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A uterotonic, also known as ecbolic, is an agent used to induce

contraction or greater tonicity of the uterus. Uterotonics are used both to


induce labor, and to reduce postpartum hemorrhage.

 These agents intensify uterine muscle contractions at the beginning


and during labor, and during the postpartum period. Oxytocin, a
hormone produced by the posterior pituitary, is a natural uterotonic.

 Uterotonic agents are used to induce labor and for elected abortions.
They lessen blood loss during childbirth and are extremely important
in the prevention and treatment of postpartum hemorrhage
1.Hemabate -generic name: carboprost

2.Mifeprex -generic name: mifepristone

3.Methergine- generic name: ethylergonovine

4.Pitocin -generic name: oxytocin

5.Cervidil- generic name: dinoprostone

6.-Korlym generic name: mifepristone

7.Prepidil -generic name: dinoprostone

8.Prostin E2 -generic name: dinoprostone

9.Syntocinon -generic name: oxytocin


1.Hemabate -generic name:
carboprost
 Condition: Abortion, Postpartum Bleeding

 Class: Prostaglandin D2 antagonists, Uterotonic


agents

 Form: Liquid solution, Intramuscular (IM)

 Ingredients: carboprost, benzyl alchohol, sodium


chloride, tromethamine, water for injections
2.Cervidil- generic name:
dinoprostone
Condition: Abortion, Labor Induction, Trophoblastic Disease

 Class: Uterotonic agents

 Form: Vaginal (e.g., douche, pessary, etc.)

 Ingredients: dinoprostone
3.Prepidil -generic name:
dinoprostone
 Condition: Abortion, Labor Induction,
Trophoblastic Disease
 Class: Uterotonic agents
 Form: Cream, gel, liniment or balm, lotion,
ointment, etc, Vaginal (e.g., douche, pessary,
etc.)
 Ingredients: dinoprostone, colloidal silicon,
dioxide, triacetin
4.PROSTIN (E2)
 Condition: Abortion, Labor Induction, Trophoblastic Disease

 Class: Uterotonic agents

 Form: Tablets
TOCOLYTICS
 Tocolytics (also called anti-contraction medications or
labor suppressants) are medications used to suppress
premature labor (from the Greek tokos, childbirth, and
lytic, capable of dissolving). They are given when
delivery would result in premature birth
 Tocolytics are medicines that attempt to stop labor. They are
used if labor begins before term. Tocolytics can stop labor or
delay labor to give the baby's lungs time to mature. If started
early in premature labor, they may be effective. They are not
as successful later in labor, if the membranes have broken,
or if your cervix is already dilated beyond 2 centimeters.
When taking this medication, PATIENT may need
hospitalization or home therapy.

 Terbutaline, ritodrine, nifedipine and magnesium sulfate are


all used as tocolytic drugs. Tocolytics are not used if the
mother has chorioamnionitis (an infection in the membranes
around the baby), abruptio placenta, severe preeclampsia or
eclampsia, cardiac disease, or other severe medical
illnesses. Tocolytics are also not used if the fetus has died in
the uterus, or if the fetus is in acute distress. Some of these
drugs are used in combination with other medications.
1.TERBUTALINE
 This medicine is used to stop preterm labor. It is also known as Brethine.

 ROUTE- a pill, through an IV (through a catheter directly into vein), as


an injection, or through a controlled infusion pump.. A subcutaneous (the
medicine is injected under skin but not directly into a vein) .

 SIDE EFFECTS- Some of the side effects can include nervousness,


restlessness, insomnia, headache, rapid heart rate, nausea,
hyperglycemia (high blood sugar) and hypokalemia (low blood
potassium). A rare but serious side effect is pulmonary edema. The baby
may also experience a fast heart rate and high or low blood sugar after
birth. The mother and baby should be monitored while taking this drug.
2.RITODRINE
This medicine is used to stop preterm labor. It acts
in a similar way to terbutaline.
ROUTE- IV. The side effects are like those of
terbutaline- history of cardiac dysrhythmias
(irregular heart rhythms) or cardiac disease,
hypertension or thyrotoxicosis (an excess of thyroid
hormones), patient should discuss this with doctor
before taking terbutaline or ritodrine.
Nifedipine: This medicine is used to
NIFEDIPINE
stop contractions. It is also called
Adalat or Procardia and is taken as a
pill. It is used to stop contractions and
delay labor, and may also be used for
occasional uterine irritability. Some of
the side effects that may occur
include facial flushing, headache,
nausea, palpitations, and
lightheadedness. No serious newborn
side effects have been noted.
4.MAGNESIUM SULFATE
This medicine can be used to stop contractions as well as in the treatment
and prevention of seizures in a patient with preeclampsia.

ROUTE- It can be taken as a pill or through an IV.

Side effects may include feelings of extreme warmth, perspiration,


flushing, nausea, vomiting, blurred vision, lightheadedness, lethargy, nasal
stuffiness and constipation. Magnesium sulfate can affect reflexes and
slow breathing. Some women report chest pain, especially if they are
taking this medicine with another of the tocolytics.

Women who have myasthenia gravis, a history of renal impairment


(kidney problems), heart block, or a history of a myocardial infarction
(heart attack) should discuss this with doctor before using magnesium
sulfate.
 Side effects usually go away within a few days. The fetus may show
a decreased baseline heart rate. A newborn who has been exposed
to magnesium sulfate may seem drowsy, have a weak cry and a
decreased sucking rate in the early postpartum period. The mother
and fetus should be monitored while on this medication.
5.INDOMETHACIN
 Indomethacin: This medicine is used to try to stop preterm labor, and
is also called Indocin.

 It can be taken as a pill or as a suppository (in the rectum).

 Side effects include abdominal discomfort, nausea, vomiting,


depression and dizzy spells for the mother. Indocin can also have
serious effects on the fetus if used long term or if the gestational age
is greater than 32-34 weeks.

 This drug may also be dangerous for the mother is she has a history
of bleeding disorders, aspirin sensitivity, or kidney problems.
6.BETAMETHASONE
 Betamethasone: This medicine is a steroid used to help the fetal
lungs develop more quickly. It is also called Celestone and is given
as an injection into muscle tissue.

 The use of betamethasone can decrease the chance that the baby
will have respiratory distress syndrome when born. It is usually used
if preterm delivery is a concern. Sometimes doctors use
dexamethasone, which is a very similar medicine.

 Side effects may include sleeplessness and higher blood sugar


levels for the mother and decreased fetal movement for the baby.
NURSING MANAGEMENT
1.ASSESS-Fetal heart tones, pulse and BP,intensity and length of
uterine contractions.

2.ADMINISTER -With meals to reduce GI upset.

3.PROVIDE-storage at room temperature, positioning of patient in left


lateral recumbent position to decrease hypotension .

4.EVALUATE-reduced uterine contractions, absence of preterm labor,


increased pulse volume,decreased BP.

5.TEACH PATIENT AND FAMILY-To notify physician if rash develops,


to make position changes slowly or fainting may occur.
TERATOGENIC DRUGS

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