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Midwife Licensure Exam Midwifery Pharmacology & Newborn Procedures — Midwifery Pharmacology — The Limited FormularyMemory Anchors

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Memory anchors for Midwifery Pharmacology — The Limited Formulary — mnemonic devices, acronyms, and tricks that make the Midwife Licensure Exam Midwifery Pharmacology & Newborn Procedures syllabus stick. Use these when a concept just will not stay in your head.

Exam context

On the Midwife Licensure Exam 2026, the Midwifery Pharmacology & Newborn Procedures subtest carries a "Core" weight in Professional Regulation Commission (PRC) — Board of Midwifery's pattern. Midwifery Pharmacology — The Limited Formulary lands at position 1st out of 4 in the standard review order. Target score is 75% weighted average, and roughly a meaningful share of items come from Midwifery Pharmacology & Newborn Procedures on a typical Midwife Licensure Exam paper.

Midwifery Pharmacology — The Limited Formulary - Memory Anchors

Memory techniques can boost recall by up to 400% compared to plain reading. The secret? Your brain loves stories, images, emotions, and connections — NOT isolated facts. For the MLE, you must know not just WHAT drugs exist, but WHO gets them, HOW MUCH, WHEN, and critically — WHEN TO REFER instead. These anchors transform dry pharmacology into vivid mental movies, colorful acronyms, and unforgettable stories. Every time you see a question about Vitamin K or MgSO4, your brain will instantly replay the story, the image, or the acronym — and the correct answer will follow. Build these anchors now, review them often, and watch your exam confidence soar!

Anchors

Topic

Oxytocics and AMTSL

Concept

AMTSL — 3 components of Active Management of the Third Stage of Labor

Anchor Id

Difficulty

easy

Memory Aid

Remember 'OCU' — Oxytocin first, Controlled cord traction second, Uterine massage third. Think of OCU as 'One Clean Uterus' — that is exactly your goal after every delivery: a clean, contracted, safe uterus. Say it fast: 'OCU! One Clean Uterus!' every time you think about the third stage.

Anchor Type

acronym

Why It Works

Acronyms create a short, reproducible mental tag that retrieves an entire list in correct sequence. The phrase 'One Clean Uterus' also encodes the PURPOSE of AMTSL, reinforcing why the steps matter.

Example Usage

Question: 'What are the three components of AMTSL?' Think OCU: Oxytocin 10 IU IM within 1 minute → Controlled cord traction with counter-pressure → Uterine massage after placenta delivery.

Recall Trigger

Third stage of labor → OCU → One Clean Uterus

Topic

Oxytocics and AMTSL

Concept

Oxytocin 10 IU IM within ONE minute of birth — after ruling out second twin

Anchor Id

Difficulty

easy

Memory Aid

Imagine Ate Midwife holding a stopwatch. The baby cries — she checks the mother's belly quickly ('Is there another baby inside? No!') and IMMEDIATELY draws up the oxytocin. She says: 'Isang minuto lang! One minute or we miss the window!' She injects the deltoid/thigh area as the clock hits 60 seconds. She wins the race against hemorrhage. Every delivery — same race, same winner.

Anchor Type

micro_story

Why It Works

Micro-stories place facts inside a narrative with emotion and urgency, making them far more memorable than a plain statement. The image of a stopwatch encodes the critical time limit.

Example Usage

Question: 'When do you give oxytocin in AMTSL?' Picture Ate Midwife's stopwatch: 1 minute after birth, after ruling out second baby — so the answer is 10 IU IM within 1 minute of delivery of the baby.

Recall Trigger

Baby is born → stopwatch → check for second twin → INJECT within 1 minute

Topic

Oxytocics and AMTSL

Concept

Oxytocin is preferred over ergometrine because it does NOT raise blood pressure

Anchor Id

Difficulty

medium

Memory Aid

Think of ergometrine as a grumpy traffic enforcer who BLOCKS all the blood vessels — he squeezes them shut, causing the BP to shoot up, like cars jammed on EDSA. Oxytocin is the calm barangay tanod who just focuses on squeezing the uterus — he does not touch the roads (blood vessels) at all. So when you do not know the mother's BP, you always call the calm tanod (oxytocin), NOT the grumpy enforcer (ergometrine).

