Tuesday, May 5, 2020

Subcutaneous Fentanyl and Intramuscular Pethidine - MyAssignmenthelp

Question: Discuss about the Subcutaneous Fentanyl and Intramuscular Pethidine. Answer: Introduction: Pethidine is a form of drug that is used for relieving the pain. Pethidine are sometimes used as the analgesic form of pain relief medication for childbirth related pain and the pain associated with the surgery (Fenwick et al., 2015). The other form of name for Pethidine is Methadone. The classifications of Pethidine are as follows: Synthetic narcotic Narcotic detoxification adjunct Opioid analgesic An antagonist is a drug that acts by blocking opioids by attaching to the opiod receptors without activating them.Antagonistscause no opioid effect and block full agonist opioids. The indicators for the use of the drug are as follows: It is used for the prehospitality phase for the isolation of the extreme form of pain due to the severe form of pain that has been occurred due to severe trauma. These drugs are often recommended for severe, chronic pain and are also used for the detoxification and for the promotion of health of the patients with the opiate form of abstinence syndrome. The contraindications for the use of the drug are as follows: It is often contraindicated in patients who have the hypersensitivity for the drugs. It should be used very cautiously in case of the debilitated pregnant woman having renal or hepatic impairments, hypothyroidism and acute form of abdominal conditions, prostatic hyperplasia, HI, asthma, increased form of the intracranial pressure, urethral structures and the Addisons disease. There are certain forms of precautions that are needed to be taken for the correct usage of the drug. During the administration of the drug a woman who is pregnant needs to be careful about the harmful effects of narcotic form of the analgesics. The administration of the drug is to be made after taking proper precaution for the woman if she is already under the action of taking the narcotics (Fleet, Jones Belan, 2017). The adverse forms of effects for the usage of the drugs are as follows: The symptoms of cholera, sedation, sensorium, euphoria, dizziness, insomnia, seizures, syncope and agitation The hypotension, cardiac arrests, bradycardiac shocks, palpitation, nausea, disturbances in the visual periphery, vomiting, constipation, retention of the urine and urticaria The interactions, stability and the compatibility of the drugs are as follows: The use of the concomitant Central nervous system potentiates the respiratory of the drugs and the depression level of the CNS and also the effects of the hypotensive and the sedations. The combination of the use of the anticholergenics that may essentially cause the paralytic form of the ileus The special forms of considerations are as follows: The most common form of signs and the symptoms that are due to the overdose of the drug can cause the depression of the CNS and the depression in the respiration of the individual. The woman who essentially becomes physically very much dependent on the drugs that are been experienced with the acute form of withdrawal of the syndrome that are been given to a narcotic form of antagonists. The uses of the drugs are to be done with the caution and the monitor it very closely. Pathedine is a widely used drug for the relief of the pain during the labour. It is a similar form of drug that acts the same as the morphine and the heroine. These drugs belong to the family of drugs that are known as the opioids. The morphines is a natural form of drugs that are been extracted from the opium poppy, where there are pethidine is made out of synthetics (Martin et al., 2017). Pethidines were first used in Germany in the year 1940 for reducing the pain in the labour that are continued for the present day. It essentially works my mimicking the effects of the endorphins that are like the own morphine of the body. One of the major functions of the endorphins is to acts the natural form of pain killer for the woman. The Pethidine is been attached to the special form of sites on the outside of the cells of the nerves (Tveit et al, 2017). These sites are known as the opioids receptors. Once these pethidines are been attached to the receptors, the chain of the events that occur can result from depression and the normal form of activity for a little period. The effects of the Pathidine drugs are far more severe than the endorphins. The effect of the pethidin on the body of the women is readily observed after it has been administered. The person becomes drowsy, dizzy and the appearances of her eyes may also change. In addition, her perceptions about the events occurring around might change. The Pethidine acts on the central nervous systems by inhibiting the signals of the pain that are that are been sent to the brain. The subsequent can generally result to the pain that are been experienced by the women who are going through the labour pain. The most common and easiest way to give the pethidine to the women going through labour is to inject it into the muscles. The occasional form of the pethidine administration is injecting it in the vein through a drip. It is usually prescribed by the doctors, however, they are been given by the midwives. The dosage that the women receive usually ranges from 50 mg upto the level of 100mg. The total volume that are been injected into the muscles is one to two millilitres. The Pethidine may not be provided in the adequate pain relief for some of the women. Since nausea and vomiting are common, the medications may be mixed with the pethidine for helping to reduce this form of effects (Goods Martis, 2014). The other potential forms of the side effects for the woman who is in labour include problems in urination, drying of the mouth, hallucinations, the respiratory depressions, low amount of blood pressure and various allergic reactions. It has been observed that there are no impacts on the baby if the mother is under the observation of the Pethidine drug. The pethidine is known for crossing the placenta and is found to have their traces in the breast milk. The major effect for the baby is that the presence of the drug in the mothers milk can cause severe form of respiratory troubles. These effect