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Tocolytics are used in preterm labor, which refers to when a baby is born too early before 37 weeks of pregnancy. As preterm birth represents one of the leading causes of neonatal morbidity and mortality, the goal is to prevent neonatal morbidity and mortality through delaying delivery and increasing gestational age by gaining more time for other management strategies like corticosteroids ...
In a 2010 meta-analysis, [10] nifedipine is superior to β 2 adrenergic receptor agonists and magnesium sulfate for tocolysis in women with preterm labor (20–36 weeks), but it has been assigned to pregnancy category C by the U.S. Food and Drug Administration, so is not recommended before 20 weeks, or in the first trimester. [9]
Isoxsuprine is used in humans for treatment of premature labor, i.e. a tocolytic, [6] and as a vasodilator for the treatment of cerebral vascular insufficiency, Raynaud's phenomenon, and other conditions. [7] Isoxsuprine may increase the heart rate, cause changes in blood pressure, and irritate the GI tract.
The use of tobacco, cocaine, and excessive alcohol during pregnancy increases the chance of preterm delivery. Tobacco is the most commonly used drug during pregnancy and contributes significantly to low birth weight delivery. [62] Babies with birth defects are at higher risk of being born preterm. [63]
Terbutaline, sold under the brand names Bricanyl and Marex among others, is a β 2 adrenergic receptor agonist, used as a "reliever" inhaler in the management of asthma symptoms and as a tocolytic (anti-contraction medication) to delay preterm labor for up to 48 hours.
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The tocolytic agent atosiban (Tractocile) acts as an antagonist of oxytocin receptors. It is registered in many countries for use in suppressing premature labor between 24 and 33 weeks of gestation. It has fewer side effects than drugs previously used for this purpose (such as ritodrine, salbutamol and terbutaline). [11]
Ritodrine, sold under the brand name Yutopar, is a tocolytic drug used to stop premature labor. [2] [3] This drug has been removed from the US market, according to FDA Orange Book. It was available in oral tablets or as an injection and was typically used as the hydrochloride salt. The drug acts as a selective β 2-adrenergic receptor agonist. [4]