Tocolytic Therapy for the Management of Preterm Labor

Medication

Mechanism of action

adrenergic receptor agonist sympathomimet ic; decreases free intracellular calcium ions

2.5 to 5 pg/min; increased by 2.5 to 5 pg/min every 20 to 30 minutes to a maximum of 25 pg/min, or until the contractions have abated. 0.25 mg sub-cutaneously every 20 to 30 minutes for up to four doses or until tocolysis is achieved. 0.25 mg every 3 to 4 hours.

Nifedipi ne

(Procar dia)

Calcium channel blocker

30 mg orally, followed by 20 mg orally in 90 minutes, followed by 20 mg orally every four to eight hours.

ei m

Prostaglandin inhibitor

50- to 100-mg rectal suppository, then 25 to 50 mg orally every six hours

Complications Associated With the Use of

Tocolytic Agents

Beta-adrenergic agents

Indomethacin (Indocin)

• Renal failure

• Hypokalemia

• Hepatitis

• Hyperglycemia

• Gastrointestinal

• Hypotension

bleeding

• Pulmonary edema

Nifedipine (Procardia)

• Arrhythmias

• Transient hypotension

• Cardiac insufficiency

• Myocardial ischemia

• Maternal death

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