Drug Guide
Carboprost Tromethamine
Classification
Therapeutic: Obstetric agent, Uterotonic
Pharmacological: Prostaglandin F2α analogue
FDA Approved Indications
- Postpartum hemorrhage due to uterine atony or incomplete abortion
Mechanism of Action
Carboprost Tromethamine acts as a prostaglandin F2α analogue, inducing uterine contractions by binding to specific prostaglandin receptors on uterine smooth muscle, thereby promoting uterine involution and reducing bleeding.
Dosage and Administration
Adult: 250 mcg intramyometrially or intramyometrially every 15-90 minutes as needed, not to exceed 2 mg in 24 hours
Pediatric: Not typically used in pediatric patients
Geriatric: No specific dosage adjustments established, use with caution due to increased risk of adverse effects
Renal Impairment: Use caution; no specific dose adjustment available
Hepatic Impairment: Use caution; no specific dose adjustment available
Pharmacokinetics
Absorption: Rapidly absorbed at site of injection
Distribution: Widely distributed after administration
Metabolism: Metabolized locally at the site of action
Excretion: Metabolized by prostaglandin pathways; no specific data on excretion
Half Life: Approximately 30 minutes to 1 hour
Contraindications
- Known hypersensitivity to prostaglandins or components
- History of asthma or active pulmonary disease
Precautions
- Use with caution in patients with renal or hepatic impairment, cardiovascular disease, or in cases of anemia; monitor for adverse reactions
Adverse Reactions - Common
- Nausea (Frequent)
- Vomiting (Frequent)
- Diarrhea (Less common)
- Transient fever (Less common)
Adverse Reactions - Serious
- Severe bronchospasm or asthma exacerbation (Rare)
- Hypotension or hypertension (Rare)
- Uterine rupture or hyperstimulation (Rare)
Drug-Drug Interactions
- Other uterotonics (may increase risk of hyperstimulation)
Drug-Food Interactions
- No significant food interactions
Drug-Herb Interactions
- Limited data; use with caution
Nursing Implications
Assessment: Monitor uterine tone, bleeding, vital signs, and allergic reactions
Diagnoses:
- Risk for uterine hyperstimulation, postpartum hemorrhage
Implementation: Administer as prescribed, observe for adverse reactions, and prepare resuscitation equipment in case of severe hypersensitivity or adverse reactions
Evaluation: Assess effectiveness in controlling hemorrhage and monitor for adverse effects
Patient/Family Teaching
- Report any severe pain, difficulty breathing, chest pain, or allergic reactions immediately
- Inform about the purpose of the drug and possible side effects
Special Considerations
Black Box Warnings:
- Use with caution due to risk of severe bronchospasm and hypersensitivity reactions
Genetic Factors: None established
Lab Test Interference: None established
Overdose Management
Signs/Symptoms: Severe bronchospasm, hypotension, signs of hypersensitivity
Treatment: Discontinue drug, administer supportive care, and provide respiratory support if needed
Storage and Handling
Storage: Store at controlled room temperature, 20°C to 25°C (68°F to 77°F) in a dry place
Stability: Stable when stored appropriately, check expiration date prior to use