Tocolytics - Pharm Flashcards
Tocolytics
Cause smooth muscle in the uterus to relax to stop contractions
Terbutaline Sulfate (Brethine)
Beta-agonist that works by stimulating the beta receptors in the uterus, resulting in relaxation and decreased contractions
Terbutaline sulfate (Brethine) Considerations
- Sub-Q injection or IV
- Short term - lasts 1-2hrs
Side Effects of Terbutaline
- Maternal/fetal tachycardia (hold if HR >100)
- Tremors
- Palipitations
- SOB
- Anxiety
- Pulmonary Edema
Indomethacin (Indocin)
Works by inhibiting the production of prostaglandins, which usually cause contractions
Indomethacin (Indocin) Considerations
- Short term use only <48hrs
- PO or rectal
- Only use if <32wks
- Hold if s/s pulmonary edema (wet lung sounds)
Nifedipine (Procardia)
Blocks the calcium channels in the uterine muscle cells, preventing them from contracting
Nifedipine (Procardia)
- Short term use only <48
- Given if 32-34wks
- PO
- Hold if hypotension
- Monitor FHR
Nifedipine (Procardia) Nursing Interventions
- Explain side effects
- Monitor VS, FHR, contractions
- Monitor I/Os
- Comfort measures
Magnesium Sulfate
Works by reducing the amount of calcium in the uterine muscles, which results in the relaxation and decreased contractions
Magnesium Sulfate Nursing Considerations
- Loading dose then maintenance dose
- Administer by pump
- Long term use
- Monitor VS closely
- Monitor DTR Q2H (patellar & biceps reflex)
- Monitor serum magnesium levels Q2H
Magnesium Sulfate Side Effects
- Sweating
- Flushing
- Burning at administration site
S/S of Magnesium Toxicity
- N/V
- Depressed DTR
- Flaccid paralysis (can’t lift arms)
- Hypokalemia (calcium levels too low)
- Bradycardia
- Bradypnea
Magnesium Levels
- Therapeutic: 4-7mEq/L
- Loss of DTRs: 10 mEg/L
- Resp Depression: 15 mEq/L
- Cardiac Arrest: 25 mEq/mL
Magnesium Toxicity Nursing Interventions
- Discontinue immediately if levels too high or s/s toxicity
- Have antidote at bedside at all times (Calcium gluconate)