Anchor Type

analogy

Why It Works

Analogies anchor abstract pharmacology to a vivid, locally familiar image (Manila traffic). The contrast between the two characters makes the distinction easy to remember under exam pressure.

Example Usage

Question: 'A mother has elevated BP. Which uterotonic is contraindicated?' Remember the grumpy enforcer who raises BP — that is ergometrine. Choose oxytocin instead.

Recall Trigger

Ergometrine = grumpy enforcer = raises BP → contraindicated in hypertension

Topic

Oxytocics and AMTSL

Concept

Ergometrine 0.2 mg IM — contraindicated in hypertension, pre-eclampsia, heart disease

Anchor Id

Difficulty

medium

Memory Aid

Remember 'ERGO = HEart High BP' — ERGOmetrine is contraindicated in Hypertension, Eclampsia/pre-eclampsia, and Heart disease. The word ERGO itself sounds like 'ERROR' — it is an ERROR to give it when any of these conditions exist. Spell it: E-R-G-O = Error-Raises-General-pressure-On heart.

Anchor Type

mnemonic

Why It Works

Embedding the contraindications inside the drug name itself creates an inseparable link. The word-play on 'ERROR' also triggers caution, reinforcing the 'do not give' message.

Example Usage

Question: 'Ergometrine is CONTRAINDICATED in which condition?' Think ERGO = ERROR in Hypertension, Eclampsia, Heart disease — answer: any of these three.

Recall Trigger

Ergometrine → ERROR → Hypertension, Eclampsia, Heart disease = NEVER give

Topic

Oxytocics and AMTSL

Concept

Misoprostol 600 mcg orally for AMTSL — used when NO cold chain available

Anchor Id

Difficulty

medium

Memory Aid

Picture a tiny orange tablet sitting under the blazing Philippine sun — no refrigerator in sight, no ice, no electricity. The tablet is perfectly fine because misoprostol is HEAT-STABLE. The sun's rays bounce right off it. Stamp the number 600 on the sun. That image: orange tablet + burning sun + 600 = misoprostol 600 mcg oral for AMTSL in remote/no-cold-chain settings.

Anchor Type

visual_association

Why It Works

Visual associations anchor numeric doses and drug properties to a single, striking mental image. The burning sun is unforgettable and encodes both the setting (remote BHS) and the key advantage (heat-stable).

Example Usage

Question: 'A midwife is at a remote BHS with no cold chain. What uterotonic does she use for AMTSL?' Picture the sun and orange tablet — misoprostol 600 mcg orally.

Recall Trigger

No refrigerator, remote BHS, burning sun → orange tablet → 600 mcg oral misoprostol

Topic

PPH management

Concept

PPH priority actions — refer, massage, oxytocin, empty bladder, check tears

Anchor Id

Difficulty

medium

Memory Aid

When the blood won't stop, shout 'ROMEO Call!' — R: Refer/call for help, O: Oxytocin (give it!), M: Massage the uterus, E: Empty the bladder, O: Open for tears (check for lacerations). ROMEO is a Filipino love story, and you are SAVING the mother's life — the ultimate love act. R-O-M-E-O: Refer, Oxytocin, Massage, Empty bladder, Open/check for tears.

Anchor Type

acronym

Why It Works

The name ROMEO is emotionally loaded and culturally familiar to Filipinos, making it instantly retrievable under exam stress. The love-story framing also signals life-saving urgency.

Example Usage

Question: 'What are the priority actions of a midwife for postpartum hemorrhage?' Think ROMEO: Refer, Oxytocin, Massage, Empty bladder, Open/check tears.

