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Ritodrine
Aka: Ritodrine, Yutopar
- See Also
- Preterm Labor Management
- Tocolytic
- Indications
- Preterm Labor
-
General
- Listed for historical reasons
- No longer available in the United States as of 2013
- Was the only FDA approved drug for Preterm LaborTocolysis
- Efficacy
- Not shown to be more effective than Placebo
- Does not reduce perinatal mortality or delay labor
- (1992) N Engl J Med 327:308-12 [PubMed]
- Contraindications
- Absolute contraindications
- Maternal cardiac disease
- Pregnancy Induced Hypertension (PIH)
- Uncontrolled Diabetes Mellitus
- Hyperthyroidism
- Hypovolemia
- Relative contraindications
- Diabetes Mellitus
- Chronic Hypertension
- Migraine Headache
- Resting Tachycardia
- Fever
- Dosing: Intravenous
- Preparation
- Mix Ritodrine 150 mg in 500 ml D5W (0.3 mg/ml)
- Results in drip of 50 mcg/minute = 10 ml/hour
- Start: 50 mcg per minute
- Increase by 50 mcg/minute every 10 minutes until
- Contractions cease
- Adverse effects limit use
- Maximum dosage: 350 mcg per minute
- After contractions stop
- Reduce by 50 mcg every 30 minutes
- Titrate dose to lowest effective Tocolytic dose
- Dosing: Oral (Not effective)
- Start: 10 mg PO every 2 hours for 24 hours
- Next: 10 to 20 mg PO every 4 to 6 hours as needed
- Adverse Effects
- Maternal Tachycardia
- Fetal Tachycardia
- Palpitations
- Anxiety
- Shortness of Breath
- Pulmonary Edema
- Headache
- Nausea or Vomiting
- Hypokalemia
- Hyperglycemia
- Cardiac ischemia
- Monitoring
- Baseline testing to consider
- Electrocardiogram
- Serum Glucose
- Serum Potassium
- Complete Blood Count
- Type and screen
- Close monitoring
- Blood Pressure for Hypertension
- Pulse for maternal Tachycardia over 100
- Follow Urine Output
- Lung Exam for signs of Pulmonary Edema
- Follow Serum Glucose and Serum Potassium
- Consider fluid restriction <2400 cc per day
- References
- Gabbe (2002) Obstetrics p. 787-91
- Roberts (1998) Procedures Emergency Medicine p. 993-5