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Carboprost Tromethamine
Carboprost Tromethamine is a synthetic prostaglandin analogue used to induce labor, control postpartum hemorrhage, and terminate pregnancies. It is primarily used in obstetric emergencies to manage severe bleeding after childbirth when other treatments have failed. Carboprost Tromethamine works by stimulating uterine contractions, helping to expel the contents of the uterus or control uterine bleeding.
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Frequently Asked Questions
How quickly does Carboprost Tromethamine work?
Carboprost Tromethamine begins to work within minutes after injection. It is used in emergencies to induce strong uterine contractions and control severe bleeding or induce pregnancy termination.
Can Carboprost Tromethamine be used in asthma patients?
No, Carboprost Tromethamine is contraindicated in patients with asthma due to the risk of bronchospasm, which can worsen breathing difficulties. Other options should be considered for asthma patients.
What should I expect after receiving Carboprost Tromethamine?
After receiving Carboprost, patients may experience strong uterine contractions, which can cause cramping and discomfort. Gastrointestinal side effects like nausea, vomiting, and diarrhea are also common. Patients will be closely monitored for side effects and the effectiveness of the treatment.
Can Carboprost Tromethamine be used for labor induction?
Carboprost is not typically used for labor induction in uncomplicated pregnancies. It is primarily reserved for controlling postpartum hemorrhage or for pregnancy termination in specific medical circumstances.
How many doses of Carboprost Tromethamine can be given?
For postpartum hemorrhage, the typical dosing is 250 mcg every 15-90 minutes as needed, with a maximum total dose of 2 mg (approximately 8 doses).
Comprehensive Drug Guide
How Does Carboprost Tromethamine Work?
Carboprost works by mimicking the effects of prostaglandin F2α, a naturally occurring compound that induces strong uterine contractions. These contractions help expel the contents of the uterus in cases of pregnancy termination or manage uterine atony (lack of muscle tone) to stop excessive bleeding after childbirth.
What is Carboprost Tromethamine Used For?
Termination of Pregnancy: Used to induce abortion between 13 and 20 weeks of pregnancy when other methods are not successful.
Postpartum Hemorrhage: Used to control bleeding after childbirth when other medications (such as oxytocin) are ineffective.
Common Dosages
Carboprost Tromethamine is available by prescription only and is not classified as a controlled substance. It is typically administered as an intramuscular injection in a hospital setting for emergency obstetric situations.
Administration: Carboprost is injected into a large muscle, typically the upper arm or thigh, under the supervision of a healthcare provider in a hospital setting. The dosing is carefully monitored to prevent side effects, and treatment is stopped as soon as uterine bleeding is controlled or the pregnancy is terminated.
Duration: The treatment is typically short-term and given only until the desired result (bleeding control or pregnancy termination) is achieved.
Typical Dosing
FDA Approved Indications
Carboprost Tromethamine is administered via intramuscular injection. Typical doses include:
- For Postpartum Hemorrhage: 250 mcg (1 mL) every 15 to 90 minutes as needed, with a maximum total dose of 2 mg.
- For Pregnancy Termination: The same dose of 250 mcg is given, and additional doses may be given every 1.5 to 3.5 hours depending on the patient's response.
Who Shouldn't Take Carboprost Tromethamine?
Carboprost Tromethamine is contraindicated in patients with:
- Hypersensitivity to carboprost or other prostaglandins.
- Acute pelvic inflammatory disease.
- Active heart, lung, kidney, or liver disease.
- A history of asthma, due to the risk of bronchospasm.
- Glaucoma or increased intraocular pressure.
Advice From The Pharmacist
Patients receiving Carboprost Tromethamine should be advised to:
- Be aware that the medication will be administered in a hospital or clinical setting under close monitoring by a healthcare provider.
- Report any difficulty breathing, chest pain, or abnormal side effects to the healthcare team immediately.
- Understand that common side effects may include gastrointestinal distress (nausea, vomiting, diarrhea) and fever, but serious reactions should be reported promptly.
Side Effects of Carboprost Tromethamine
Common Side Effects
- Nausea and vomiting
- Diarrhea
- Chills or fever
- Flushing or sweating
- Abdominal pain or cramping
Uncommon/Severe Side Effects
- Bronchospasm: Particularly in patients with asthma.
- Severe Hypertension: Elevated blood pressure.
- Cardiac Arrhythmias: Irregular heartbeats.
- Pulmonary Edema: Fluid buildup in the lungs, leading to shortness of breath.
Risks and Warnings of Carboprost Tromethamine
Asthma: Carboprost can cause bronchoconstriction and should not be used in patients with a history of asthma due to the risk of bronchospasm.
Hypertension: The drug can cause a significant increase in blood pressure, and patients with hypertension should be monitored closely.
Gastrointestinal Side Effects: Severe nausea, vomiting, and diarrhea are common side effects, so patients should be monitored for dehydration and electrolyte imbalances.
Uterine Rupture: Prolonged or excessive uterine contractions may increase the risk of uterine rupture, particularly in women with previous uterine surgery.
Interactions with Carboprost Tromethamine
Common Drug Interactions
Carboprost Tromethamine may interact with other medications, including:
- Other Oxytocic Drugs: Such as oxytocin or methylergonovine, can increase the risk of excessive uterine contractions or rupture.
- Beta-blockers: May exacerbate the bronchoconstrictive effects of carboprost.
- NSAIDs: Use with caution, as both NSAIDs and carboprost affect prostaglandin pathways, which could increase gastrointestinal side effects.
Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.
Alternatives to Carboprost Tromethamine
Alternatives for managing postpartum hemorrhage and terminating pregnancies include:
- Oxytocin: Used to induce labor and manage postpartum hemorrhage by stimulating uterine contractions.
- Methylergonovine: Another uterotonic agent used to control postpartum hemorrhage.
- Misoprostol: A prostaglandin analog that can also be used to terminate pregnancies and control bleeding.
The choice of treatment depends on the clinical situation, the patient's medical history, and their response to initial therapies.