Recall Trigger

PPH → ROMEO → Refer, Oxytocin, Massage, Empty bladder, Open for tears

Topic

Newborn drugs — Vitamin K

Concept

Vitamin K1 (phytomenadione): 1 mg IM for term (≥1.5 kg), 0.5 mg IM for preterm (<1.5 kg) — given in the anterolateral thigh

Anchor Id

Difficulty

easy

Memory Aid

Sing to any simple tune: 'Big baby full-term, one whole milligram — tiny preterm baby, half is all you can. Shoot it in the thigh, the vastus lateralis — Vitamin K for VKDB, prevention is the basis!' The contrast BIG = 1 mg vs TINY = 0.5 mg is encoded in the song, and 'thigh' locks in the injection site.

Anchor Type

rhyme

Why It Works

Rhymes and rhythm engage auditory memory, which is independent of visual memory — giving the brain two retrieval pathways. The size contrast (big vs tiny) makes the dose difference intuitive.

Example Usage

Question: 'A 1.2 kg preterm infant is born. What dose of Vitamin K1 is given and where?' Sing the rhyme: tiny baby = 0.5 mg IM, in the thigh (vastus lateralis).

Recall Trigger

Newborn injection → rhyme → big baby 1 mg, tiny baby 0.5 mg, in the thigh

Topic

Newborn drugs — Eye prophylaxis

Concept

Eye prophylaxis: erythromycin 0.5% ophthalmic ointment — do NOT irrigate afterward

Anchor Id

Difficulty

easy

Memory Aid

Imagine the newborn finally doing skin-to-skin with Nanay — eye contact, bonding, first love. THEN the midwife applies a thin ribbon of erythromycin ointment in each lower conjunctival sac, sealing in the protection like a tiny invisible shield. A nurse's aide reaches for a saline flush — Ate Midwife stops her: 'HUWAG! Do not wash it away! The shield must stay!' The ointment stays. The baby's eyes are protected from gonorrhea and chlamydia forever.

Anchor Type

micro_story

Why It Works

The story encodes the drug, the timing (AFTER bonding), the technique (ribbon in lower sac), and the critical prohibition (no irrigation) in a single narrative with emotional weight.

Example Usage

Question: 'After applying erythromycin eye ointment, what should the midwife NOT do?' Remember 'HUWAG!' — do not irrigate the eyes. The ointment must remain.

Recall Trigger

After skin-to-skin → ointment → 'HUWAG irrigate!'

Topic

Micronutrients — Iron and Folic Acid

Concept

Iron + Folic Acid: 60 mg iron + 400 mcg folic acid once daily throughout pregnancy + 3 months postpartum

Anchor Id

Difficulty

easy

Memory Aid

Chunk it as '60-400-3': 60 mg iron, 400 mcg folate, 3 months postpartum. Say it like a Filipino street vendor chant: 'Anim-na-pu, apat-na-raan, tatlong buwan!' (60, 400, 3 months). That rhythmic Filipino chant fires up faster than any English sentence under exam pressure.

Anchor Type

chunking

Why It Works

Chunking reduces cognitive load by grouping three numbers into one memorable unit. Using Tagalog engages cultural-linguistic memory pathways that are deeply embedded for Filipino students.

Example Usage

Question: 'What is the standard iron-folic acid dose for a pregnant woman?' Recall the chant: 60 mg iron + 400 mcg folic acid, continued 3 months postpartum.

Recall Trigger

Iron supplement → Filipino chant → 60 iron, 400 folate, 3 months post

Topic

Micronutrients — Vitamin A

Concept

High-dose Vitamin A is CONTRAINDICATED in pregnancy (teratogenic); postpartum dose is 200,000 IU

Anchor Id

A10

Difficulty

medium

Memory Aid

Think of high-dose Vitamin A as a 'pasaway na bisita' (troublesome visitor) during pregnancy. The baby's developing organs are delicate — and this visitor, if let in during pregnancy, causes birth defects (teratogenicity). So the door is LOCKED during pregnancy. But AFTER the baby is born (postpartum), the door opens and the visitor gives the mother a 200,000 IU gift capsule. Lock during pregnancy, open after birth.

