Ritodrine HCl

A to Z Drug Facts

Ritodrine HCl

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(RIH-toe-dreen HIGH-droe-KLOR-ide)

Ritodrine HCl, Ritodrine HCl in 5% Dextrose, Yutopar, Yutopar

Class: Uterine relaxant

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

Indications Management of preterm labor in suitable patients.

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.

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.

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.

Lab Test Interferences None well documented.

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.

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

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.

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

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.