390 Where There Is No Doctor 2011 Green Pages
WARNING:
1. Too much diazepam can slow down or stop
breathing. Be careful not to give too much!
2. Diazepam is a habit-forming (addictive) drug.
Avoid long-term or frequent use. Keep this
medicine under lock and key.
3. Diazepam can be dangerous for pregnant or
breastfeeding women. Only use to stop seizures
(eclampsia).
For tetanus, give enough to control most of
the spasms. For adults and children over 5 years,
start with 5 mg. by mouth or into the anus (less in
children) and give more later if necessary, but not
more than 10 mg. at 1 time, or more than 50 mg. in
1 day. Wait for 30 minutes before repeating a dose.
For children younger than 5 years old, give 1 to 2
mg. in the anus every 3 to 4 hours.
To relax muscles and calm pain, 30 minutes
before setting broken bones in an adult, give
10 mg. by mouth.
For eclampsia (sudden seizures during
pregnancy or childbirth), give 20 mg. diazepam
solution in the anus. If there are other convulsions,
give 10 mg. after each one, leaving at least 20
minutes between doses. Magnesium sulfate works
better, and is safer for pregnant women.
Magnesium Sulfate—for eclampsia
Name:__________________ price:________ for_ ______
Often comes in: 10%, 12.5%, 25%, or 50% solution
for injection
Dosage to stop a seizure in a woman with eclampsia:
Inject 5 g. of 50% solution into each buttock muscle
once. Repeat after 4 hours if needed.
WARNING: Too much magnesium sulfate can slow
down or stop breathing. Be careful not to give too
much! Do not give to women with kidney problems.
FOR SEVERE BLEEDING AFTER
BIRTH (POSTPARTUM HEMORRHAGE)
For information on the right and wrong use
of medicines to control bleeding after birth, see
page 266. Ergonovine, oxytocin, and misoprostol
should only be used to control bleeding after
the baby is born. Their use to speed up labor
or to give strength to the mother in labor can be
dangerous both to the mother and child. If there
is much bleeding before the afterbirth (placenta)
comes out, but after the child is born, oxytocin
or misoprostol can be given. But do not use
ergonovine or ergometrine before the afterbirth
comes out, as this may prevent it from coming out.
Pituitrin is similar to oxytocin, but more
dangerous, and should never be used except in
a case of emergency bleeding when oxytocin,
misoprostol, and ergonovine are not available.
For bleeding in the newborn child, use vitamin K
(see p. 392). Vitamin K is of no use for bleeding of
the woman from childbirth, miscarriage, or abortion.
Ergonovine or ergometrine maleate
(Ergotrate, Methergine)
Name:_________________________________________
Often comes in:
injections of 0.2 mg. in a 1 ml. ampule
Price:_________________ for_ ___________________
tablets of 0.2 mg.
Price:_________________ for_ ___________________
Ergonovine can be used to prevent or control
severe bleeding after the placenta has come
out. It is also used to control heavy bleeding after
miscarriage or abortion.
Dosage:
To treat heavy bleeding after the afterbirth
(placenta) has come out, or after miscarriage or
abortion, give 1 ampule (0.2 mg.) of ergonovine
by intramuscular injection or 1 tablet (0.2 mg.)
by mouth. In extreme emergencies, you can give
1 ampule by intravenous injection if you have been
trained to do so. Repeat dose every 2 to 4 hours for
severe bleeding (more than 2 cups) or every 6 to
12 hours for less severe bleeding. Continue to give
the medicine until the bleeding has stopped.
To prevent heavy bleeding after giving birth, give
0.2 mg. of ergonovine after the afterbirth comes out.
Oxytocin (Pitocin)
Name:__________________ price:________ for_ ______
Often comes in: ampules of 10 units in 1 ml.
Oxytocin can be used to prevent or control
severe bleeding of the mother after the baby is
born and before or after the afterbirth comes out.
(It also helps bring the afterbirth out, but should not
be used for this unless there is severe bleeding or
great delay.) It can also be used to control heavy
bleeding after miscarriage or abortion.
Dosage:
To treat heavy bleeding, give 1 ml. (10 units)
by intramuscular injection. If severe bleeding
continues, inject another 1 ml. in 15 minutes.
To prevent heavy bleeding after birth, give 1 ml.
after the baby is born.