Related Experiment Video

Updated: Jul 5, 2026

Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
09:04

Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods

Published on: September 10, 2018

Developments in the pharmacotherapeutic management of spontaneous preterm labor

K Y Ronald Kam1, Ronald F Lamont

  • 1Imperial College London, Department of Obstetrics and Gynaecology, Northwick Park and St Mark's NHS Trust, Watford Road, Harrow, Middlesex HA1 3UJ, UK.

Expert Opinion on Pharmacotherapy
|April 22, 2008
PubMed

Insights

No single tocolytic drug is perfect for preventing preterm birth. While nifedipine and atosiban are preferred over older beta-agonists, atosiban shows superior evidence and safety compared to nifedipine.

Area of Science:

  • Perinatal medicine
  • Obstetrics
  • Pharmacology

Background:

  • Preterm birth is a leading cause of infant mortality and morbidity globally.
  • Significant healthcare costs are associated with preterm birth management.

Purpose of the Study:

  • To review the pathophysiology of preterm labor.
  • To evaluate the efficacy and safety of various tocolytic agents used to prevent or delay preterm birth.
  • To assess the role of antepartum glucocorticoids in preterm birth management.

Main Methods:

  • Extensive literature review using established scientific search engines.
  • Analysis of evidence regarding tocolytic drug efficacy.
  • Evaluation of fetomaternal safety profiles of different tocolytics.

Main Results:

  • Magnesium sulfate demonstrates limited evidence for tocolytic use.
  • Beta-agonist use is declining globally.
  • Nifedipine and atosiban are increasingly utilized as effective and safer alternatives.

Conclusions:

  • The ideal tocolytic agent remains elusive.
  • Atosiban offers superior evidence and safety compared to nifedipine, despite higher cost.
  • Ongoing safety concerns with nifedipine warrant careful consideration.
Abstract

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Intrauterine Drug Delivery Systems01:21

Intrauterine Drug Delivery Systems

Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
Preclinical Development: Overview01:28

Preclinical Development: Overview

Preclinical development consists of a series of tests that ensure the safety and efficacy of a new therapeutic compound before it is tested in humans. There are four main phases to this process. First, safety pharmacology tests are conducted to ensure the drug does not produce any acutely harmful effects. These tests examine parameters such as bronchoconstriction, cardiac dysrhythmias, blood pressure changes, and ataxia. Next, preliminary toxicological testing is performed to determine the...
Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is clinically...
Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions01:15

Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions

PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure (CHF).