aches and pains,Nasal congestion,Temporarily reduces fever,Headaches,Runny Nose,Sore Throat,Sneezing. INGREDIENTS: Active Ingredients:Acetaminophen 500mg (Pain reliever/fever reducer), Diphenhydramine HCl 25 mg (Antihistamine), Pseudoephedrine HCl 30mg (Nasal decongestant). DIRECTIONS: Adults and children 12 years and over Take 2 gelcaps at bedtime.May repeat every 6 hours.Do not take more than 8 gelcaps in 24 hours WARNINGS: Alcohol Warning: If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage. Sore Throat warning: If sore throat is sever, persists for more than 2 days, is accompanied or followed by fever, headache, rash or nausea or vomiting, consult a doctor promptly. Do not use:If you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric or emotional conditions, or Parkinson's disease) or for 2 weeks after stopping the MAOI drug. LEG CRAMPS
Calcium 500 mg at bedtime ½ banana per day (for potassium)
SMALL RASHES OR ITCHING
Benadryl cream or tablets, 1% Hydrocortisone cream, Calamine lotion, and Aveeno oatmeal bath.
• Aveeno Anti-Itch Cream INDICATIONS: Provides fast temporary relief of the itching and pain associated with many minor skin irritations such as poison vy/oak/sumac, insect bites, and chicken pox rash. INGREDIENTS:Active Ingredients: Calamine 3.0%; Pramoxine HCl 1.0%; Camphor 0.47%. DIRECTIONS: Adults and children 2 years and older: Apply no more than 4 times daily. • 1 % Hydrocortisone Anti Itch Cream INDICATIONS: Use for the temporary relief of itching associated with minor skin irritations, inflammation, and rashes due to seborrheic dermatitis, eczema, psoriasis, poison ivy, poison oak, or poison sumac, insect bites, soaps, detergents, cosmetics, jewelry, and for external anal itching. INGREDIENTS: Active Ingredient: Hydrocortisone (1.0%) DIRECTIONS: Adults and children 2 years of age and older: Apply to affected area not more than 3 to 4 times daily. • Benadryl Original Cream INDICATIONS: For the temporary relief of itching and pain associated with insect bites, minor skin irritations and rashes due to poison ivy, poison oak or poison sumac. Dries the oozing and weeping of poison ivy, poison oak and poison sumac. INGREDIENTS:Active Ingredients: Diphenhydramine Hydrochloride 1%; Zinc Acetate 0.1%. DIRECTIONS: Adults and children 2 years of age and older: Apply to affected area not more than 3 to 4 times daily. HEMORRHOIDS
Hemorrhoids worsen with constipation. Please increase oral fluids to 8-10 glasses of water per day along with the fiber supplements listed in the section for constipation. If hemorrhoids worsen despite these treatments, call the office. • Anusol INDICATIONS: Temporarily relieves the pain, soreness, burning and itching associated with hemorrhoids and other anorectal disorders while it forms a temporary protective coating over inflamed tissues to help prevent drying of tissues. INGREDIENTS:Active Ingredients: contains: Pramoxine Hydrochloride (1%), Zinc Oxide (12.5%), Mineral Oil. DIRECTIONS: Adults: When practical, cleanse the affected area with mild soap and warm water and rinse thoroughly. Gently dry by patting or blotting with toilet tissue or a soft cloth before application of this product. Anusol Ointment is to be applied externally or in the lower portion of the anal canal up to 5 times daily. • Preparation H Cream INDICATIONS: Helps relieve the local itching and discomfort associated with hemorrhoids. Temporarily shrinks hemorrhoidal tissue and relieves burning. Temporarily provides a coating for relief of anorectal discomforts. Temporarily protects the inflamed, irritated anorectal surface to help make bowel movements less painful. INGREDIENTS: Active Ingredients: Glycerin 12%; Petrolatum 18%; Phenylephrine HCl 0.25%; Shark Liver Oil 3.0%. DIRECTIONS: Adults: When practical, cleanse the affected area by patting or blotting with an appropriate cleansing wipe. Gently dry by patting or blotting with tissue or a soft cloth before applying cream. Apply externally or in the lower portion of the anal canal only. Apply externally to the affected area up to 4 times daily, especially at night, in the morning or after each bowel movement
• Tucks Hemorrhoidal Pads with Witch Hazel INDICATIONS: For the temporary relief of external itching, burning, and irritation associated with hemorrhoids. INGREDIENTS:Active Ingredients: per pad: Witch Hazel (50%). DIRECTIONS: For external use only. Hemorrhoidal treatment-Adults: When practical, cleanse the affected area with mild soap and warm water and rinse thoroughly. Gently dry by patting or blotting with toilet tissue or soft cloth before application of this product. Gently apply the affected are by patting and then discard. Can be used up to 6 times daily or after each bowel movement. CONSTIPATION
• Fibercon Caplets INDICATIONS: Helps restore and maintain regularity and relieve constipation. This product generally produces bowel movement in 12 to 72 hours. INGREDIENTS: Active Ingredients: Per Caplet: 625 mg Calcium Polycarbophil Equivalent to 500 mg Polycarbophil. DIRECTIONS: FIBERCON acts like natural fiber so continued use for 1 to 3 days is normally required to provide full benefits. FIBERCON dosage may vary according to diet, exercise, previous laxative use or severity of constipation. Adults and children over 12: 2 caplets once a day (daily maximum: up to 4 times a day [refer to directions above]).
