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Nitrous Oxide
Grab Bag II
100

Name 2 medications you would utilize for multimodal analgesia for a C-section

Tylenol

Toradol

Intrathecal/epidural/IV Opioids

Decadron

100

Options for anti-emetics in pregnancy?

Zofran

Phenergan

100

When does organogenesis occur in the fetus?

2-8 weeks gestation

100

Which of the following properties is most associated with the use of Nitrous Oxide for labor analgesia?
A: Anxiolysis
B: Nausea
C: Amnesia
D: Hypnosis

Anxiolysis

100

Name two classes of medications commonly used in anesthesia that cross the placenta

Opioids

Local Anesthetics
Propofol
Benzos
Beta blockers

200

When does peak respiratory depression from Neuraxial Morphine occur

18 hours after the dose

200

What is the most common cause of PPH?
A: uterine atony
B: placenta accreta
C: retained placenta
D: cervical laceration

Uterine atony

200

How long do you continue Magnesium therapy for pre-eclampsia?

Through delivery and up to 24 hours postpartum

200

What side effects could you see with Nitrous Oxide use?

Nausea/vomiting
Dizziness

200

Which of the following explains why 2-Chloroprocaine has a short onset time?
A: It is metabolized by plasma cholinesterase
B: the pKa is approx 9.0
C: It is usually given in high concentrations
D: It is a mu-receptor agonist

C

300

Which of the following is most likely to be a risk factor for peripartum cardiomyopathy?
A: maternal age < 20
B: single gestation
C: Preeclampsia
D: Caucasian race

Pre-eclampsia

300

Why do we pre-treat OB patients with pepcid and bicitra?

Increased risk of aspiration

Slowed gastric emptying during labor

300

Options for treatment of HYPOtension in OB patients

Phenylephrine
Ephedrine


Epinephrine

300

Name 2 contraindications to Nitrous Oxide

B12 deficiency
Inability to hold their own mask
Sedated: Mag, sedative medications, intoxicated
Abnormal air filled cavity: pneumothorax

300

Which statement about epidural fentanyl administration is MOST likely correct?
A: the risk of N/V is independent of the dose
B: It is associated with decreased risk of N/V compared to epidural morphine
C: It is associated with increased risk of N/V compared to epidural morphine

B

400

Name a medication you could utilize for rapid profound, yet short duration of uterine relaxation

Nitroglycerin (50 mcg IV) titrated to effect

400

Name a situation you would need quick, profound uterine relaxation

Before delivery: external version
Delivery: fetal head entrapment, extraction of 2nd twin
Post delivery: retained placenta

400

Are benzos safe in pregnancy? 

Defend your answer

Maybe?

400

Does Nitrous Oxide provide good analgesia?

Defend your answer

No, studies show efficacy is relatively low but patient satisfaction is high

400

Contraindications to tocolytic therapy?

Chorioamnionitis
Fetal distress
Preeclampsia or Eclampsia

500

23 y/o pt. is POD #3 from C-section for pre-eclampsia. On 3NW she experiences a generalized tonic-clonic seizure. What drug would be the anticonvulsant of choice?

Magnesium

500

Which of the following anti-hypertensive agents is MOST likely to be contraindicated in pregnancy?
A: Enalapril
B: Labetalol
C: Hydralazine
D: Nifedipine

A: Enalapril


500

You are caring for a 20y/o Jehovah's Witness with Postpartum bleeding 2/2 uterine atony. She has a history of severe asthma and is refusing blood products. What medication would you consider after additional Oxytocin? 

Defend your choice

Methergine

TXA


500

Pain control options in labor besides and epidural

IV: Pushes, PCA (remifentanil)


Nitrous Oxide


500

Drugs/classes of medications that do NOT cross the placenta

Heparin

Glycopyrrolate

Insulin

Paralytics