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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 ...
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]
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]
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.
The FDA ordered the immediate withdrawal of Makena, a drug marketed as a treatment for preterm births, saying it had risks but no benefits for pregnant women.
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.
Retosiban also known as GSK-221,149-A [1] [2] is an oral drug which acts as an oxytocin receptor antagonist. It is being developed by GlaxoSmithKline for the treatment of preterm labour. [3] [4] Retosiban has high affinity for the oxytocin receptor (K i = 0.65 nM) and has greater than 1400-fold selectivity [5] over the related vasopressin receptors
Indometacin is an effective tocolytic agent, [21] able to delay premature labor by reducing uterine contractions through inhibition of prostaglandin synthesis in the uterus and possibly through calcium channel blockade. Indometacin readily crosses the placenta and can reduce fetal urine production to treat polyhydramnios.