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Carboprost Tromethamine (Hemabate)

Anesthesia Implications
Classification:
Prostaglandin with oxytoic properties, Uterotonic
Therapeutic Effects:
Vasoconstriction and uterine contraction
Primary Considerations:

Big concern about this drug is it can cause bronchoconstriction and hypertension. If this drug is used - its because the surgeon has requested it. Used to treat uterine atony ("boggy uterus") after delivery of the placenta. The primary use is to slow postpartum bleeding/hemorrhage. Hemabate is typically used if Oxytocin was unsuccessful at slowing blood loss. Side effects also include tachypnea, vomiting, diarrhea, or increase in body temperature.

Contraindications:

Hx of preeclampsia, asthma, hypo/hypertension, anemia, diabetes, epilepsy

IV infusion dose:

NEVER. If requested, give slowly (>1min) and watch for hypertension and tachycardia.

IM dose:

250 mcg every 15 minutes. Max: 2mg (8 doses). This may also be injected directly into the uterus.

Reference

Barash. Clinical anesthesia. 7th edition. 2013.
Chestnut. Chestnut’s obstetric anesthesia principles and practice. 5th edition. 2014.
Nagelhout. Nurse anesthesia. 5th edition. 2014.
NICE British National Formulary