ACTIVE LEARNING TEMPLATE:
Medication
Fredy Ortiz
STUDENT NAME______________________________________
Tocolytic
MEDICATION___________________________________________________________________________
REVIEW MODULE CHAPTER____________
CATEGORY CLASS__tocolytic/adrenergics
_____________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Stimulates beta-adrenergic receptors in the
uterus, resulting in uterine relaxation.
Therapeutic Use
Decreased intensity and frequency of
premature uterine contractions.
Complications
CNS: headache, anxiety, nervousness
CV: Pulmonary Edema, angina, hypotension, tachycardia (maternal and fetal)
GI: nausea, vomiting, drug-induced hepatitis
Derm: erythema
Hemat: agranulocytosis, leukopenia
Endo: hyperglycemia
Neuro: tremors
Medication Administration
IV (Adults): 50–100 mcg/min,
increased q 10 min by 50 mcg/min
until desired response is obtained
or maternal heart rate reaches 130
bpm, followed by maintenance
infusion at 150–350 mcg/min.
Contraindications/Precautions
Hypersensitivity,Cardiovascular disease or uncontrolled hypertension,
Uncontrolled hyperthyroidism, Pheochromocytoma, Chorioamnionitis,
Hypovolemia, Pulmonary hypertension, Eclampsia,Intrauterine fetal death or
nonreassuring fetal status, Pregnancy less than 20 weeks.
Abruptio placentae or placenta previa, Pre-eclampsia, Hypertension, History
of migraine headache, Diabetes mellitus.
Interactions
Corticosteroids may increase the risk of hyperglycemia or fluid
retention.
Additive adrenergic effects may occur with sympathomimetics or
other adrenergics.
Beta blockers may negate the beneficial effects of ritodrine.
Evaluation of Medication Effectiveness
Decreased intensity and frequency of premature uterine
contractions. Discontinue ritodrine as soon as labor is irreversible to
allow for metabolic recovery before delivery.
ACTIVE LEARNING TEMPLATES
Nursing Interventions
Assess uterine activity frequently throughout
therapy. Assess gestational age and fetal
maturity to determine premature labor.
Monitor maternal BP and pulse and fetal
heart rate frequently throughout
administration. Monitor intake and output
ratios for significant discrepancies in totals.
Assess patient frequently during IV infusion
for signs and symptoms of pulmonary
edema
Client Education
Instruct patient to notify health care
professional immediately if
contractions begin again or if water
breaks.
Therapeutic Procedure
A7