Oxytocin
Trade names: Pitocin, Syntocinon
Class: Labor inducer " induce
uterine contractions ", oxytocic agent.
Pregnancy: (Category B)
Action:
It has
uterine stimulant, vasopressive & antidiuretic properties.
• Mimics uterine contractions of normal labor.
• Facilitates ejection of milk from the breasts by stimulating
smooth muscles.
Uses:
• Antepartum induction or stimulation of labor.
• Uterine inertia (hypotonic contractions).
• For induction of labor in case of preeclampsia, eclampsia
,maternal diabetes & other conditions.
• To hasten uterine involution .
• Intranasally
for postpartum hemorrhage & uterine atony.
Dose:
For
Prevention and treatment of hemorrhage
Prevention of
postpartum hemorrhage, after delivery of placenta, by slow intravenous
injection, 5 units (if infusion used for induction or enhancement of labor,
increase rate during third stage and for next few hours) Note:
May be given in a dose
of 10 units by intramuscular injection [unlicensed route] instead of oxytocin
with ergometrine
Treatment of postpartum hemorrhage, by slow
intravenous injection, 5–10 units, followed in severe cases by intravenous
infusion of 5–30 units in 500 mL infusion fluid at a rate sufficient to control
uterine atony.
Important
Avoid rapid intravenous injection
(may cause short-lasting drop in blood pressure).
Contraindications:
§ Hypersensitivity
§ cephalopelvic disproportion (C.P.D. )
§ Malpreresentation
§ undilated cervix
§ History of cesarean delivery.
Side effects:
Tetanic uterine contraction, rupture uterus
Hypertension , tachycardia.
To Fetus :- it may cause death, intracranial
hemorrhage, brady or tachycardia Nursing considerations:
1-
The physician should be
available during administration of the drug.
2-
Use Y-tubing for I.V.
administration (one bottle contain oxytocin & another free) .
3-
Note any history of
hypersensitivity & other contraindications.
4-
Check for cervical dilation
& uterine contractions patterns.
5-
Remain with the client
throughout the administration of medication.
6-
Monitor fetal heart rate at least every 10 minutes.
7-
Check vital signs every
15minutes.
Prevent
uterine rupture & fetal damage by clamping off I.V. oxytocin , start
medication – Free fluid , provide O2 & notify the physician in case of
hypertonic uterine contraction & abnormal fetal heart rate patterns.
