Details About Generic Salt ::  Ritodrin

Main Medicine Class:: Uterine relaxant   

(RIH-toe-dreen HIGH-droe-KLOR-ide)
Ritodrine HCl, Ritodrine HCl in 5% Dextrose, Yutopar,  Yutopar
Class: Uterine relaxant

 

Drugs Class ::

 Action Inhibits contractility of uterine smooth muscle through beta-adrenergic receptor stimulation.

Indications for Drugs ::

 Indications Management of preterm labor in suitable patients.

Drug Dose ::

 Route/Dosage

ADULTS: IV 0.05 mg/min initially, increasing by 0.05 mg/min q 10 min until desired result is obtained. The usual effective dose is between 0.15 to 0.35 mg/min, continued for at least 12 hr after uterine contractions cease.

Contraindication ::

 Contraindications Before 20th wk of pregnancy and when continuation of pregnancy is hazardous to mother or fetus; hypersensitivity; pre-existing maternal conditions that would be seriously affected by pharmacologic properties of betamimetic agent.

Drug Precautions ::

 Precautions

Pregnancy: Contraindicated before 20th wk of pregnancy; otherwise, Category B. Lactation: Undetermined. Cardiovascular responses: Are common and more pronounced with IV administration. Maternal pulmonary edema: Has been reported. Closely monitor and avoid fluid overload. Mild to moderate preeclampsia, hypertension or diabetes: Do not use in these patients unless benefits clearly outweigh risks. Advanced labor: Safety and efficacy in advanced labor (cervical dilation > 4 cm or effacement > 80%) are not established. Sulfite sensitivity: May cause allergic-type reaction in susceptible patients.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Palpitations; chest pain or tightness; heart murmur; angina pectoris; myocardial ischemia; alterations in BP; pulmonary edema; sinus bradycardia upon drug withdrawal; arrhythmias; drowsiness; weakness; mild tachycardia. CNS: Tremor, headache (including migraines); nervousness; jitteriness; restlessness; emotional upset; anxiety; malaise; hyperventilation. DERM: Erythema; rash GI: Nausea; constipation; diarrhea; vomiting; epigastric distress; ileus; bloating. HEMA: Leukopenia; agranulocytosis. HEPA: Hemolytic icterus; impaired liver function. META: Lactic acidosis; glycosuria. RESP: Dyspnea. OTHER: Sweating; chills; hypokalemia; hyperglycemia.

Drug Mode of Action ::  

 Action Inhibits contractility of uterine smooth muscle through beta-adrenergic receptor stimulation.

Drug Interactions ::

 Interactions

Atropine: Systemic hypertension may be exaggerated. Beta-adrenergic blockers: Effects are antagonistic; avoid coadministration. Corticosteroids: Concomitant use may lead to pulmonary edema. Magnesium sulfate; diazoxide; meperidine; general anesthetics: Cardiovascular effects of ritodrine may be potentiated. Sympathomimetics: Effects may be additive or potentiated.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Monitor maternal HR, BP, lung sounds and fetal HR frequently during IV administration.
  • Evaluate strength and frequency of contractions at regular intervals.
  • Notify physician if patient develops persistent tachycardia or tachypnea or increased systolic BP with widening pulse pressure.
  • Discontinue drug, notify physician and obtain ECG if chest pain or tightness develops.
  • Assess baseline serum glucose (in patients with diabetes) and electrolytes and monitor at regular intervals with IV administration.
  • Assess baseline ECG prior to starting drug.
  • Notify physician if palpitations, tremor, nausea, vomiting, headache, erythema, nervousness, restlessness, anxiety or malaise develops.
  • Monitor I&O for possible fluid overload.
  • Assess neonate for ileus and hypotension.
  • Monitor glucose and electrolytes of neonate.
OVERDOSAGE: SIGNS & SYMPTOMS
  Symptoms relate to excessive betaadrenergic stimulation and include tachycardia, palpitations, cardiac arrhythmias, hypotension, dyspnea, nervousness, tremor, nausea, vomiting

Drug Storage/Management ::

 Administration/Storage

  • 150 mg in 500 ml fluid yields a final concentration of 0.3 mg/ml. When fluid restriction is desirable, may prepare a more concentrated solution. Dilute with 5% Dextrose. Because of increased probability of pulmonary edema, reserve saline diluents for cases where D5W is undesirable.
  • Do not use if solution is discolored or contains any precipitate.
  • Administer IV infusion with patient in left lateral position to minimize risk of hypotension.
  • Use controlled infusion device to deliver medication.
  • Use diluted drug within 48 hr. Store at room temperature and avoid excessive heat.
  • Store at room temperature, protected from excessive heat.

Drug Notes ::

 Patient/Family Education

  • Tell patient to report palpitations, chest pain or tightness, tremor, headache, nervousness, emotional upset, anxiety, malaise, hyperventilation, nausea, vomiting, epigastric distress, bloating, chills or sweating.

Disclaimer ::

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