South Dakota Administrative Rules › Title 20 - PUBLIC SAFETY › Article 20:86 - CERTIFIED PROFESSIONAL MIDWIVES › Chapter 20:86:03 - The practice of certified professional midwifery › Appendix A - Drug formulary

Current through Register Vol. 51, page 10, July 15, 2024
Drug
Indication
Dose
Route of
Administration
Duration of
Treatment
Phylloquinone (Vitamin K1)
Prophylaxis for Vitamin K deficiency bleeding
1 mg
Intramuscularly
1 dose
Oxytocin (Pitocin)
Postpartum hemorrhage only
10 Units/ml
Intramuscularly only
1-2 doses. Transport to hospital required if more than two (2) doses are administered.
Misoprostol
Note: This is an appropriate off label use of this drug.
Postpartum
hemorrhage only
200 microgram tabs, at 800 micrograms per dose (4 tabs)
Rectal or sublingual, or may be used as 1/2 rectally and 1/2 sublingually
1-2 doses. Transport to hospital required if more than 2 doses are administered. Not to exceed 800 micrograms.
Methylergonovine (Methergine)
Postpartum hemorrhage only
0.2mg
Intramuscular or orally
Single dose. Every six hours, may repeat 3 times. Contraindicated in hypertension and Raynaud's Disease.
Lidocaine HCL 1% or 2%
Local anesthetic for use during postpartum repair of lacerations or episiotomy
Maximum 50 ml (1%) Maximum 15 ml (2%)
Precutaneous 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 >=100 ml LR, NS or D5LR
Until birth of baby
Ampicillin Sodium (Alternative)
Group B Strep Prophylaxis
2 grams initial dose, then 1 gram every 4 hours until birth
IV in >=100ml
NS
Until birth of
baby
Cefazolin Sodium
Group B Strep Prophylaxis
2 grams initial dose, then 1 gram every 8 hours
IV in >=100 ml LR, NS or D5LR
Until birth of baby
Clindamycin Phosphate
Group B Strep Prophylaxis
900 mg every 8 hours
IV in >=100 ml NS or LR
Until birth of baby
Lactated Ringers (LR)
To administer group B Strep Prophylaxis
Intravenous catheter
5% Dextrose in Lactated Ringer's solution (D5LR)
To administer group B Strep Prophylaxis
Intravenous catheter
0.9% Sodium Chloride (NS)
To administer group B Strep Prophylaxis
Intravenous catheter
Oxygen
Maternal/Fetal Distress, or Neonatal Resuscitation
10-12 L/min 10 L/min
Mask or bag and mask
Until stabilization is achieved or transfer to a hospital is complete
0.5% Erythromycin Ophthalmic Ointment
Prophylaxis of Neonatal Opthalmia
1 cm ribbon in each eye
Topical
1 dose
Rh(D) Immune Globulin
Prevention of RH(D) sensitization in Rh(D) negative women
300 mcg
Intramuscularly
Single dose at any gestation for Rh(D) negative, antibody negative women within 72 hours of spontaneous bleeding or abdominal trauma.
Single dose at 2628 weeks gestation for Rh(D) negative, antibody negative women.
Single dose for Rh(D) negative, antibody negative women within 72 hours of delivery of Rh(D) positive infant, or infant with unknown blood type,.
Epinephrine HCL
Post-exposure treatment of severe allergic reaction to approved medication
0.3 to 0.5 in a concentration of 1:1000
Intramuscular injection into anterolateral aspect of the thigh or via metered dose auto-injector
Seek medical attention immediately after administration of first injection. Can be given every 5-15 minutes as needed for 3 to 4 doses.
Tranexamic Acid (TXA) To be used when initial anti-hemorrhagic therapies fail and with notification of local medical support
Control of Postpartum Hemorrhage
100mg/ml (1 g)
IV at 1 ml per minute
2nd dose if bleeding continues past 30 minutes or restarts with 24 hours.
IV Fluids
* Lactate Ringers (LR)
* .45% Saline
* .9% Normal Saline
To treat maternal hemorrhage
Infuse 1 liter in wide-open rate
IV line with 16 18 gauge needle
After first liter, a second liter may be titrated to client's condition.
General Authority:
SDCL  36-9C-32(2)
Law Implemented:
SDCL  36-9C-13(7)