Oxytocin - enhancing agent contractile activity and tone of the myometrium.
The composition of the drug and the release form
Oxytocin is produced in the form of a colorless transparent solution for intravenous and intramuscular administration. In 1 ml contains 5 IU of oxytocin and auxiliary components: water for injection, 96% ethanol, chlorobutanol hemihydrate, acetic acid glacial. The glass ampoules, 5 pieces per pack.
Oxytocin is a synthetic hormone drug that interacts with receptors oksitotsinospetsificheskimi uterine myometrium. As the pregnancy progresses the body's reaction to the action of oxytocin increases and reaches its maximum to its end.
The drug stimulates the generic activities by increasing the permeability of cell membranes for calcium and increase its concentration inside the cells, which causes an increase in membrane excitability. The action of oxytocin temporarily impairs blood flow to the uterus, resulting in fights like a normal spontaneous delivery. Also causes contraction of the myoepithelial cells in the alveoli of the mammary gland and stimulates the production of breast milk.
According to the instructions indicated for Oxytocin induction of labor and induction of labor in such cases:
- when prolonged pregnancy (over 42 weeks);
- late in pregnancy when the urgent need to delivery due to preeclampsia;
- in primary or secondary weakness of labor in the first and second stage of labor;
- when Rh-conflict;
- when fetal death;
- if premature rupture of membranes or by discharge of amniotic fluid;
- in intrauterine growth retardation.
Oxytocin is also used according to instructions for the treatment and prevention of hypotonic bleeding after abortion or childbirth, cesarean section.
As adjunctive therapy Oxytocin is used in the failed or incomplete abortion.
How to use oxytocin and dosing regimen
According to the instructions Oxytocin is administered intravenously or intramuscularly.
Intravenous Oxytocin is used to stimulate labor and strengthen contractions, for induction. The dosage is adjusted individually by the attending physician. Standard single dose of 5 mU oxytocin. During the administration of the drug is necessary to monitor the fetal heart rate, uterine tone at rest, its strength and duration of contractions. In the case of symptoms of hyperactivity or uterine fetal distress should immediately stop the introduction of the drug and to give the patient oxygen therapy.
For the treatment and prevention of bleeding hypotonic postpartum oxytocin dosage instructions are as follows:
- 5 IU / ml when administered intramuscularly. The drug is administered after the separation of the placenta;
- when administered intravenously: 10-40 IU of oxytocin was dissolved in 1000 ml negidratiruyuschey liquid; for the prevention of uterine atony dosage is 20-40 mU / min.
Incomplete or the failed abortion drug is administered intravenously. For this purpose 10 IU / ml of the preparation was added to 500 ml of 5% glucose saline or simply in saline.
Contraindications to the use of Oxytocin
Oxytocin is contraindicated in under the instruction:
- contraindications for vaginal delivery (narrow pelvis, partial or complete placenta previa, prolapse of the umbilical cord or placenta previa);
- oblique or transverse fetal position that prevents an independent childbirth;
- emergency situations requiring surgical intervention;
- hypertonicity of the uterus, does not arise in the course of delivery;
- state of distress long before the terminal stages of pregnancy;
- severe preeclampsia (kidney function, high blood pressure);
- long-term use in the inertia of the uterus;
- personal fetal presentation;
- impaired renal function;
- squeezing fruit;
- heart disease;
- excessive stretching of the uterus;
- Hypersensitivity to oxytocin.
Oxytocin Review childbirth can cause the following side effects:
- Cardiovascular system: when given too rapidly can cause subarachnoid hemorrhage, bradycardia. At excessive doses of oxytocin on responses can cause severe hypertension, hypotension, arrythmia, shock, reflex tachycardia.
- Reproductive system: tetany, cramps, hypertension, uterine rupture of the uterus. In the postpartum period Oxytocin Review can cause increased bleeding due gipoprotrombinemii, afibronogenemii and thrombocytopenia caused by the action of oxytocin.
- Digestive System: dyspepsia.
- Immune system: Allergic reactions, anaphylaxis. Too rapid introduction of possible bronchospasm. Very rarely - death.
- Water and electrolyte metabolism: Prolonged intravenous injection, severe overhydration, sometimes accompanied by convulsions and coma.
In the opinion of Oxytocin in the fetus or newborn causes such side effects:
- due to the action of oxytocin: low Apgar score at the first and fifth minute, hyperbilirubinemia;
- the rapid introduction may be bleeding in the retina of the eye, lowering fibrinogen level in the blood;
- due to uterine activity: tachycardia, arrhythmia, sinus bradycardia, ventricular ekstrasistologiya, changes in the central nervous system, fetal death as a result of asphyxiation.
Oxytocin during pregnancy and lactation
In the first trimester of oxytocin can only be used in induced or spontaneous abortion. In the opinion of Oxytocin when properly used no negative effects on fetal development.
Penetrates into breast milk, therefore, requires cessation of breastfeeding for the period of application.
The shelf life
Subject to the conditions Oxytocin is stored for three years.