• Benefiber Fiber Supplement INDICATIONS: Benefiber is a 100 natural fiber that you can mix with almost anything. It's taste free, grit- free, sugar-free and will never thicken. So it won't alter the taste or texture of your foods or beverages. Be creative with Benefiber. INGREDIENTS: Partially Hydrolyzed Guar Gum (A 100 natural fiber). DIRECTIONS: Stir 1 tablespoon (tbsp) of Benefiber into at least 4 oz. of any beverage or soft food (hot or cold). Use 8 oz. if using 2 tbsp. Stir until dissolved. 12 yrs. to adult ---- 1-2 tbsp up to 3 times daily • Phillips Milk Of Magnesia INDICATIONS: As a laxative: To relieve occasional constipation (irregularity). This product generally produces bowel movement in 1/2 to 6 hours. As a antacid: To relieve acid indigestion, sour stomach and heartburn. INGREDIENTS:Active Ingredients:Per Teaspoon (5 mL): Magnesium Hydroxide 400 mg. DIRECTIONS: Shake well before using. FOR LAXATIVE USE: Adults/Children 12 years and older: 2-4 tablespoonsful (TBSP) at bedtime or upon arising, followed by a full glass (8 oz.) of liquid. FOR ANTACID USE: DO NOT USE DOSAGE CUP. Adults/Children 12 years and older: 1-3 teaspoonsful with a little water up to 4 times a day or as directed by a doctor.
• Citrucel Clear Mix Fiber Laxative INDICATIONS: For relief of constipation (irregularity). This product helps restore and maintain regularity. Also useful in the treatment of constipation associated with other bowel disorders when recommended by a physician. INGREDIENTS:Active Ingredients:Per 11.5 g Adult Dose: Methylcellulose 2 g (a Non-Allergenic. Fiber). DIRECTIONS: Adult dose: dissolve 1 leveled scoop (1 heaping tablespoon - 11.5 g) in 8 oz. of any cold non-carbonated beverage of your choice, up to 3 times daily at the first sign of constipation or irregularity. Use enclosed clear scoop. Generally produces effect in 12-72 hours. VAGINAL YEAST INFECTIONS
Over the counter Monistat, or other over the counter product for vaginal yeast. If symptoms persist or worsen, call for an appointment.
• Monistat-7 or Monistat-3 INDICATIONS: Treats vaginal yeast infections and relieves external vulvar itching and irritation due to a repeat vaginal yeast infection. INGREDIENTS:Active Ingredients: Miconazole Nitrate 2% (100 mg).Cream: Miconazole Nitrate 2%. DIRECTIONS: Applicator - Insert 1 applicatorful into the vagina at bedtime for 7 nights in a row. External Cream - Squeeze a small amount of cream onto your fingertip. Gently apply the cream onto the itchy, irritated skin outside the vagina. Use daily for up to 7 days as needed. • Vagisil Anti-Itch Creme INDICATIONS: Vagisil cream temporarily relieves itching. INGREDIENTS:Active Ingredients:Vagisil cream Contains Benzocaine (5%), Resorcinol (2%). DIRECTIONS: Adults and children 2 years and older: Apply a fingertip amount (approximately 1-inch strip) to affected area not more than 3 to 4 times daily We limit the use of most herbal remedies in pregnancy. Please notify us regarding any herbal remedies you are considering using. High dose vitamin supplementation is not recommended in pregnancy and can be harmful to your baby.
aDivision of General Medicine, University of Iowa Hospitals and Clinics,200 Hawkins Drive, Iowa City, IA 52242, USAbDivision of General Medicine, University of California—Davis, 4150 V Street/Suite 2400,To complete a comprehensive preoperative medical assessment prior tomajor surgery, the consultant must invariably address the issue of the pre-vention of postoperative thromboembolic complica
Inappropriate Medication Prescribing in Residential Care/Assisted Living Facilities Philip D. Sloane, MD, MPH,* Sheryl Zimmerman, PhD,* Lori C. Brown, PharmD,‡Timothy J. Ives, PharmD, MPH,† and Joan F. Walsh, PhD* OBJECTIVES: To identify the extent to which inappro- estimating equations, IPM use was associated with thepriately prescribed medications (IPMs) are administered tonumber o