Anchor Type

analogy

Why It Works

The familiar Filipino concept of a pasaway na bisita (troublesome guest who should not enter) creates a vivid emotional image of why Vitamin A is kept OUT during pregnancy. The 'gift after birth' anchors the postpartum dose.

Example Usage

Question: 'A pregnant woman asks for Vitamin A supplementation. What do you do?' Remember the locked door — high-dose Vitamin A is contraindicated in pregnancy. It is given postpartum (200,000 IU) only.

Recall Trigger

Vitamin A + pregnant = LOCKED door; postpartum = 200,000 IU gift

Topic

Immunization — Tetanus Toxoid

Concept

Tetanus Toxoid schedule: TT1–TT5, with TT2 protecting the current pregnancy, TT5 giving lifetime protection

Anchor Id

A11

Difficulty

medium

Memory Aid

Remember 'Two Protects, Five for Life' — TT2 gives the FIRST real protection (that pregnancy is safe), and TT5 means LIFETIME coverage. Think of it as a loyalty card: by your second stamp (TT2) you get your first reward; by the fifth stamp (TT5) you are a lifetime member. The card numbers are 4-weeks, 6-months, 1-year, 1-year gaps between TT2-3, TT3-4, TT4-5.

Anchor Type

mnemonic

Why It Works

The loyalty card analogy is instantly familiar to Filipinos who use coffee shop or grocery reward cards. It transforms an abstract schedule into a reward-based progression that feels natural to follow.

Example Usage

Question: 'A pregnant woman received TT2 last month. Is her current baby protected from neonatal tetanus?' Yes — TT2 protects for approximately 3 years and covers the current pregnancy.

Recall Trigger

Tetanus toxoid → loyalty card → 2nd stamp = first reward, 5th stamp = lifetime member

Topic

Family Planning — Injectables

Concept

DMPA: 150 mg IM every 3 months — preferred over COCs in breastfeeding women

Anchor Id

A12

Difficulty

medium

Memory Aid

Picture a big calendar with every 3rd month circled in red, and a nursing mother breastfeeding her baby at the center. The circled months = every 3 months for DMPA injection (150 mg). The nursing mother = DMPA and POPs are preferred in breastfeeding because COCs (combined = estrogen) reduce milk supply. Stamp '150' on the syringe in the mother's hand. One image: nursing mother + quarterly calendar + 150 mg syringe.

Anchor Type

visual_association

Why It Works

Layering multiple facts (frequency, dose, preferred population) into one unified visual image allows simultaneous recall of all three facts with a single mental trigger.

Example Usage

Question: 'A breastfeeding mother wants injectable contraception. What is the correct drug and schedule?' Picture nursing mother + calendar = DMPA 150 mg IM every 3 months.

Recall Trigger

Breastfeeding mother + quarterly calendar + syringe = DMPA 150 mg every 3 months

Topic

Emergency — MgSO4 for Eclampsia

Concept

MgSO4 loading dose: 4 g IV slow + 10 g IM (5 g each buttock), mixed with lignocaine IM

Anchor Id

A13

Difficulty

hard

Memory Aid

Remember '4 + 10 = SAVE HER': 4 g IV slow over 5-20 minutes (slowly, like 'patience saves lives') PLUS 10 g IM total (5 g in each buttock — 'bilateral buttock blast'). The lignocaine mixed in the IM = 'the painkiller with the lifesaver.' Chunk: 4 IV + 5L + 5R = 14 grams total loading, then REFER. Write it on your palm mentally: 4 top (IV), 5 left, 5 right (IM).

Anchor Type

chunking

Why It Works

Chunking the loading dose into a body diagram (top/left/right) exploits spatial memory. The nickname 'bilateral buttock blast' adds humor that makes it impossible to forget.

Example Usage

Question: 'What is the MgSO4 loading dose for eclampsia?' Think 4 top (IV) + 5L + 5R IM: 4 g IV slow + 5 g each buttock (10 g IM), mixed with lignocaine. Then refer.

