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Women during pregnancy, absolutely should not buy drugs for treatment, especially those in the group of antibiotics, the group that acts on the nervous system, antispasmodic drugs, .... Because of these types of drugs. This drug can easily cause fetal changes or cause uterine contractions that seriously affect the fetus.
1. Some antispasmodic drugs
1.1 Nifedipine Drugs Nifedipine: As first choice drugs to reduce uterine contractions. If it does not fall into one of the contraindications.
Contraindications of the drug:
People with cardiovascular disease, including heart failure, left ventricular dysfunction People with low blood pressure (< 90/50 mmHg) Women with antenatal bleeding, preeclampsia, infections Amniotic fluid and fetal distress Do not use concurrently with Betamimetics such as Salbutamol Dosage :
Initial dose: Take 20mg Nifedipine orally (do not use delayed release). After 30 minutes, if uterine contractions continue, give an additional 20mg oral dose. After the next 30 minutes, if contractions still continue, give the woman another 20mg oral dose. In case of stable blood pressure, the dose can be maintained at 20mg 3 times/day for 48-72 hours. Note: The maximum dose is 120mg / day
Nifedipine has a strong onset of action within 30-60 minutes after taking it. If medication fails, other tocolytic agents (second choice) should be administered only 2 hours after the last dose of nifedipine.
1.2 Salbutamol Drug Salbutamol is considered the 2nd choice, in case it does not fall into the case of contraindications. Nifedipine should not be used concurrently, because these two drugs interact. Thyroid Dosage:
In case of reduction of uterine contractions: Use 5mg (5ml tube of Ventolin for infusion in obstetrics). To achieve a solution concentration of 50 mcg/ml should be diluted with solvent to 100 ml
When administering Salbutamol intravenously, an electric syringe should be used. For intravenous infusion, Salbutamol is recommended at an initial infusion rate of 12ml/hour (10mcg/min). Every 30 minutes, increase to 4ml/hr (3.3 mcg/min) until the following signs appear:
Stop uterine contractions Heart rate reaches 120 beats/min Maximum infusion rate is 36ml/ hour (30 mcg/min)
1.3 Glyceryl Trinitrate (GTN) GTN is an organic nitrate. When entering the body, it is converted into nitric oxide (NO), which helps the uterus "quiet" during pregnancy. To date, there is not enough medical evidence to support the use of GTN in threatened preterm birth. This drug has a strong effect within 1-2 hours after the intervention. When using the patch, release the medication at a steady 24 hour period.
Dosage:
Use a patch containing 5-10 mg. Repeat dose 1 hour later, if uterine contractions persist. Note that the maximum dose is 20mg in 24 hours).
1.4 Indometacin Drugs Indometacin drugs inhibit Prostaglandin synthesis. This drug may be considered for short-term use to reduce contractures in the event of contraindications or failure of other agents. Theoretically, the risk of fetal pulmonary hypertension and decreased renal function with short-term use is still controversial, while long-term use is clear.
Dosage: Initial dose: 100mg rectally. Then take 25 mg every 4 hours for 48 hours. If uterine contractions continue, within 1-2 hours after the initial ostomy dose, an additional 100 mg rectal dose may be added prior to oral administration.
2. Side effects of antispasmodic drugs
2.1 Nifedipine Drugs Precautions :
Caution when acting "synergistically" with Magnesium Sulphate (MgSO4). This case is not an absolute contraindication, but it should be carefully monitored, especially since blood pressure begins to decrease. It is necessary to monitor the mother's electrolyte balance, urea, creatinine and liver function Every 30 minutes check pulse, blood pressure and respiratory function until uterine contractions cease. In case of maternal hypotension, intravenous intervention is the first choice Continue to monitor fetal heart rate until uterine contractions have subsided Monitor cardiopulmonary function every 8 hours for 24 hours First-line therapy Adverse effects: Hot flushing, heart palpitations, dizziness, hypotension, headache, nausea, unusual occurrence in people with normal blood pressure, heart failure, increased liver enzymes.
2.2 Salbutamol Drugs Precautions:
Before infusion, it is necessary to check the balance of electrolytes, urea and creatinine, repeat necessary if there is any abnormality. Repeat every 4 hours if abnormal Monitor cardiopulmonary function every 8 hours To avoid overload, do not administer further IV After 30 minutes check pulse, blood pressure and respiratory function until established maintenance dose If maternal pulse is > 120 beats/min, reduce infusion Stop infusion and seek immediate intervention if chest pain, dyspnea or respiratory rate > 30/min.
Monitor fetal heart rate once every 30 minutes Salbutamol therapy should not be prolonged for more than 48 hours. In some special cases, is continued for more than 24 hours as prescribed by the doctor. Undesirable effects: Some side effects may occur such as: tachycardia, low blood pressure, tremor (especially hand tremor), pulmonary edema, hyperglycemia and hypokalemia. Therefore, special monitoring is required when taking the drug.
2.3 Glyceryl Trinitrate drug Precautions for use:
Before taking the drug, it is necessary to check the electrolyte, glucose, urea and creatinine parameters of the pregnant woman. Monitor cardiopulmonary function every 8 hours After 30 minutes check pulse, blood pressure and respiratory function until maintenance dose has been established Continue fetal heart rate monitoring until uterine contractions have subsided Undesirable effects: Headache, hot flushes, low blood pressure, heart palpitations.
2.4 Indomethacin Drugs Precautions for use: This drug is not used for stomach ulcers.
Undesirable effects:
Long-term use of Indomethacin, especially in pregnant women, can lead to narrowing or blockage of the fetal ductus arteriosus. In addition, it also reduces kidney function in the fetus. Above is reference information about the side effects of antispasmodic drugs. Women should consult and before planning to take any medicine during pregnancy, you should consult your doctor for the best indications.
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