Obstetrics Book

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RitodrineAka: Yutopar

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  1. See Also
    1. Preterm Labor Management
    2. Tocolytic
  2. Indications
    1. Preterm Labor
  3. General
    1. Only FDA approved drug for Preterm Labor Tocolysis
  4. Efficacy
    1. Not shown to be more effective than Placebo
      1. Does not reduce perinatal mortality or delay labor
      2. (1992) N Engl J Med 327:308
  5. Contraindications
    1. Absolute contraindications
      1. Maternal cardiac disease
      2. Pregnancy Induced Hypertension (PIH)
      3. Uncontrolled Diabetes Mellitus
      4. Hyperthyroidism
      5. Hypovolemia
    2. Relative contraindications
      1. Diabetes Mellitus
      2. Chronic Hypertension
      3. Migraine Headache
      4. Resting tachycardia
      5. Fever
  6. Dosing: Intravenous
    1. Preparation
      1. Mix Ritodrine 150 mg in 500 ml D5W (0.3 mg/ml)
      2. Results in drip of 50 mcg/minute = 10 ml/hour
    2. Start: 50 mcg per minute
    3. Increase by 50 mcg/minute every 10 minutes until
      1. Contractions cease
      2. Adverse effects limit use
      3. Maximum dosage: 350 mcg per minute
    4. After contractions stop
      1. Reduce by 50 mcg every 30 minutes
      2. Titrate dose to lowest effective Tocolytic dose
  7. Dosing: Oral (Not effective)
    1. Start: 10 mg PO every 2 hours for 24 hours
    2. Next: 10 to 20 mg PO every 4 to 6 hours as needed
  8. Adverse Effects
    1. Maternal Tachycardia
    2. Fetal Tachycardia
    3. Palpitations
    4. Anxiety
    5. Shortness of Breath
    6. Pulmonary edema
    7. Headache
    8. Nausea or Vomiting
    9. Hypokalemia
    10. Hyperglycemia
    11. Cardiac ischemia
  9. Monitoring
    1. Baseline testing to consider
      1. Electrocardiogram
      2. Serum Glucose
      3. Serum Potassium
      4. Complete Blood Count
      5. Type and screen
    2. Close monitoring
      1. Blood Pressure for Hypertension
      2. Pulse for maternal tachycardia over 100
      3. Follow urine output
      4. Lung exam for signs of pulmonary edema
      5. Follow Serum Glucose and Serum Potassium
      6. Consider fluid restriction <2400 cc per day
  10. References
    1. Gabbe (2002) Obstetrics p. 787-91
    2. Roberts (1998) Procedures Emergency Medicine p. 993-5

Ritodrine (C0035661)

Definition (MSH)Adrenergic beta-agonist used to control premature labor.
Definition (NCI)A phenethylamine derivative with tocolytic activity. Ritodrine binds to and activates beta-2 adrenergic receptors of myometrial cells in the uterus, which decreases the intensity and frequency of uterine contractions. Specifically, ritodrine probably activates adenyl cyclase, thereby increasing production of cyclic adenosine monophosphate (cAMP), which in turn enhances the efflux of calcium from vascular smooth muscle cells. A lack of intracellular calcium prevents uterine myometrial contractions. In addition, this agent may directly inactivate myosin light chain kinase, a critical enzyme necessary for the initiation of muscle contractions.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD012312
EnglishRitodrine, RITODRINE PREPARATION
Spanishritodrina
Parent ConceptsEthanolamines (C0014983), Phenethylamines (C0031399), Propanolamines (C0033442), Adrenergic beta-Agonists (C0001644), [AU100] SYMPATHOMIMETICS (ADRENERGICS) (C0973492), Selective beta-2 adrenoceptor stimulants (C0354671)
SourcesAOD, LCH, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Yutopar (C0043440)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD012312
EnglishAstra Brand of Ritodrine Hydrochloride, Janssen Brand of Ritodrine Hydrochloride, Pre Par, Pre-Par, PrePar, Solvay Brand of Ritodrine Hydrochloride, Yutopar
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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