What drugs are tocolytics?
Several different classes of drugs are used for tocolysis, including:
- Betamimetics (such as terbutaline)
- Magnesium sulfate.
- Prostaglandin inhibitors (like indomethacin, ketorolac)
- Calcium channel blockers (such as nifedipine)
- Nitrates (like nitroglycerine)
- Oxytocin receptor blockers (such as atosiban)
What is tocolytic therapy used for?
Tocolysis is an obstetrical procedure carried out with the use of medications with the purpose of delaying the delivery of a fetus in women presenting preterm contractions. These medications are administered with the hope of decreasing fetal morbidity and mortality.
What is tocolytics in pregnancy?
Tocolytics are medicines that are used to slow or stop the contractions of a woman’s uterus during pregnancy. They are typically given to women who are in preterm labour to try to delay birth for 1 to 2 days.
Which tocolytic is used in eclampsia?
Intravenous magnesium sulfate (“tocolytic therapy”) is used to treat preterm labor, pre-eclampsia, and eclampsia.
What is the best tocolytic?
Prostaglandin inhibitors and calcium channel blockers were the tocolytics with the best probability of being ranked in the top three medication classes for the outcomes of 48 hour delay in delivery, respiratory distress syndrome, neonatal mortality, and maternal side effects (all cause).
When do you give tocolytics?
Tocolytic medications for preterm labor aren’t used before 24 weeks of pregnancy. In certain situations, your doctor may use it when you are at 23 weeks of pregnancy. Many doctors stop giving tocolytics after a woman has reached her 34th week of pregnancy, but some doctors begin tocolytics as late as 36 weeks.
Is oxytocin a tocolytic?
Peptide OTR Antagonists. Selective human oxytocin receptors antagonists have also been synthesized as tocolytic agents for the management of preterm labor.
Why is nifedipine used in pregnancy?
Nifedipine is an effective drug to treat severe hypertension in pregnancy and preterm labour. Because it is given in a tablet or capsule by mouth, it is easier to use than intravenous drugs. The described side effects of nifedipine to the pregnant woman and her infant appear minimal.
How do you use tocolysis with nifedipine?
Initial dose 20 mg orally stat. If contractions persist after 30 minutes further 20 mg orally may be given at 30 min intervals for a further two doses. Maintenance 20-40 mg orally qid for up to 48 hours. NOTE: MAXIMAL DOSE IS 160 mg per day.
What are contraindications of tocolytics?
General contraindications to tocolytic therapy include severe preeclampsia, placental abruption, intrauterine infection, advanced cervical dilation, and evidence of fetal compromise or placental insufficiency.
What drug relaxes the uterus?
Doctors may try to stop or delay preterm labor by administering a medication called terbutaline (Brethine). Terbutaline is in a class of drugs called betamimetics. They help prevent and slow contractions of the uterus. It may help delay birth for several hours or days.
Why is labetalol used in pregnancy?
Labetalol and pregnancy
It’s important to treat high blood pressure during pregnancy. This will help you and your baby to stay healthy. You can take labetalol while you are pregnant. Labetalol can affect the baby’s growth in the womb so you may be offered extra scans to check that your baby is growing OK.
Does nifedipine stop labor?
How effective is nifedipine? Nifedipine can reduce the number and frequency of contractions, but its effect and how long it lasts varies from one woman to another. Like all tocolytic medications, CCBs don’t prevent or delay preterm delivery for a significant period.
Why is nifedipine no longer used?
Nifedipine, a dihydropyridine calcium channel blocker, was once one of the most widely used medications for hypertension, but safety and tolerability concerns along with the introduction of new classes of antihypertensive medications and an increasing pool of data showing mortality benefit of other classes caused …
What is the most common side effect for tocolytics?
Side effects: Tachycardia, hypotension, palpitations, shortness of breath, chest pain, pulmonary edema, hypokalemia, hyperglycemia. Contraindications include tachycardia-sensitive maternal cardiac conditions.
Which drug induces uterine contractions?
Oxytocin is a medicine given through your veins (IV or intravenous) to either start your contractions or make them stronger. A small amount enters your body through the vein at a steady rate. The dose may be slowly increased as needed.
Does Progesterone relax uterus?
Progesterone relaxes the uterus during pregnancy, resulting in retention of the fetus. A recent study in mice uncovers a molecular pathway through which progesterone indirectly inhibits contraction-associated proteins during pregnancy.
What is the drug of choice for hypertension in pregnancy?
Methyldopa is a drug of first choice for control of mild to moderate hypertension in pregnancy and is the most widely prescribed antihypertensive for this indication in several countries, including the US and the UK.
Does nifedipine affect baby?
If your doctor or health visitor says your baby is healthy, it’s OK to take nifedipine while you’re breastfeeding. Nifedipine passes into breast milk in very small amounts and has not been known to cause side effects in breastfed babies.
Why is nifedipine given to a pregnant woman?
Calcium channel blockers (CCBs), commonly used to reduce blood pressure, can also be used to relax uterine contractions and postpone a preterm birth. A common CCB for this purpose is nifedipine (Procardia).
What is the best substitute for nifedipine?
Nisoldipine appears to be an effective substitute treatment for nifedipine in severely hypertensive patients sensitive or resistant to nifedipine.
When should you not take nifedipine?
Nifedipine capsules (Procardia) should not be taken within the first week or two after a heart attack.
What is a contraindication for tocolysis?
Which of the following are uterine relaxants?
Uterine relaxants include selective β2-adrenoceptor agonists, calcium channel blockers, cyclooxygenase inhibitors and oxytocin receptor antagonists; and the indication for all of them is the same: prevention or arrest of preterm labor.
Which hormone relaxes the uterus?
Relaxin is a hormone produced by the ovary and the placenta with important effects in the female reproductive system and during pregnancy. In preparation for childbirth, it relaxes the ligaments in the pelvis and softens and widens the cervix.