can also worsen if the baby is born after one to two hours from injecting the drug to the mother. Therefore, this is one of the major reasons for which the pethidine are been avoided during the expected period of birth. An antidote might be been given for reversing the level of the drug. However, the effects of the antidote only last for a shorter period and tend to diminish. As a result, the baby may also experience the same form of the breathing problems. The babies are at risk of suffering from jaundice (Goods Martis, 2014). The drug can also affect the sucking reflex of the baby and may lead to new complications that a re related to the breast feeding for the first few days. The baby may also require the special form of care or the neonatal form of intensive care from the various effects of the pethidine, resulting in the separation of the mother and the baby. In the United Kingdom, it has been observed that it is very common for the hospitals to claim that they have the normal birth rate of about 80 percent. However, the study of the midwives birth rates are about five maternity units delivering between 1200 and up to the 5500 women every year that has revealed that about 1 to 6 first time mothers and 1 to 3 women have the second and subsequent form of labor that defines the normal births that are administered without the interventions or the drugs. However, it is difficult to find data on the number of babies who have been exposed to the drugs to understand the changes in normal behavior after birth due to the administration of the drug. The usage of the pethidine is the becoming less popular since there are a number of loopholes. Pethidine can effectively make the labour difficult and its effect can definitely wear out within a short span of time. It makes them light headed, unaware, disoriented, woozy etc. It has been also seen that occasionally, some of the women also experiences major hallucinations with the intake of pathidine. Further, it can also cause the problems on the respiratory tracts in the babies shortly after the birth especially in the case of the babies who are premature. This is because when the drug crosses the placenta, it makes the baby woozy and it makes the baby less likely to breathe in a vigorous manner at the time of the birth. However, pethidine can make the baby very less responsive and sleepy over the first few days after the birth that can help in the process of breast-feeding. The midwife needs to inject the pethidine into the thigh. The Pethidine can make them feel sick so that the injection is likely to support other forms of drug for addressing the health concerns. The midwife can also give the mother the doses of pethidine in about 50 mg or about 100mg. She can also repeat the dosage that is between the hours and three hours that is not having any other form of the drug for controlling the effect of the drug. The midwife should also take care that the woman does not have more than 400 mg in the next one day (Tveit et al., 2013). It has been observed in several cases that some women are more sensitive towards the opioids than others. However, the medication can have positive form of effects on the women who are given a small amount of dose of the same. A 50 mg of the drug may suit the woman well in the initial stage and they can be henceforth cautious about the drugs that can suit the mother. The midwife can also sent suggest some form of vaginal examination and see how the cervix may have been dilated, before giving the patient some form pethidine. The mother should also stop taking pathedine, if the midwife thinks that the mother is close to expecting the birth as it can essentially make the baby drowsy and effect the breathing of the child. Therefore, these are the above ways through which the drug influences the care of the midwives. References Fenwick, J., Gamble, J., Brittain, H., Sneddon, A. (2015). Birth outcomes: Private practising midwives at Gold Coast University Hospital.Women and Birth,28, S13-S14. Fleet, J. A. (2015).A Comparison of Intranasal Fentanyl, Subcutaneous Fentanyl and Intramuscular Pethidine during Childbirth: A Randomised Controlled Trial(Doctoral dissertation, Flinders University). Fleet, J. A., Jones, M., Belan, I. (2017). Taking the alternative route: Women's experience of intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for labour analgesia.Midwifery,53, 15-19. Fleet, J., Belan, I., Jones, M. J., Ullah, S., Cyna, A. M. (2016). A Comparison of Fentanyl With Pethidine for Pain Relief During Childbirth: A Randomized-Controlled Trial.Obstetric Anesthesia Digest,36(2), 102-103. Goodson, C., Martis, R. (2014). Pethidine: to prescribe or not to prescribe? A discussion surrounding pethidine's place in midwifery practice and New Zealand prescribing legislation.New Zealand College of Midwives Journal,49. Izumi, M., Uematsu, S., Watanabe, A., Manabe, E., Yau, S. Y., Leung, C. Y., ... Cheng, W. S. (2017). Midwifery and Nursing Care.J. Obstet. Gynaecol. Res,43(S1), 83-86. Larkin, P., Begley, C. M., Devane, D. (2017). Womens preferences for childbirth experiences in the Republic of Ireland; a mixed methods study.BMC pregnancy and childbirth,17(1), 19. Martin, T., Hauck, Y., Fenwick, J., Butt, J., Wood, J. (2014). Evaluation of a next birth after caesarean antenatal clinic on women's birth intention and outcomes, knowledge, confidence, fear and perceptions of care.Evidence-Based Midwifery,12(1), 11-5. Niven, C. A. (2013).Psychological care for families: before, during and after birth. Butterworth-Heinemann. Steel, A., Adams, J., Sibbritt, D., Broom, A., Gallois, C., Frawley, J. (2015). Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.Health Expectations,18(5), 1633-1644. Tveit, T. O., Halvorsen, A., Seiler, S., Rosland, J. H. (2013). Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study.International journal of obstetric anesthesia,22(1), 19-25. Wilson, M., MacArthur, C., Smith, F. G., Homer, L., Handley, K., Daniels, J. (2016). The RESPITE trial: remifentanil intravenously administered patient-controlled analgesia (PCA) versus pethidine intramuscular injection for pain relief in labour: study protocol for a randomised controlled trial.Trials,17(1), 591.

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