Recall Trigger

Eclampsia → 4 top (IV) + 5 left + 5 right (IM) → total 14 g loading → REFER

Topic

Emergency — MgSO4 monitoring

Concept

MgSO4 toxicity monitoring: RR ≥12/min, Urine ≥30 mL/hr, Patellar reflexes present

Anchor Id

A14

Difficulty

hard

Memory Aid

Remember 'RUP before you top up' — before giving or continuing MgSO4, always check RUP: R = Respiratory rate (must be ≥12), U = Urine output (must be ≥30 mL/hr), P = Patellar reflex (must be PRESENT). If any part of RUP fails, STOP MgSO4. It is like asking 'Is the RUP (roof) still solid before we pour more concrete?' If the roof is cracking, STOP.

Anchor Type

acronym

Why It Works

RUP is a Filipino-sounding word, and the roof analogy creates an architectural image where 'pouring more' (giving more MgSO4) requires a safe structure (RUP intact). Negative consequences of ignoring it (roof collapse = respiratory arrest) reinforce the stakes.

Example Usage

Question: 'Before giving MgSO4 maintenance, what do you assess?' Think RUP: Respiratory ≥12, Urine ≥30 mL/hr, Patellar reflex present. If any fails → STOP and give antidote.

Recall Trigger

MgSO4 → check RUP → Respiratory rate, Urine output, Patellar reflex

Topic

Emergency — MgSO4 antidote

Concept

MgSO4 antidote: Calcium gluconate 1 g (10 mL of 10% solution) slow IV

Anchor Id

A15

Difficulty

hard

Memory Aid

Think of MgSO4 as a strong fire hose blasting away the seizure — useful, but if it over-blasts, it can drown the patient (respiratory arrest). Calcium gluconate is the OFF-SWITCH — it neutralizes the magnesium overdose like turning off the water supply. Dose: 1 gram = 10 mL of 10% = 'one, ten, ten' — 1 g / 10 mL / 10% solution. Give it SLOW IV or the heart may complain.

Anchor Type

analogy

Why It Works

The fire hose analogy gives MgSO4 a visual role (powerful but dangerous), and the OFF-SWITCH clearly signals calcium gluconate's antidote function. '1-10-10' is a rhythm chunk for the dose.

Example Usage

Question: 'A woman on MgSO4 develops respiratory rate of 8/min. What do you give?' OFF-SWITCH = calcium gluconate 1 g (10 mL of 10% solution) slow IV.

Recall Trigger

MgSO4 overdose → OFF-SWITCH → calcium gluconate → 1-10-10 (1 g, 10 mL, 10%)

Topic

Prohibited acts — Labor augmentation

Concept

Oxytocin for INDUCTION/AUGMENTATION of labor is a PHYSICIAN act — midwife must NEVER give it before the baby is born

Anchor Id

A16

Difficulty

medium

Memory Aid

Story: A midwife once thought, 'Mabagal ang dating ng baby, i-speed up ko na!' (The baby is coming slowly, let me speed things up!) She reaches for the oxytocin drip. Suddenly, she hears the voice of her supervisor: 'TIGIL! That is not your lane! Oxytocin to speed labor is the DOCTOR'S order, not yours! You can cause uterine rupture and kill the baby!' She puts it down. She REFERS. Lesson burned forever: before the baby is born, oxytocin drip = DOCTOR'S ORDER ONLY.

Anchor Type

micro_story

Why It Works

The forbidden action scenario with a dramatic consequence (uterine rupture, baby death) creates an emotionally charged memory. Filipino students relate to the 'baka magkamali ako' (I might make a mistake) anxiety, making the correction stick.

Example Usage

Question: 'A woman has been in active labor for 10 hours with slow progress. The midwife considers starting oxytocin. Is this appropriate?' NO — augmentation of labor is a physician act. The midwife must REFER.

