Uterine Relaxants (Tocolytics)
TERM
□ ritodrine (Yutopar)
QUICK LOOK AT THE CHAPTER AHEAD
Uterine relaxants, also called tocolytics, are used to treat preterm labor. Preterm labor occurs before the thirty-seventh week of pregnancy. Uterine relaxants are generally used between the twentieth and thirty-seventh week of pregnancy. They work by relaxing the smooth muscles of the uterus and preventing contractions and labor induction. This action increases the chances of fetal survival.1 Other treatment of preterm labor includes bedrest, hydration, and sedation. Although Terbutaline (Brethine) is prescribed to treat preterm labor, its use is considered off-label as the United States drug labeling does not recognize it for this use.1 Magnesium sulfate can be used to treat preterm labor but is used primarily as an anticonvulsant in pregnancy-induced hypertension. Note, nifedipine, a calcium channel blocker, and the nonsteroidal anti-inflammatory drug indomethacin may be used to treat preterm labor.
Table 59-1 Uterine Relaxants (Tocolytics) | |||||||||
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UTERINE RELAXANTS (TOCOLYTICS) CLIENT TEACHING
Instruct client on the importance of following treatment including bed rest.
Contact health care provider if membranes rupture or if contractions resume or if there is loss of fetal activity.
ACTION
All Uterine Stimulants
All uterine stimulants relax the smooth muscle of the uterus, preventing the uterus from contracting.
USE
All Uterine Stimulants
Inhibit contractions in preterm labor, usually after the 20th week of gestation
Terbutaline (Brethine)
Also used as a bronchodilator to treat asthma
Magnesium Salts
Magnesium Sulfate
Also used as an anticonvulsant in severe preeclampsia (pregnancy-induced hypertension [PIH])
Other uses: Treatment of torsades de pointes and treatment/prevention of hypomagnesemia
ADVERSE EFFECTS AND SIDE EFFECTS