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Uterine relaxants (tocolytics)
1. Uterine Relaxants (Tocolytics)
For BNS Ist Year
Dr. Pravin Prasad
Ist Year Resident, MD Clinical Pharmacology
Maharajgunj Medical Campus
2nd October, 2015(Asoj 15, 2072); Friday
3. Ritoridine
• Mechanism of action:
– β2 selective agonist
• Use:
— Supress premature labour
— Delay delivery
— Treatment beyond 48 hrs not
recommended
• Side Effects:
‒ CVS – hypotension, tachycardia,
arrhythmia, pulmonary edema
‒ Metabolic – hyperglycaemia,
hyperinsulinemia, hypokalemia
‒ Anexity, restlessness, headache
‒ Neonate – foetal pulmonary
edema, hypoglycaemia, ileus
• Contraindication:
– Mother having diabetes or heart
disease, or receiving β blockers or
steroids
4. Nifedipine
• Mechanism of Action:
• Reduces the tone of myometrium and opposes contraction
• Prominent smooth muscle relaxant action
• Side Effects:
• Maternal - Tachycardia, Hypotension
• Foetal – Foetal Hypoxia due to placental perfusion
5. Other Tocolytics
• Atosiban
• Mechanism of Action: Antagonist at the oxytocin receptors
• Availability in Nepal (??)
• Magnesium sulfate
• Mechanism of Action: Acts as tocolytics by competiting with Ca++ ions for
entry into myocardium through both voltage gated and ligand gated Ca++
channels
• Higher risk to be used as tocolytics – increases perinatal mortality
• Not recommended
• Halothane
• Used as relaxant when external or internal version is attempted