Recall Trigger

Oxytocin before birth → TIGIL → doctor's order → refer, do not augment labor

Topic

Scope of practice — Formulary limits

Concept

The midwife's formulary principle: if the drug TREATS A DISEASE/COMPLICATION, it is outside the formulary — REFER

Anchor Id

A17

Difficulty

medium

Memory Aid

Think of the midwife's formulary as a BARANGAY HEALTH KIT — it contains tools for NORMAL events: preventing PPH, preventing anemia, preventing tetanus, giving birth safely. If someone in the barangay needs treatment for a complication — heart attack, seizure management, infection therapy — they must be brought to the HOSPITAL. The kit was never meant for hospital-level problems. If the drug is treating a DISEASE, it goes to the hospital.

Anchor Type

analogy

Why It Works

The barangay health kit analogy is culturally grounded and perfectly mirrors the community-based scope of midwifery practice. It creates a clear mental boundary: prevention/normal = BHS, treatment/complication = hospital.

Example Usage

Question: 'A postpartum woman develops signs of UTI. Should the midwife prescribe antibiotics?' The antibiotic treats a disease — outside the barangay kit — REFER to the physician.

Recall Trigger

Drug treats disease? → NOT in the barangay kit → REFER

Topic

Immunization — Tetanus Toxoid

Concept

Td vaccine: 0.5 mL IM into the deltoid; given to pregnant women to prevent maternal and neonatal tetanus

Anchor Id

A18

Difficulty

easy

Memory Aid

Picture a pregnant woman flexing her bicep (deltoid muscle) with a tiny shield symbol on it labeled '0.5 mL Td'. Below her, a tiny newborn is also wearing the same shield — because the antibodies cross the placenta and protect the baby too. The shield has '5 stamps' on it (TT1-TT5), and the last stamp glows with 'LIFETIME PROTECTION.' One image tells you: deltoid, 0.5 mL, mother-and-baby protection, five-dose schedule.

Anchor Type

visual_association

Why It Works

Layering multiple facts (site, volume, who is protected, total doses) into one image leverages the picture superiority effect — images are recalled up to 65% better than words alone.

Example Usage

Question: 'How many doses of tetanus toxoid give lifetime protection, and what is the volume and site?' Remember the 5-stamp shield on the deltoid: 5 doses (TT5), 0.5 mL IM, deltoid.

Recall Trigger

Pregnant woman + flexed arm + shield = Td 0.5 mL deltoid, 5-dose = lifetime

Topic

Family Planning — Contraceptive choice

Concept

COCs are not first choice in breastfeeding women (estrogen reduces milk supply); POPs and DMPA are preferred

Anchor Id

A19

Difficulty

medium

Memory Aid

Remember 'COC DRIES the milk' — COC (combined oral contraceptive) contains Estrogen which Reduces Iyak ng Sanggol (baby's cry for milk because supply drops). DMPA and POP = 'Progestin-Only = Pumipiga ng SAFE' (safely squeezes — progestin-only methods do not reduce milk supply). Short: 'COC DRIES, POP SUPPLIES.' When breastfeeding, choose POP or DMPA.

Anchor Type

mnemonic

Why It Works

The Filipino-English hybrid phrase 'COC DRIES, POP SUPPLIES' is phonetically catchy and uses vivid consequences (baby crying from hunger) to reinforce clinical importance.

Example Usage

Question: 'Which oral contraceptive is preferred in an exclusively breastfeeding mother?' COC DRIES the milk — avoid COC, give POP (progestin-only pill) or DMPA instead.

Recall Trigger

Breastfeeding + contraception → COC DRIES → choose POP or DMPA

Topic

Safe medication administration

Concept

The 7 Rights of Medication Administration

Anchor Id

A20

Difficulty

easy

Memory Aid

Remember 'PDDRRTA': Patient, Drug, Dose, Route, Time, Right documentation, Allergies and expiry. Or use the mnemonic 'Puede Daw Dito, Recto Route, Tara na!' — a Tagalog-flavored phrase meaning the nurse is giving medication correctly step by step. P-D-D-R-R-T-A. Always check ALLERGY first before injecting anything.

Anchor Type

acronym

Why It Works

Using a Tagalog sentence fragment as a mnemonic creates a culturally unique memory hook that stands out from other pharmacology mnemonics and is instantly memorable to Filipino students.

