Complication of tocolytic agent is?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Pharmacology

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Explanation

Tocolytic agents, particularly beta-adrenergic agonists like terbutaline and ritodrine, are used to suppress premature labor by relaxing uterine smooth muscle.
A major and serious complication of these agents is pulmonary oedema (fluid accumulation in the lungs).
This occurs due to cardiovascular effects such as tachycardia and increased cardiac output, combined with drug-induced fluid retention and increased capillary permeability.
The risk is significantly elevated in patients receiving high volumes of intravenous fluids, those with multiple gestations, or those concurrently receiving corticosteroids for fetal lung maturation.

Option A: Uterine rupture is associated with excessive uterine contractions, which is the opposite effect of tocolytic agents.
Option B: Hyperstimulation of the uterus (tachysystole) is caused by agents that stimulate uterine contractions, not those that relax it.
Option C: Increased peristaltic movement is not a known side effect of tocolytic agents.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Tocolytic Agents as background academic context rather than a clinical decision trigger.
Nurses must closely monitor patients receiving tocolytic therapy for early signs of pulmonary oedema, including shortness of breath, coughing, tachypnea, crackles on lung auscultation, and decreasing oxygen saturation.
Strict monitoring of fluid intake and output is a critical nursing intervention to prevent fluid overload, which exacerbates the risk of pulmonary oedema.
What if? If the patient were receiving magnesium sulfate instead of a beta-agonist, the primary nursing concern would shift from pulmonary oedema to magnesium toxicity. The nurse would need to monitor for loss of deep tendon reflexes, respiratory depression, and changes in level of consciousness.

How to Approach the Question

First, identify the core concept of the question, which is the complications associated with 'tocolytic agents'.
Recall the primary function of tocolytics: they are medications used to suppress premature labor by relaxing the uterus.
Evaluate the given options in the context of uterine relaxation. Options A (uterine rupture) and B (hyperstimulation of uterus) are related to excessive uterine contraction, which is the opposite effect of tocolytics. These are caused by uterotonics (e.g., oxytocin). Therefore, eliminate A and B.
Consider the remaining options, C and D. Evaluate the known side effect profiles of common tocolytic drug classes.
Recall that beta-agonist tocolytics (like terbutaline) have significant cardiovascular effects, including tachycardia and fluid retention. This combination is a well-known cause of pulmonary oedema.
Option C (increased peristaltic movement) is not a characteristic side effect of any major tocolytic agent.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 6-8

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