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There is no clear first-line tocolytic agent. [6] [7] Current evidence suggests that first line treatment with β 2 agonists, calcium channel blockers, or NSAIDs to prolong pregnancy for up to 48 hours is the best course of action to allow time for glucocorticoid administration.
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Hexoprenaline is a selective β 2 adrenergic receptor agonist used in the treatment of asthma. [2] Hexoprenaline is also used in some countries (such as Russia and Switzerland) as a tocolytic agent (i.e., labor suppressant), with the most common trade name being Gynipral.
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.
Magnesium sulfate was once used as a tocolytic, [27] [28] but meta-analyses have failed to support it as an anti-contraction medication. [29] [30] Usage for prolonged periods (more than five to seven days) may result in health problems for the baby. [31]
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In Canadian and German guidelines, carbetocin is recommended as a first-line therapy treatment for post-partum hemorrhaging with notable efficacy when used with cesarean section deliveries. [10] Carbetocin has been shown to be more effective than oxytocin in preventing postpartum hemorrhaging as well.
Furosemide is primarily used for the treatment of edema, but also in some cases of hypertension (where there is also kidney or heart impairment). [14] It is often viewed as a first-line agent in most people with edema caused by congestive heart failure because of its anti-vasoconstrictor and diuretic effects.