Example Usage

Question: 'What are the rights of medication administration the midwife must observe?' Think PDDRRTA: Right Patient, Drug, Dose, Route, Time, Documentation, and check for Allergies and expiry.

Recall Trigger

Before giving any drug → PDDRRTA → Patient, Drug, Dose, Route, Time, Record, Allergy

Revision Game

Oxytocin 10 IU IM

Clue

I am the first drug given after a baby is born — within exactly ONE minute, into the muscle, to keep the uterus tight. I do not touch blood pressure at all. What am I?

Memory Link

A2 — Ate Midwife's stopwatch story

Ergometrine 0.2 mg IM — contraindicated in hypertension because it causes vasoconstriction and raises BP

Clue

I am the grumpy traffic enforcer who squeezes all the blood vessels and raises blood pressure. I am only called when oxytocin cannot come. What am I, and why should you NEVER call me when the mother has high BP?

Memory Link

A3 — EDSA traffic analogy

Vitamin K1 (phytomenadione): 1 mg term, 0.5 mg preterm IM; prevents VKDB (Vitamin K Deficiency Bleeding)

Clue

I am a Vitamin that protects newborn blood from leaking. My dose depends on the baby's size: full-term gets ONE of me, preterm gets HALF. I go into the baby's thigh. What deficiency do I prevent?

Memory Link

A7 — Big baby/small baby rhyme

Misoprostol 600 mcg orally

Clue

I live happily under the blazing Philippine sun without a refrigerator. I come in an oral dose of 600 micrograms for AMTSL. I am the heat-stable option for the remote BHS midwife. Who am I?

Memory Link

A5 — Orange tablet under the sun visual

Calcium gluconate 1 g (10 mL of 10% solution) slow IV — antidote for MgSO4 toxicity

Clue

The RUP is cracking — the mother's breathing is only 8 times a minute, her knee-jerk is gone. You must give the OFF-SWITCH immediately. What do you inject, how much, and at what concentration?

Memory Link

A15 — Off-switch analogy and 1-10-10 chunk

Vitamin A — high-dose is contraindicated in pregnancy (teratogenic); postpartum dose is 200,000 IU

Clue

I am PROHIBITED during pregnancy because I cause birth defects (I am teratogenic) at high doses. But after the baby is born, I come as a 200,000 IU capsule gift. What vitamin am I, and what is the rule about me during pregnancy?

Memory Link

A10 — Pasaway na bisita analogy

DMPA 150 mg IM every 3 months (or POP progestin-only pill) — preferred over COC in breastfeeding because COC contains estrogen which reduces milk supply

Clue

A breastfeeding Nanay wants to prevent pregnancy. She asks about the pill. You think: COC DRIES — so what do you recommend instead, and at what dose and frequency?

Memory Link

A12 and A19 — Nursing mother quarterly calendar and COC DRIES mnemonic

R: Refer/call for help; O: Oxytocin; M: Massage uterus; E: Empty bladder; O: Open/check for tears

Clue

I am the ROMEO of emergency midwifery. When the blood will not stop after delivery, my five letters tell you exactly what to do first, second, third, fourth, and fifth. What does each letter of ROMEO stand for?

Memory Link

A6 — ROMEO PPH mnemonic

0.5 mL = standard volume per dose; IM deltoid = injection site; 5 doses total = complete immunization; intervals: TT2 ≥4 weeks after TT1, TT3 ≥6 months after TT2, TT4 ≥1 year after TT3, TT5 ≥1 year after TT4

TT1: First contact in pregnancy — no protection yet
TT2: ≥4 weeks after TT1 — protects current pregnancy (~3 years)
TT3: ≥6 months after TT2 — ~5 years protection
TT4: ≥1 year after TT3 — ~10 years protection
TT5: ≥1 year after TT4 — lifetime protection

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Mandated Newborn Procedures by the Midwife

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Midwife Licensure Exam Midwifery Pharmacology & Newborn Procedures — Midwifery Pharmacology — The Limited FormularyMemory Anchors

Exam context

Midwifery Pharmacology — The Limited Formulary - Memory Anchors

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