Idaho Administrative Code
Title IDAPA 24 - Occupational and Professional Licenses, Division of
Rule 24.26.01 - RULES OF THE IDAHO BOARD OF MIDWIFERY
Section 24.26.01.200 - USE OF FORMULARY DRUGS

Drug

Indication

Dose

Route of Administration

Duration of Treatment

Oxygen

Maternal/Fetal Distress Neonatal Resuscitation

10-12 L/min. 10L/min. 10-12L/min. 10L/min.

Bag and mask Mask Bag and mask Mask

Until maternal/fetal stabilization is achieved or transfer to hospital is complete Until stabilization is achieved or transfer to a hospital is complete

Oxytocin (Pitocin)

Postpartum hemorrhage only

10 Units/ml

Intramuscularly only

1-2 doses Transport to hospital required if more than two doses are administered

Lidocaine HCl 2%

Local anesthetic for use during postpartum repair of lacerations or episiotomy

Maximum 50 ml

Percutaneous 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

Birth of baby

Methegrine (Methylergonovine)

Postpartum hemorrhage only

0.2mg/ml

Intramuscularly only 1 dose

Transport to hospital required if single dose does not stop hemorrhage

Ampicillin Sodium (Alternative)

Group B Strep Prophylaxis

2 grams initial dose, then 1 gram every 4 hours until birth

IV in >100 ml NS or LR

Birth of baby

Cefazolin Sodium (drug of choice for penicillin allergy with low risk for anaphylaxis)

Group B Strep Prophylaxis

2 grams initial dose, then 1 gram every 8 hours

IV in > 100 ml LR, NS or D5LR

Birth of baby

Clindamycin Phosphate (drug of choice for penicillin allergy with high risk for anaphylaxis)

Group B Strep Prophylaxis

900 mg every 8 hours

IV in >100 ml NS (not LR)

Birth of baby

Epinephrine HCl 1:1000

Treatment or post-exposure prevention of severe allergic reactions

0.3 ml

Subcutaneously or intramuscularly

Every 20 minutes or until emergency medical services arrive Administer first dose then immediately request emergency services

Lactated Ringer's (LR) 5% Dextrose in Lactated Ringer's solution (D5LR) 0.9% Sodium Chloride (NS) Sterile Water

To achieve maternal stabilization Reconstitution of antibiotic powder

I - 2 liter bags First liter run in at a wide-open rate, the second liter titrated to client's condition As directed

Intravenously with >18 gauge catheter As directed

Until maternal stabilization is achieved or transfer to a hospital is complete Birth of Baby

Cytotec (Misoprostol)

Postpartum hemorrhage only

800 mcg

Rectally is the preferred method Orally is allowed

1-2 doses Transport to hospital required if more than one dose is administered

Rho(d) Immune Globulin

Prevention of Rho (d) sensitization in Rho (d) negative women

300 mcg

Intramuscularly

Single dose at any gestation for Rho (d) negative, antibody negative women within 72 hours of spontaneous bleeding or abdominal trauma.

Single dose at 26-28 weeks gestation for Rho (d) negative, antibody negative women Single dose for Rho (d) negative, antibody negative women within 72 hours of delivery of Rho (d) positive infant, or infant with unknown blood type

Phytonadione

Prophylaxis for Vitamin K Deficiency Bleeding

1 mg

Intramuscularly

1 dose

0.5% Erythromycin Ophthalmic Ointment

Prophylaxis of Neonatal Ophthalmia

1 cm ribbon in each eye

Topical

1 dose