Summary MATERNAL AND NEWBORN PHARMACOLOGY

MATERNAL AND NEWBORN PHARMACOLOGY TOCOLYTICS Overview 1. Anti-contraction meds, labor suppressant 2. Tokos = Greek word for childbirth 3. Lytic = lysis = decline of disease/symptoms Nursing Points General 1. Use: prevent premature labor by suppressing uterine contractions a. Preterm = before 37 weeks 2. If preterm labor cannot be stopped, this class of meds will allow time for the administration of betamethasone to attempt to quickly increase lung maturity over 24-48 hours 3. Different classes of drugs 4. Different meds with different level of success rates, potential adverse reactions, research changing frequently. There is currently no first-line, go to med Nursing Considerations 1. Side-lying (preferably left) if patient can tolerate it (pressure off of vena cava, increases BP) 2. Most likely, fetal monitoring will be ordered 3. Follow your protocol/order set, which will indicate frequency of assessments, vitals, adverse reactions, I&O, etc. 4. Always monitor for potential adverse reactions and notify MD when noted 5. Thoroughly educate mother and support system about what to expect 6. Please note: magnesium sulfate is also used as a tocolytic, however there are more effective agents available. a. Current research does not support this as a tocolytic, but you may run into some old school docs that still prefer to use this. See Lesson 12.03 Examples 1. Terbutaline (Brethine) a. Class: Beta 2 adrenergic-agonist b. MOA: Cause smooth muscle relaxation c. Nursing Implications i. Most adverse effects are cardiac related ii. Can delay labor up to 48 hours, but no longer due to potential cardiac issues with NB iii. Also causes bronchodilation iv. Watch beta blocker video in pharm course d. Dose/Route i. IV, SubQ