Myocardial ischemia: A complication of r ritodrine tocolysis

Michalak, Daniel; Klein, Victor R.; Marquette, Gérald P.

doi:10.1016/0002-9378(83)91092-x

Cited by 27 publications

(3 citation statements)

References 2 publications

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“…These effects reversed with cessation of the agent and therapy with sublingual nitroglycerin. Similarly, Michalak, et al 13 report ECG documentation of myocardial ischemia during ritodrine infusion that reversed with discontinuation of the ritodrine. In Phase III and IV of this study the heart rate in terbutaline-treated animals was 30 and 50 beats per minute higher, respectively, than in hexaprenaline-treated animals, thus predisposing toward increased left ventricular work and oxygen requirements.…”

Section: Discussionmentioning

confidence: 92%

A Comparison of the Relative Toxicities of β-Sympathomimetic Tocolytic Agents

Hankins

Hauth

1985

Amer J Perinatol

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To define the relative toxicities of ritodrine sulfate, terbutaline sulfate, hexaprenaline sulfate, and ritodrine with betamethasone mongrel dogs were treated with these agents for 19 hours. The maximum dose of ritodrine was 900 microgram/min (N = 5), terbutaline 120 micrograms/min (N = 4) and hexaprenaline 1.5 micrograms/min (N = 4). Betamethasone was given intramuscularly (12 mg) at initiation of ritodrine and repeated in 12 hours in four animals. Arrhythmias were responsible for five deaths; 2/4 terbutaline, 2/4 ritodrine and beta-methasone, 1/5 ritodrine, 0/4 hexaprenaline treated animals. Terbutaline-treated animals developed arrhythmias during more treatment cycles (50%) and at lower drug concentrations, whereas hexaprenaline-treated animals developed arrhythmias at higher drug concentrations, with an overall arrhythmia frequency of 14%. Terbutaline animals had the highest heart rate (P = 0.02) and lowest mean arterial pressure (P = 0.18); the least effect on these parameters being seen with hexaprenaline. Cardiac index was higher with terbutaline and hexaprenaline compared to ritodrine with or without beta-methasone (P = 0.02). Hypoxemia was most severe with terbutaline (pO2 = 58 mm Hg) and least severe with hexaprenaline (pO2 = 66 mm Hg); however, this does not explain the difference in the frequency of arrhythmias since the mean pO2 during the initial arrhythmias was 76 mm Hg in terbutaline treated animals compared to a baseline control of 85 mm Hg. Although all animals developed significant acidosis during Phases II-IV, hexaprenaline treated animals were the least acidotic (P = 0.036). Hypokalemia was most pronounced with terbutaline (P = 0.08 Phase II, P = 0.07 Phase III).(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 92%

A Comparison of the Relative Toxicities of β-Sympathomimetic Tocolytic Agents

Hankins

Hauth

1985

Amer J Perinatol

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“…The effects of stimulation of the cardiac fibers are increased cardiac output and decreased arterial vascular resistance (which results in a widened pulse pressure), palpitations and flushing, and an antidiuretic effect 4,5 . These side effects are particularly significant because plasma, volume, cardiac output, heart rate, and water retention are already increased by the physiologic state of pregnancy 6 …”

Section: Ritodrine Hydrochloridementioning

confidence: 99%

Outpatient co-management of the patient receiving oral ritodrine therapy

Fullerton¹,

Barger²

1986

Journal of Nurse-Midwifery

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“…Continuous ECG monitoring in women receiving ritodrine revealed unsuspected severe tachycardia in excess of 130 beat.min-' with premature ventricular and supraventricular contractions; cardiac symptoms resulted in the drug having to be stopped in 10 of the 30 patients [3]. The increased myocardial oxygen demand can outstrip the supply, with resultant angina and ST segment changes in previously healthy women [4,5].…”

Section: Tocolysis Agonists and Anaesthesiamentioning

confidence: 99%

Untitled

1994

Anaesthesia

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Myocardial ischemia: A complication of r ritodrine tocolysis

Cited by 27 publications

References 2 publications

A Comparison of the Relative Toxicities of β-Sympathomimetic Tocolytic Agents

A Comparison of the Relative Toxicities of β-Sympathomimetic Tocolytic Agents

Outpatient co-management of the patient receiving oral ritodrine therapy

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