Toradol for PTL?

babyktchr, BSN, RN · Oct 17, 2005

Can't imagine the use of toradol for the use of PTL. What properties does an NSAID have to stop contractions? Besides, use of NSAIDS in pregnancy after 28 weeks is contraindicated because it can cause issues with ductus if the baby is born. Would love to hear more about what you heard at the conference.

malibu03 · Oct 17, 2005

Yes, I have given it once for a 31 weeker. Supposedly it can be given until the 34th week, and I have to think about why it works, (brain is hurting)....something about prostaglandin inhibition.

JAHJF · Oct 17, 2005

Never seen toradol used but Indomethacin is an NSAID used b/c it inhibits protaglandin synthesis and can be given to premies to help close a PDA?

JaneyW · Oct 17, 2005

I have used indocin, but not toradol. I will ask the docs about why the NSAID is used. I don't work again until Friday, though.

midwife2b · Oct 17, 2005

We use short courses of Motrin (600 mg tid x 48 hr) up to 33 wks. of pregnancy. Since Toradol is in the same class it makes sense to me... NSAIDS can cause premature closure of the ductus arteriosus and are not used in pregnancy after about 34 weeks; this is why they can use the drugs on babies to close PDA after birth...

Jolie, BSN · Oct 17, 2005

Never seen toradol used but Indomethacin is an NSAID used b/c it inhibits protaglandin synthesis and can be given to premies to help close a PDA?

I took Indocin during both of my pregnancies for treatment of resistant PTL. For me, it was used in addition to terbutaline, in an effort to avoid MgSO4 therapy. Hard to tell whether or not it was effective, as it caused a significant reduction in amniotic fluid volume, and had to be discontinued. Prostaglandins are believed to play a role in the onset of labor, so inhibiting prostaglandin production is the goal of Indocin. I suspect that Toradol must work in a similar manner.

Yes, Indocin is used in the treatment of infants with PDAs. Prostaglandins in the infant keep the ductus open, so inhibiting prostaglandins in these babies is an effective way of bringing about its closure.

To avoid risk of premature closure of the ductus in utero, Indocin is not used to treat PTL past a certain point in gestation (somewhere around 31-34 weeks).

Gompers, BSN, RN · Oct 17, 2005

We use short courses of Motrin (600 mg tid x 48 hr) up to 33 wks. of pregnancy. Since Toradol is in the same class it makes sense to me... NSAIDS can cause premature closure of the ductus arteriosus and are not used in pregnancy after about 34 weeks; this is why they can use the drugs on babies to close PDA after birth...

Very interesting! As a NICU nurse, I just know about Indocin from OUR side of the situation. They are also using IV Motrin now, to close PDAs. I wish we did, as we've had problems with Indocin in the past - only seems to work 50% of the time, also seems to cause a fair amount of spontaneous bowel perforations. :uhoh21:

SmilingBluEyes · Oct 18, 2005

I can see the use----Indocin has been used for eons for PTL. Same idea. I agree w/those concerned about fetal effects in using NSAIDS in pregnancy after 33 weeks'. Our dr's tend to combine terb and Motrin 600mg PO for irritibly-contracting uteri. However, the situation must be judiciously managed, and if active labor is indeed inevitible, then MgSo4 and steriods therapy (prior to 34-35 weeks) really is your only alternative ------ if Terb is not doing the trick.

acuteobrn · Oct 24, 2005

very interesting use of Torodol.

I would be interested to know which conference you went to and their references.